Polycystic Ovarian Syndrome (PCOS) – It's not a Life Sentence.

Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder affecting women in their reproductive years. Causing a wide range of clinical symptoms, it is currently the leading cause of infertility in women.

The name of the syndrome is actually an anomaly as it may occur in women without ovarian cysts. Symptoms range from obesity, hirsutism (male pattern hair growth) alopecia (Hair loss), acne, virilisation (male characteristics), amenorrhea (Loss of period), high cholesterol levels, hypertension, insulin resistance, exhaustion, decreased libido, obstructive sleep apnea syndrome and the appearance of acanthosis nigricans (black to brown, poorly defined, velvety hyperpigmentation of the skin).

There may also be a psychological component to PCOS for certain women who experience depression and/or anxiety. This may be hormonally related, or due to self esteem issues related to the expression of PCOS symptoms.

Twenty percent of women have a build up of ovarian follicles on ultrasound screening, however only 7-8 % of these women are diagnosed with PCOS. When any anovulatory state exists for a period of time, the ovaries tend to become polycystic, as findings have shown that 70- 80 % of women who not ovulate regularly suffer from PCOS (Tricky, 2003, pg.333).

According to the NIH criteria, to be diagnosed with PCOS, ‘a woman has to present with chronic oligoanovulation and either biochemical or clinical signs of androgen excess’ (DiMarcantonio, 2008). Ultrasound technology is also used for confirmation of the presence of the syndrome. According to Allahbadia & Agrawal, the ultrasound morphological features to diagnose polycystic ovaries requires the presence of twelve or more follicles in each ovary, each measuring 2-9mm in diameter, and/or increased ovarian volume, above 10 ml (2007, pg.16).

The disturbances that occur in the normal process in ovulation are the cause of the build up of ovarian cysts, which are actually multiple follicles in the ovaries. These follicles grow to half or less the normal size. In a normal cycle, one follicle would continue to grow and release an egg, however in PCOS the follicle stalls halfway.

Endocrinologic studies reveal an array of underlying abnormalities leading to the cause of PCOS including insulin resistance, often secondary to obesity, in association with a build up, or overactivity of hormonal androgens, causing erratic ovulation.

Conventional doctors may prescribe Clomiphene tablets to aid in ovulation for fertility issues.  Clomiphene tablets maybe combined with steroid tablets to suppress androgen production. However this does not address the underlying issue. Suppression is not a long term answer, nor is it helping your body.

Let’s look at how PCOS develops in the body, and how to naturally and indefinitely reverse the syndrome.

1. Women who are obese may be predisposed to PCOS.  Fatty tissue produces oestrogen and stores oestrogen, leading to hormonal imbalances that effect the development and ripening of immature follicles within the ovary. Fatty tissue also secretes excess androgens leading to many of the masculising signs and symptoms of PCOS.  Thus weight loss and control for those with weight issues is a must, especially if weight is carried around the abdomen.

Researchers describe ‘belly fat’ an active "organ", one that churns out hormones and inflammatory substances. ‘Abdominal fat is thought to break down easily into fatty acids, which flow directly into the liver and into muscle’ (WebMD, 2007). Thus overworking the liver and reducing hormonal clearance. During this time insulin can also become less effective in controlling blood sugar, so insulin resistance sets in, yet another cause of PCOS.

2. High stress levels and a ‘maxed’ out liver also contribute to hormonal imbalances in women, leading to acne, anovulation and PCOS. The liver is responsible for clearing built up hormones in the body. When the liver is overloaded with the use of alcohol, caffeine, pharmaceutical or non-pharmaceutical drugs, overloaded with the clearance of elevated stress hormone, environmental toxins, cleaning agents, aerosolized paints, thinners, or under attack by viral hepatitis, then the liver is unable to clear hormones from the blood stream. Estrogens and testosterone levels then build up. 

The treatment is stress reduction and a liver detox. Look over the blog on stress to see that stress is not just physiological, and all stressor must be removed or reduced. Speak to a healthcare practitioner to guide you through a liver detox (which may also aid in weight loss).

3. Diabetes which causes insulin resistance is a major cause of PCOS. Diabetes is controlled with drugs like Metformin and a low carbohydrate and sugar diet. This diet is a must for anyone with PCOS symptoms. The axis around insulin resistance and diet control is a number one priority for anyone wanting to cure themselves of the syndrome.

4. An adrenal gland dysfunction, or tumour, can lead to the adrenals secreting excess androgen (so can chronic stressors). Please see you G.P to get this checked if you predominantly experience male pattern hair growth and acne.

5. Pituitary dysfunction will lead to an abnormal secretion of other menstrual related hormones, causing anovulation, and a build up of follicles within the ovaries. This is the last call, and should be checked if all else fails.

References

1. Trickey,R, 2005, ‘Women, Hormones and the Menstrual Cycle’, Allen & Unwin, Second edition, NSW Australia

2. DiMarcantonio. T, 2008,’ Controversy around the diagnosis of PCOS continues’ Endocrine Today, viewed 7/7/11 -www.endocrinetoday.com/view.aspx?rid=27868

3. Allahbadia, G. & Agrawal, R., 2007, ‘Polycystic ovary Syndrome’, Anshan Ltd, England.

4. 2007, ‘Risks of Belly Fat’, WebMD, viewed 7/7/11 - www.webmd.com/diet/risks-weight-around-waist-7/belly-risks?page=2

DAMP. What is it. How did I get it. How do I clear it.

