Polycystic Ovarian Syndrome (PCOS)
If you’re suffering from irregular or absent periods, excessive facial hair, acne, weight gain and infertility, chances are you may have polycystic ovarian syndrome or PCOS. This is another hormonal condition I feel passionate about because it is multi-faceted and its symptoms can be addressed nutritionally.
What is PCOS?
PCOS is a common female hormonal disorder affecting up to 10% of women. Poly means many and cystic means follicles. Ovarian follicles are small, fluid-filled sacs in the ovary that each contain one immature egg. It is normal to have 6 to 12 developing follicles. Once the egg in one follicle matures, ovulation occurs and the rest of the follicles are suppressed. It is normal for teenagers to have up to 25 follicles on each ovary.
Symptoms of PCOS are related to anovulation (lack of ovulation) and high androgen levels (male hormones). If anovulation occurs, the follicles in the ovary do not mature and they accumulate in the ovary.
Testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS) are the three androgens. It is normal to have some androgens in females for mood, libido, and bone health, but too much can result in PCOS symptoms.
Symptoms:
The main symptom of PCOS is oligomenorrhoea (irregular periods) and is typically a feature of anovulatory cycles. Other symptoms include hirsutism (facial hair), acne, hair loss, weight gain and infertility.
The Androgen Excess and PCOS Society classifies a woman with PCOS using all of the following criteria:
1. Irregular periods or polycystic ovaries on ultrasound
2. Blood test showing high androgens or symptoms of high androgens such as hirsutism
3. No other reasons for high androgens
The main drivers for PCOS include:
Insulin resistance PCOS - increases production of testosterone
Inflammatory PCOS - inflammation disrupts hormone receptors, suppresses ovulation and stimulates both your adrenal glands and ovaries to make more androgens
Post oral contraceptive pill (OCP) PCOS - you do not have insulin resistance plus you were fine before you started the pill
Stress induced PCOS - elevated adrenal androgens but normal ovarian androgens
Treatment
Treatment depends on the type of PCOS you are diagnosed with but the general guidelines are as follows.
Insulin resistance - reduce sugar & carbohydrate intake, increase protein intake & increase exercise if not exercising already
Inflammatory - avoid inflammatory foods & increase anti-inflammatory foods
Post OCP - allow time to detox from pill & eat enough nutrient dense foods
Stress induced PCOS - reduce stress & practise relaxation techniques such as meditation, massage, and yoga.
PCOS is sometimes misdiagnosed as another condition called hypothalamic amenorrhea because they both cause irregular or absent periods. This is a problem because they each occur for different reasons and therefore, treatment differs. Working with a health practitioner can help start the investigation and work on addressing your symptoms appropriately.
Please make an appointment if you want to take control of your menstrual health.
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