What is PCOS?

Polycystic Ovarian Syndrome (PCOS) is one of the main causes of infertility in women, and is believed to affect approximately 5% of the female population. It is in fact the most common hormonal disorder (hormone infertility) among women of a reproductive age. PCOS is associated with increased levels of insulin in the blood. Insulin regulates blood glucose levels, and is produced by specialized cells within the pancreas. When blood glucose levels rise (eg. after eating), these cells produce insulin to help the body use glucose for energy.

If glucose levels do not respond to normal levels of insulin, the pancreas produces more insulin. An over-production of insulin leads the body to respond by producing high levels of male hormones, or androgens. The elevated androgen levels can sometimes cause excessive facial hair growth, acne, and/or male-pattern hair thinning. There is unfortunately no single test for diagnosing PCOS. It will be diagnosed using blood tests, and checking for all the common symptoms. PCOS can also lead to irregular menstrual periods. If blood glucose levels continue to rise despite increased insulin levels, the person could develop Type 2 diabetes.

PCOS and The Menstrual Cycle

Although PCOS is not completely reversible, there are a number of treatments that can reduce or minimize bothersome symptoms. And women with PCOS are able to lead a normal life without significant complications.

During a women’s normal menstrual cycle, the brain (including the pituitary gland), ovaries, and uterus normally follow a sequence of events which prepare the body for pregnancy – whereby several follicles develop within the ovaries. Each follicle contains an egg. Two hormones, follicle stimulating hormone (FSH) and luteinizing hormone (LH), are made by the pituitary gland. Two other hormones, progesterone and estrogen, are made by the ovaries.

As the menstrual cycle continues, only one follicle will remain which will produce the egg during ovulation. After the egg has matured, LH levels will surge, causing the egg to burst from the follicle thus causing ovulation. After ovulation, the ovary produces both estrogen and progesterone, which prepare the uterus for possible implantation and pregnancy.

During the menstrual cycle in women with PCOS, multiple follicles may develop (4 to 9 mm in diameter) and accumulate in the ovary, hence the term polycystic ovaries. In short, the hormones are imbalanced, and the follicles are unable to grow to a size that would trigger ovulation; indeed some may later develop into cysts.

PCOS may show up on an ultra sound as a “string of pearls” within the ovary. This “string of pearls” represents the follicles that have not developed. And because ovulation does not occur, progesterone is not produced, which is what causes the lining of the uterus to thicken. Most women are unaware that they have PCOS. Some women may be lucky enough to conceive during an irregular ovulation cycle. Symptoms for PCOS vary with each woman – some women only have an irregular period as a symptom.

What Can You Do – Naturally?

There are several immediate steps that can be taken to begin to address the problem.

Eat a healthy, low GI diet – there are certain components in common foods that can actually make your symptoms worse. Some of these you may be eating every day, unaware that they are contributing to the problem. Your diet is the first place to start if you want to beat PCOS.

Some women can simply treat their PCOS by losing weight, which in turn can help to improve hormone imbalances. Weight loss is one of the simplest, yet most effective, approaches for managing insulin abnormalities, irregular menstrual periods, and other symptoms of PCOS. For example, many overweight women with PCOS who lose 5 to 10 percent of their body weight notice that their periods become more regular. Weight loss can often be achieved with a program of diet and exercise.

Reduce the amount of toxic substances coming into your body, and speed up elimination of the ones that do get in. We are living in a toxic world now, and our bodies are suffering because of it. People who have greater health have several lifestyle factors in common – quality sufficient sleep, a good social exercise regime, and, very crucially, a positive attitude about their health.

What Can You Do – Medically?

Metformin is a drug that improves the body’s ability to absorb insulin. It is considered safe to use on women who do not have diabetes, because it affects insulin levels and does not actually lower blood sugar directly. Clomid or other fertility drugs are often used in the treatment of infertility relating to PCOS.

Clomid blocks estrogen receptors in the brain, so it thinks there are low estrogen levels. Low estrogen levels trigger the body to produce more FSH and LH which signal the body to ovulate.

In Vitro Maturation (IVM) is an option for women with PCOS – where immature eggs are harvested early in a woman’s cycle. The eggs are then matured in a laboratory and afterwards can be used for fertilization. IVM is helpful for women who do not respond to drug therapy.

In Vitro Fertilization (IVF) harvests the eggs after they are already mature. The eggs are then fertilized and implanted in the woman’s uterus. IVF treatments also include medications that help the eggs develop.

Oral contraceptives (OCs) are the most commonly used treatment for regulating menstrual periods in women with PCOS. They decrease the body’s production of androgens, and anti-androgen drugs (such as spironolactone) decrease the effect of androgens. These treatments can be used in combination to reduce and slow hair growth.