Polycystic Ovarian Syndrome

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Trouble losing weight? Irregular periods? Fertility issues? Acne pimples?
Polycystic ovarian syndrome can be the cause of these seemingly unrelated symptoms.
Did you know dietary changes and a few supplements can bring these hormones back in balance in just a few months?

Women with polycystic ovarian syndrome present with the following symptoms: irregular periods, multiple cysts on the ovaries on a pelvic ultrasound, acne, excessive hair growth and weight management problems. Every woman may not necessarily have all of these symptoms, but most will present with several. Women with PCOS can also be overweight and at risk for type-2 diabetes. Unfortunately, PCOS and its lack of regular healthy ovulation can at times also affect fertility.

Naturopathic medicine can greatly help in the treatment of PCOS through:
–    Implementation of a low-glycemic diet – with few refined starches and sugary items
–    Supporting the individual through an exercise regimen if necessary
–    Herbs to promote regular ovulation
–    Supplements such as D-chiro-inositol or myo-inositol which have been increasingly researched in helping the ovary’s regular monthly ovulation
–    Working on intestinal health, should digestive factors contribute to the development of acne
Sometimes, deeper factors may be at play, in which case certain psychotherapeutic tools may be useful  in exploring the more profound causes of biochemical imbalances.

Because of the wide range of symptoms, it may take time for a woman to get an accurate diagnosis.The biochemistry in of PCOS is very complex – some of its hallmarks can be summarized as follows:

Insulin resistance: the body no longer responds appropriately to insulin production. Normally, when a healthy person eats starches or sugar-containing foods, insulin is produced in response to rising blood sugar (glucose) levels. Insulin helps the cells absorb and burn the sugar that was eaten. When refined “white” starches or sweet foods are eaten (i.e. chocolates, biscuits, cookies, fruit juices…), the body creates an insulin spike proportional to the amount of sugar glucose that enters the blood. This stimulates the cells to absorb the sugar and lower blood sugar levels. With insulin resistance, large amounts of insulin are produced, but the cells no longer respond by absorbing the sugar that was eaten, and blood sugar levels remain high. This means that insulin keeps on being produced, with a number of negative consequences. Insulin resistance is a risk factor for type 2 diabetes and heart disease.

Abnormal ovarian production of male hormones: the excess insulin stimulates the ovaries to produce large amounts of male hormones and another hormone called inhibin. This essentially prevents normal ovulation and explains the many cysts that appear on the ovaries of a woman with PCOS. High levels of male hormones explain the other symptoms of PCOS, such as acne and excess facial or body hair. Although not all women with acne have PCOS, understanding it better can help shed some light on the hormone-acne connection. The physiology of PCOS sheds a great deal some light on the hormonal biochemistry of acne. Being overweight and having  its accompanied insulin resistance, combined with a poor diet, might promote excessive insulin release leading to overproduction of androgens (male hormones). These factors may then lead to the development of acne.
Abdominal weight gain:  the excess insulin favors the deposition of body fat in the abdominal area which further contributes to insulin resistance. When overweight women lose weight, insulin resistance improves and they may begin to ovulate normally again.

If PCOS is suspected, then a few laboratory tests may be useful:

Luteinizing Hormone (LH) and Follicular Hormone (FSH): these are the hormones released by a woman’s hypothalamus (a part of the brain) that would normally favor ovulation. In PCOS, FSH tends to be normal or low, while LH is low. The LH/FSH ratio is 1:1 in healthy subjects. A ratio of 2:1 or 3:1 is considered diagnostic of PCOS in premenopausal women.

Free Testosterone: this is the amount of active testosterone present in the blood. Testosterone is a male hormone and accounts for symptoms such as acne and excess facial hair. It is typically elevated in PCOS.

Fasting glucose levels: this test indicates the amount of sugar that is found in the blood after having fasted for 12 hours. It can be elevated in women with PCOS.

Glycated hemoglobin (HbA1c): this is another indicator of blood sugar levels. Whereas fasting glucose levels tell us about the current blood sugar levels, HbA1c gives us an idea of the long-term levels (in the last 3 months).

Pelvic ultrasound: this may be necessary to evaluate whether the ovaries are enlarged. In PCOS, the ovaries tend to be 1.5-3 times larger and may  have 12 or more cysts on their surface. These are the immature ovarian follicles.  The presence of multiple cysts helps aids in the diagnosis of us diagnose PCOS, although not all women with ovarian cysts will have a diagnosis of  PCOS.