What is Polycystic Ovary Syndrome?
Polycystic ovary syndrome (PCOS) is not just the number one cause of infertility or the most common hormone disorder affecting women. This disorder has many other serious health concerns.
Most women with PCOS are overweight and develop many small cysts on their ovaries. These cysts are not harmful, but they do cause hormonal imbalance in your brain and your ovaries. It happens when a hormone called LH (from the pituitary gland) or levels of insulin (from the pancreas) are too high, which results in extra testosterone production by the ovary.
What are the Symptoms of PCOS?
This hormonal imbalance expresses itself with symptoms of acne, excess body and facial hair, irregular or non-existing periods and weight gain. It is most familiar as a cause of female infertility yet, in addition to infertility, PCOS is associated with insulin resistance, type 2 diabetes, and an increased risk of miscarriage, heart disease, and endometrial cancer.
The exact causes of PCOS are not known, but one theory associates it with insulin resistance. The job of insulin is to attach to the cell wall and allow glucose into the cell so it can be converted into energy. If the cells do not have enough receptor sites for insulin to attach and do its job, glucose remains in the blood, which elevates blood sugar and is stored as fat. Suffice it to say this is related to the increase in obesity, difficulty with weight loss, diabetes, and heart disease also associated with PCOS.
Insulin also stimulates cells on the ovaries to grow. These cells normally produce a small number of male hormones called androgens. Ovarian tissue does not become resistant to insulin, so when there is too much insulin, the ovarian tissue makes too many follicles. This leads to the production of too many androgens and there is a loss of ovulation, or menstrual cycles, which creates the challenge of trying to conceive.
PCOS can affect as many as 5 to 10 % of women in reproductive age. These symptoms can begin in the teen years. In fact, with the rise in childhood obesity, there has been a significant increase in PCOS found in teenage girls. Typically, it remains undiscovered until a woman is having difficulty becoming pregnant. Treatment can help control the symptoms and prevent long-term problems.
PCOS is often linked to genetics.
PCOS seems to run in families and can be passed down from either your mother’s or father’s side, so look for signs of insulin resistance and diabetes. Nutritional state of the mother during the time of conception also has a huge impact on how the baby’s ovaries develop. This huge responsibility should be an incentive to become as healthy as possible before getting pregnant.
How Is PCOS Diagnosed?
In addition to the physical signs and symptoms, the diagnosis of PCOS is made based on a number of lab tests to check blood sugar, insulin and other hormone levels. A pelvic ultrasound is frequently performed to look for cysts on the ovaries. These are often called a string of pearls, as they look like a string of pearls draped on the ovary.
The first line of treatment for PCOS is exercise and eating foods that are low on the glycemic index. The glycemic index measures the rate at which ingested food causes the level of blood glucose to rise. This means eating foods that manage blood sugar. It is recommended to:
- Eat a higher protein diet in the form of lean meat that has not been treated with hormones.
- Cut out all forms of refined sugar and carbohydrates such as white bread, pasta, and white rice.
- Eat whole grains or gluten-free foods.
These things are crucial for managing the symptoms of PCOS, and this is the best form of medicine. For more information about what to eat, check out my blog ‘PCOS Diet: Stabilizing Your Blood Sugars & Managing Insulin Resistance‘.
Treatment for infertility from PCOS:
- If you are overweight, weight loss of as little as 5 percent over six months can lower your insulin and androgen levels. This will help balance hormones and restart your menstrual cycle and ovulation. Healthy eating and regular exercise are especially important if you are planning to have a baby.
- If weight loss alone does not start ovulation (or if you don’t need to lose weight), acupuncture and Oriental medicine can be helpful to restore ovulation. Several months of treatment may be needed. Acupuncture can also be helpful when used with medicated treatments.
- Medication such as metformin/Glucophage can be used to help lower your insulin levels and help you start to ovulate. This treatment may also take several months.
- If metformin/Glucophage does not work, fertility drugs such as clomiphene or gonadotropins can be used to stimulate ovulation for timed intercourse, intrauterine insemination or in-vitro fertilization.
- If you smoke, quit. Women who smoke have higher levels of androgens than women who don’t smoke. Smoking also harms egg quality and increases your risk of heart disease.
PCOS cannot be prevented or cured, but it can be controlled.
Many women experience improvement in the signs and symptoms of PCOS if they are able to maintain a healthy weight. In order to have a higher quality of life, regular exercise and making conscious decisions about food will lower the risk of infertility, miscarriages, diabetes, heart disease and uterine cancer. Treatments such as acupuncture, Oriental medicine, and hormone therapy can help control problems caused by hormones. Regular checkups are important for staying ahead of the condition and catching any PCOS complications.