You may have heard the Chinese Medical term 'Dampness'.  What exactly is damp? How did it get there, and how do you get rid of it?

Internal dampness is directly due to the impaired transformative and transportive function of the digestive organs which results in some form of pathogenesis within the body, organs and meridians. Dampness can be thought of as the condition of "high humidity" inside the body.

A Damp condition creates symptoms of sluggish energy, a tendency to gain weight, a feeling of heaviness in the body, joints and or head, swelling or water retention, distended abdomen, sticky stools, loose bowels, phlegm discharge from lungs or nose, nodular masses, a sound of water sloshing in the stomach and or stomach rumblings, sores, weeping eczema, profuse purulent leukorrhea, turbid urine and stools containing mucus, no thirst, fatigue, and the tongue is often puffy with teeth marks and a greasy tongue coating at the back of the tongue. In Chinese Medicine, dampness is considered to be the cause of many illnesses such as high cholesterol, cancer, metabolic disorders, chronic fatigue syndrome, Candida, Herpes outbreaks, fibromyalgia, allergies and environmental illness.

A collection of dampness over long periods of time generate heat to build in the body due to the nature of damp blocking Qi and blood flow. The damp and heat mixed together may lead to such problems as inflammation, allergies (especially food allergies), high blood sugar, weight gain, and urinary tract infections. Symptoms can include heaviness, a sensation of fullness in the chest, a smelly and sluggish bowel, abdominal pain, leukorrhea, eczema, and deep yellow colored urine. The tongue is commonly has a greasy coating.

Raw food is a controversy to Chinese medical practitioners. Traditional Chinese doctors work on the principle that raw food may be full of vitamins nutrients, however raw food can be very hard to digest and absorb these nutrients. This is the reason why we do not feed young babies raw food. Everything we feed a baby is cooked, warmed and soft. Baby food is easy to digest and thus nutrients are easily extracted.When the digestive system is not firing properly it is better to stay away from raw food until the digestive system has gained strength, this is especially true for anyone suffering from a damp condition. It is better to eat food that is is easy to digest and warming in nature.

What should I eat? Food Therapy for Dampness & Phlegm -

General Principles:

•    Ideal cooking methods are steaming, boiling, grilling, soup. Ideally always eat cooked meals that are warm when you eat them.

•    Avoid sugar, concentrated sweeteners, high glycemic index foods, yeast (check labels especially if you have Candida signs), alcohol and fruits except citrus and berries.

•    Avoid raw foods including salads and raw fruit (whole or juiced) until damp has cleared and digestion is stronger.

•    Eat a whole food diet and remove foods that are difficult to digest such as milk products, (small amounts of yoghurt are ok) soy milk, animal fat, greasy foods, and food and liquids that are cold in temperature ie. Icy or cold drinks, especially beer. (this also means we say good bye to ice cream)

•    Eat regularly, avoiding heavy meals especially in the evening

•    Eat rich, nutritious meals in small quantities that are well distributed throughout the day.

•    Eating on the run or when you’re stressed creates dampness as digestive enzymes are low or not available at these times. Food banks up when we eat at these times.

•  Limit the intake of nuts. Sunflower seeds, pumpkin seeds, walnuts and almonds are less congesting however.

•    Worry, pensiveness and mental overwork often negatively affect the transporting and transforming function of the Spleen and contribute to deranged water metabolism as internal dampness. Take a deep breath, and spend a little quite time alone or start a meditation practice.

•    Overeating creates dampness due to food backing up. Eat until your 80% full.

•    Regular stretching and exercise (eg yoga) is an essential part of treatment

•    Increase the amount of mild spices in the diet (not chilli)

•    Avoid deep fried and ‘junk’ food

•    Avoid wheat and gluten products (wheat, rye, oats, barley)

•    Vinegar, mushrooms, fermented foods can also create damp – avoid if you experience Candida

•    Watch your Vitamin C intake, over 1-2g per day can contribute to dampness.

•    Avocado, banana and tropical fruits are absolutely forbidden in the morning.

Beneficial foods:

Vegetables: Pumpkin, sweet potato, celeriac, squash, zucchini, carrot, parsley, Include all green leafy vegetables: broccoli, bok choy, cauliflower, brussel sprouts

Protein: chickpeas, black beans, yam, peas, walnuts, chicken, beef, lamb, liver, kidney, tuna, mackerel, anchovy

Beneificial spices:  Onion, leek, garlic, turnip, fresh ginger, cinnamon, nutmeg, fennel, cumin, coriander, cardamom, star anise, turmeric. 

Drinks: green tea, lemongrass and ginger

Unfortunately a Western diet is damp in nature. You may feel like you have to completely revolutionise your diet and lifestyle to get rid of Damp. All Western students of Traditional Chinese medicine thought the same thing when they found out about damp too. But once you make the change to a non damp diet you will feel younger,  look younger, loose weight, your skin will thankyou and you will feel energised, refreshed and liberated.

If this information is too much or confusing don’t opt out, just simply stick to a Japanese diet (except the tempura) and you’ll be fine.