Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder to affect women of reproductive age, affecting 1 in 15 women worldwide. Although classic PCOS presents with obesity, polycystic ovaries or multiple ovarian cysts, elevated androgen hormone levels and irregular or anovulatory cycles, many patients with PCOS experience varying symptoms and health issues that do not consistently fit the classic PCOS picture. The signs, symptoms, and health risks associated with PCOS include:
- Absent period
- Anovulatory cycles
- Irregular menstrual cycles
- Mid-cycle bleeding and/or heavy menstrual bleeding
- Alopecia (balding)
- Hirsutism (excessive body hair)
- Acanthosis nigricans – a darkening of the skin in the armpits, back of the neck, or groin
- Polycystic ovaries
- History of ovarian cysts
- Mood disorders
- Recurrent Miscarriage
- Possible increased risk for endometrial and breast cancer due to estrogen dominance
- Cardiovascular disease
- Type 2 Diabetes
- Gestational diabetes
PCOS is due to insulin resistance but the exact cause is still unclear. Scientific research suggests there may be a genetic link, possible abnormal fetal development and inflammatory response contributing to the cause. PCOS is also negatively affected by diet, lifestyle and exposure to certain environmental toxins.
Insulin, released by the pancreas in response to dietary intake of carbohydrates and sugar and stress which triggers an increase cortisol and blood glucose is a hormone that is essential for absorption of glucose and metabolism of carbohydrates, lipids and proteins. Insulin resistance occurs when the body’s cells become resistant to the effects of insulin, disrupting metabolism and glucose regulation and causing insulin and glucose levels to be elevated. Insulin also signals the ovaries to secrete testosterone and inhibit hepatic sex-hormone binding globulin (SHBG) production which leads to an increased level of circulating testosterone. Excess insulin in the bloodstream also signals the ovaries to release more estrogen which can suppress ovulation. Women whose mothers, sisters or grandmothers had PCOS are at a higher risk for developing PCOS. Research suggests that exposure to excessive amounts of male hormones (androgens) by the developing fetus may alter proper gene expression, which may cause PCOS during the reproductive years of a woman’s life. In some predisposed people eating inflammatory foods such as processed foods, sugar, hydrogenated oils, gluten and dairy or exposure to certain environmental factors may trigger an inflammatory response, which may contribute to insulin resistance and atherosclerosis.
Effectively addressing PCOS begins with thorough laboratory testing and imaging to assess hormone abnormalities, lipid, insulin and glucose imbalances, thyroid and adrenal gland function and ovarian health. Female and androgen hormones such as FSH, LH, progesterone, estrogen, testosterone, Dehydroepiandrosterone sulfate (DHEA-s), prolactin and SHBG are tested. If needed environmental toxicity and food sensitivity testing are helpful to identify causes of inflammation. A naturopathic approach to treating PCOS involves a low glycemic and anti-inflammatory diet to balance hormones, insulin and glucose and to reduce inflammation. Nutritional and herbal supplementation to improve insulin sensitivity and hormone balance is also essential to treating PCOS successfully. Acupuncture and Chinese herbal medicine, scientifically shown to improve ovulation, regulate menstrual cycles, reduce inflammation, calm the nervous system to buffer the effects of stress, and enhance fertility are also highly recommended.