Polycystic Ovarian Syndrome
Polycystic ovary syndrome (PCOS), also known as polycystic ovarian syndrome, is a common health problem caused by an imbalance of reproductive hormones. The hormonal imbalance creates problems in the ovaries. The ovaries make the egg that is released each month as part of a healthy menstrual cycle. With PCOS, the egg may not develop as it should or it may not be released during ovulation as it should be.
PCOS can cause missed or irregular menstrual periods. Irregular periods can lead to:
- Infertility (inability to get pregnant). In fact, PCOS is one of the most common causes of infertility in women.
- Development of cysts (small fluid-filled sacs) in the ovaries
Between 5% and 10% of women between 15 and 44, or during the years you can have children, have PCOS . Most women find out they have PCOS in their 20s and 30s, when they have problems getting pregnant and see their doctor. But PCOS can happen at any age after puberty .2
Women of all races and ethnicities are at risk of PCOS. Your risk of PCOS may be higher if you have obesity or if you have a mother, sister, or aunt with PCOS.
Symptoms of PCOS
- Irregular menstrual cycle. Women with PCOS may miss periods or have fewer periods (fewer than eight in a year). Or, their periods may come every 21 days or more often. Some women with PCOS stop having menstrual periods.
- Too much hair on the face, chin, or parts of the body where men usually have hair. This is called “hirsutism.” Hirsutism affects up to 70% of women with PCOS .
- Acne on the face, chest, and upper back
- Thinning hair or hair loss on the scalp; male-pattern baldness
- Weight gain or difficulty losing weight
- Darkening of skin, particularly along neck creases, in the groin, and underneath breasts
- Skin tags, which are small excess flaps of skin in the armpits or neck area
Not all PCOS is a result of high insulin, not all PCOS presents with cysts on the ovaries and not all cysts on the ovaries results in hormone disruption.
For a long time, the root cause to PCOS was believed to be a result of an overproduction of male hormones, called androgens. In more recent years, research has confirmed PCOS is correlated to a desensitization in insulin production within the body, which in turn leads to increased production of these androgenic hormones, acne formation, and difficulty managing weight.
Secondly, not all PCOS stems from the ovaries. Adrenal glands, which sit above our kidney’s and help us respond to stress stimuli, also make up a large portion of our steroid hormone known as DHEA. This precursor hormone directly coverts into testosterone and estrogen. That means that high stress and overproduction of DHEA can create polycystic ovarian syndrome without blaming the ovaries. Read more about adrenal function and fatigue here.
Assessment For PCOS
The most important thing to remember is that while PCOS may physically manifest with cysts on the ovaries, it is ultimately a hormonal syndrome. While symptoms are a great place to start, this syndrome can also be tested for via ultrasound and particular hormonal markers. The following lab markers should be tested in PCOS to help understand the root of the problem, your likelihood of fertility, and your course of treatment. All these markers will be ordered by Dr. Gupta, ND.
- FSH (day 3 of the cycle, if cycling)
- LH (day 3 of the cycle, if cycling)
- Estradiol (day 11-13 of a 28 d cycle, if cycling)
- Progesterone (day 21 of a 28 d cycle, or 7 days post-ovulation if cycling)
- Free testosterone, total testosterone
- DHT – dihydrotestosterone
- SHBG – sex hormone binding globulin
- HbA1C, fasting glucose, fasting insulin
- TSH, free T4, free T3
- 25-hydroxy Vitamin D
Furthermore, more thorough testing can also show us comparisons of both estrogen and testosterone metabolites and the activity levels of their respective enzymes, which help to further understand the cause of your PCOS and narrow down treatment options.
Treatment and Management of PCOS
- Metabolic Balance® Program (linking this to the Weight Management page) for optimal insulin control and weight management
- Evidence based nutrient therapy
- Homeopathic remedies
- Lifestyle and Exercise strategies
- Acupuncture for optimal fertility & irregular cycles
- IV therapy in cases of nutrient deficiency
- Mindset and Meditation coaching
The Metabolic Balance Program for PCOS
The Metabolic Balance Program is one of the treatments that can be used for managment and treatment of PCOS. Based on your individual blood markers, a specific nutritional plan is recommended to help balance hormones and allow the body’s metabolic processes to normalize. At the root of PCOS is often a metabolic issue and addressing this via a personalized appraoch tends to offer a better road map to healing.
The plan is based on real, whole food and is not meant to deprive you of any food group. The journry through the program teaches you how to eat to help normalize blood sugar thereby resulting in weight loss if needed.
Phase 1: Gentle cleanse and detoxification; two days
Phase 2: Prescribed foods eaten at three meals per day; generally oil free to promote liver health; 14 to 21 days
Phase 3: Expanded food list
Phase 4: Maintenance
The total duration of the program is unique to your body’s needs.
1 Trivax, B., & Azziz, R. (2007). Diagnosis of polycystic ovary syndrome. Clinical Obstetrics and Gynecology, 50(1), 168–177.
2 Bremer, A. A. (2010). Polycystic ovary syndrome in the pediatric population. Metabolic Syndrome and Related Disorders, 8(5), 375–394.
3 American College of Obstetricians and Gynecologists. (2015). Polycystic ovary syndrome .