Polycystic Ovarian Syndrome | PCOS
Polycystic Ovarian Syndrome or PCOS is a genetic, hormonal, metabolic and reproductive disorder all in one. PCOS affects 1 in 10 women and is one of the leading causes of infertility. Early identification and management of Polycystic Ovarian Syndrome can reduce the risk of diabetes and heart diseases by focusing on insulin sensitivity and improve fertility.
Polycystic Ovarian Syndrome (PCOS) is a chronic hyperandrogenic state and can present with a variety of symptoms including: obesity, amenorrhea (no period), oligomenorrhea (infrequent periods), infertility or androgenic features (acne, facial hair growth, hair thinning). Women with PCOS have an increased risk of endometrial cancer as well as heart disease and diabetes so it is not something we should ignore.
How is PCOS diagnosed?
- Serum AMH/Anti-Mullerian Hormone (however AMH is not as useful for diagnosing PCOS in obese women)
- Ultrasound of ovaries
What causes PCOS?
Elevated insulin is the most likely underlying cause. Elevated insulin leads to altered function of the hypothalamus which impairs secretion of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone(LH). Increased LH causes more androgens to be made and ovulation does not occur. There is a mismatch then between progesterone (too little) compared to estrogen causing estrogen dominance. Elevated insulin also leads to decreased Sex Hormone Binding Globulin which leads to increase in free testosterone leading to the masculine features of PCOS.
There is some research showing a link between the gut microbiome and PCOS. The hypothesis suggests that dysbiosis or a shift toward more pathogenic bacteria in the gut which can be caused by poor diet creates an increase in intestinal permeability resulting in systemic inflammation, contributing to PCOS. Studies have shown that women with PCOS tend to have lower diversity in the gut microbiome and increase intestinal permeability which leads to downstream inflammation.
Complications of pcos can include:
- Infertility
- Gestational diabetes or Preeclampsia
- Miscarriage or premature birth
- Fatty liver disease
- Metabolic syndrome — this is a cluster of conditions including high blood pressure, high blood sugar, and high cholesterol and triglyceride levels that significantly increase the risk of cardiovascular disease.
- Type 2 diabetes and prediabetes
- Sleep apnea
- Depression and anxiety
- Endometrial cancer
How should PCOS be treated?
The first target should be normalizing insulin through nutritional and lifestyle strategies.
- Increase fiber
- Increase fruit and low starchy vegetable intake (Eat the Rainbow!)
- Balance blood sugar – always pair carbs with protein, fat or fiber (more on balancing blood sugar here!)
- Include resistant starch and fermented foods
- Emphasize omega 3 fatty acids
- Avoid artificial sweeteners
- Ensure adequate hydration
- Lower stress (stress increases blood glucose)
- Regular exercise
- Optimal sleep
What supplements can help with PCOS?
- N-acetyl cysteine (NAC): comparable to Metformin at improving insulin sensitivity
- Myo-inositol: decreases insulin resistance
- Resveratrol: reverses excess androgens
- Green Tea: helps to stabilize blood glucose
- Chaste Tree Berry (Vitex) helps support healthy hormones
- Cinnamon: increases insulin sensitivity
- Cyclic Progesterone on days 14-27
You may be seeing a trend with this blog series: there is SO MUCH MORE that can be done for hormonal problems than just prescribing birth control as a bandaid. At Wild Rice Wellness, Alison uses a personalized approach to figure out what the root cause of any health problem. To book a free 15 minute consultation to see if Wild Rice Wellness is right for you, click the link below!