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About PCOS

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What is PCOS?

Polycystic ovary syndrome (PCOS) is a complex hormone & metabolic condition. Women with PCOS can have ovaries with a cystic appearance, leading to the name, however not all women with cystic looking ovaries have PCOS nor do all women with PCOS have cystic ovaries. The cystic appearance of the ovaries arises mainly due to the eggs (or follicles as they are also known) failing to mature properly and failing to ovulate. Women with PCOS commonly have high insulin levels and/or high androgen (testosterone) levels, which tends to hamper their normal hormonal function, leading to irregular ovulation and irregular cycles. Insulin resistance is a key factor for many women with PCOS but not all, many women with PCOS will have weight issues but not all, some a very thin. Due to these inconsistencies and a lack of knowledge as to what PCOS is (or isn't) and can be, many women with PCOS go un-diagnosed for a long time often years. many are told they can't have it as they are not overweight or lack some of the symptoms etc. PCOS is a bit of a minefield. 

 

Here are some of the symptoms of PCOS.

  • Irregular or absent menstrual cycles
  • Irregular or absence of ovulation (release of an egg),

  • Infertility or difficulty conceiving

  • Heavy periods

  • Weight gain or obesity 

  • Excessive facial or body hair growth (or both) called hirsutism

  • Acne 

  • Hair loss or male pattern balding

  • Anxiety and depression

  • Sleep issues

The causes of PCOS are largely unknown, though there does seem to be a family link, with up to 50% chance of having it if your mother or sister has it etc. There is often a familial link to insulin sensitivity/resistance or type 2 diabetes which are also linked with PCOS.

Diet and lifestyle can also play a big part in PCOS symptoms due to the link to insulin response, with insulin resistance able to negatively influence metabolic function. Women with PCOS can struggle to keep blood glucose levels stable, battle sugar & carbohydrate cravings and struggle with weight gain, especially around the torso. Loosing weight with PCOS can be very difficult, your whole system is trying to sabotage your every effort. 

Fluctuating insulin and blood glucose levels resulting in insulin resistance leads to increase in androgen (testosterone) levels, which in turn can lead to lack of or irregular ovulation, weight gain around the abdomen are, excess hair growth and acne.

80% of women with PCOS will have insulin resistance. This can be caused partly by diet and lifestyle factors, including lack of activity. Insulin resistance is most often found in women with PCOS that are overweight, but can also be present in those with no weight issues.

PCOS … A Much Too Common Problem

 

Approximately 12-18% of women of reproductive age are believed to suffer with PCOS, many go un-diagnosed for some time.

 

Many of the women or couples I have seen over the years are frustrated with their treatment options so far, and the advice their doctor or specialist has provided. In most cases the treatment options are not addressing the underlying problems and have only a ‘bandaid’ type approach.

For many the whole picture has been masked while on the contraceptive pill and then when they come off (usually hoping to have a baby) they find they have an irregular or even non existent menstrual cycles.

This is where they usually seek the help of naturopath, as the alternative for them is to be sent down the fertility clinic pathway for IVF etc.  Many couples are not ready or willing to go that way.

I'm certainly not against IVF it is a great and essential option for many couples. I am against it being used as the only or even first line treatment option. After many years studying both natural fertility treatments and doing my Masters of Reproductive Medicine I can assure you in most cases natural fertility and hormones balancing is the perfect place to start.

Getting tested properly

You may suspect you have PCOS because of your lack of regular periods etc., might have been told that PCOS is likely or you might have already done some comprehensive testing.

 

Here are some of the tests that I suggest getting done:

​Blood tests
  • Full Female hormone test including FSH, LH, Estradiol & Progesterone

  • Testosterone Levels, FAI & SHBG

  • Full Blood Count

  • Liver Function Test

  • Thyroid Function Test - TSH, and if possible including T3 & T4

  • Fasting glucose

  • Fasting insulin

  • Cholesterol

  • Vitamin D

  • Iron Studies

  • Optional - Morning Cortisol levels - if anxiety, stress and/or depression an issue.

Your doctor may refuse to test all these, but hopefully you will be able to get most done and get some answers.

In addition to this you will want to have an ovarian ultrasound to see the amount and size of cysts on each ovary.

This great info-graphic is thanks to PCOS challenge. You can find more information bout them on our events and resources page or at PCOSChallenge.org.