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