PCOS 101: What Is PCOS, How PCOS is Diagnosed and What Causes PCOS...
It's PCOS Awareness month! And, what not a better time to talk about the most misunderstood imbalance in women. Polycystic Ovarian Syndrome (PCOS) may be one of the most common and complex female health issues of our time, affecting about 1 and 10 women of reproductive age.
What is PCOS?
The name Polycystic Ovary Syndrome implies there is a problem with your ovaries, but truth is, PCOS is a complex metabolic endocrine disorder that affects your whole body.
PCOS does manifest differently in each woman and although the name itself is misleading, every woman with Polycystic Ovary Syndrome (PCOS) does not have cysts on their ovaries.
For starters, the name was coined due to the "cyst-like appearance" of follicles seen on ultrasound scans. Researchers noticed women with PCOS often had ovaries that looked like a string of pearls - with lots of tiny underdeveloped follicles. These "cyst" aren't really cyst at all, but multiple "baby eggs" that attmepted to grow but never fully matured in size.
For this very reason, to date, there is a push by researchers and women's health care professionals to change the name of this condition. As you can imagine this becomes a problem for women who read into the name and think their condition is just about their ovaries and nothing else.
How is PCOS diagnosed?
To be diagnosed with PCOS you have to have two of the three markers associated with the disease:
- Irregular cycles (more than 35 days between periods)
- High androgen levels
- Polycystic ovaries
Classic PCOS presents with polycystic ovaries (multiple follicles that look like a strand of pearls), elevated levels of androgens, and anovulation that result to irregular menstrual cycles. Some women may present with all three.
What are common PCOS signs and symptoms?
On average, it can take 2 to 3 years of women complaining and sharing their health concerns with their doctor before being diagnosed. Because PCOS can be overlooked in women, it's important to understand the common signs of symptoms of this condition.
- Irregular menstrual cycles
- Absent period
- Anovulatory cycles (no egg released)
- Abnormal mid-cycle bleeding
- Excessive or heavy menstrual bleeding
- Alopecia (balding)
- Hirsutism (excessive body hair)
- Facial acne
- Acanthosis nigricans – darkening of the skin in armpits, neck, or groin
- Polycystic ovaries
- Mood disorders
- Weight issues
- Recurrent Miscarriage
- Fertility challenges
How did I get PCOS?
The cause of PCOS is really unknown. Developing research suggests there are several influencers including genetics, possible abnormal fetal development, endocrine development, insulin resistance and chronic inflammatory responses contributing to the cause.
PCOS is also negatively affected by diet, lifestyle and too much exposure to certain environmental toxins like skin and beauty care items, household cleaning products, and pesticide sprayed on food.
PCOS Genetic Disposition and Fetal Development
Women whose mothers, sisters or grandmothers had PCOS are at a higher risk for developing PCOS. Research suggests that exposure to excessive amounts of male hormones (androgens) by the developing fetus may alter proper gene expression.
This means that the affected genes may not function correctly later in life, especially if the gene is turned on by environmental factors and lifestyle behavior choices, which may cause PCOS during the reproductive years of a woman’s life.
This is another reason why it's important for women with PCOS to learn how to manage and control their high hormone levels before conceiving, because when you don't you risk exposing and passing it on to your child while in the womb.
PCOS and Insulin Resistance
Women with PCOS often have insulin resistance. Insulin is a hormone produced in your pancreas and is responsible for signaling cells in your body to function correctly, most importantly to convert glucose to energy. It also plays a key role in the metabolism of carbohydrates, lipids and proteins.
Insulin resistance happens when your body’s cells become resistant to the normal effects of insulin. More insulin is then produced to keep your blood sugar normal. This raised level of insulin causes your ovaries to make too much testosterone because insulin signals the ovaries to secrete testosterone and inhibit sex-hormone binding globulin (SHBG) production, leading to an increased level of circulating testosterone.
A high level of insulin and testosterone in the bloodstream can suppress ovulation - hence, period problems and fertility challenges. It is this increased testosterone level in the blood that causes acne, excess hair growth on the body, thining hair or male pattern baldness (hirsutism) in women.
Increased insulin also contributes to weight gain by promoting fat storage.
PCOS and Chronic Inflammation
Women with PCOS have low-grade chronic inflammation, which may be a cause for insulin resistance. Inflammation happens when your body’s natural immune system reacts to a foreign substance to protect your body from a perceived threat -- white blood cells produce substances to fight infection, this is known as an inflammatory response.
Several studies have found that women with PCOS are more likely to have elevated levels of CRP compared to those without the condition. CRP (c-reactive protein) is a blood test marker for inflammtion in the body. This suggests that some form of inflammation is happening in the woman's body with PCOS.
If you have PCOS, you may also have high levels of other markers for inflammation like oxidative, inflammatory cytokines, and white blood cells called lymphocytes and monocytes. All of these factors are involved in the immune response and are also found during inflammation.
Eating certain foods, exposure to certain environmental factors, stress inducing lifestyle environments also trigger an inflammatory response.
Due to the lack of information and knowlegde that women are given about there PCOS condition, many women remain crippled by this very manageble dis-ease. However, there are several natural and effective lifestyle changes you can incorpate to help manage and suppress your condition.
When left untreated and unmanaged, PCOS can have long-term effects that can cause fertility challenges, pregnancy complications, type 2 diabetes, gestational diabetes, high blood pressure, and serious mood disorders in women.
Truth is, PCOS is a complex endocrine and metabolic disorder, and it requires a comprehensive approach to help naturally manage. With women in my practice I take a holistic functional approach through herbal supplementing, nutrition and lifestyle to help balance underlying hormonal issues and address root cause.