Polycystic Ovarian Syndrome
What is it?
PCOS stands for Polycystic ovarian syndrome and is a complex metabolic and endocrine condition that more than 7 million women have.
Common symptoms are:
- Absent or irregular menstrual cycles
- Hirsuitism (excessive hair growth in women)
- Hair loss
- Weight gain
Not all women will have all of the symptoms associated with PCOS, and others, will have all of them to varying degrees. Symptoms and clinical features of PCOS can change over time depending on age and lifestyle.
How is diagnosis made?
Diagnosis will be made via:
- Medical history
- Hormonal testing
- Ultrasound scanning of the ovaries.
Diagnosis is made when a woman has high androgen levels and ovarian dysfunction.
Please Note: There are many conditions which may produce similar symptoms which need to be ruled out first, such as Hypothyroidism which may also be linked.
How does PCOS develop?
PCOS is intrinsically linked to insulin resistance, which is what complicates this condition further and feeds into the symptom picture. 50-70% of women who have PCOS are insulin resistant.
Insulin resistance triggers a rise in insulin secretion which increases storage of fat. Obesity then triggers more insulin secretion which then keeps this cycle going.
An increase in insulin in the body also disrupts other sex hormones such as luteinizing hormone (LH) and follicle stimulating hormone (FSH). Higher levels of LH are found compared to FSH. This causes the follicles on the ovaries to produce more of the male hormone testosterone than the female hormone oestrogen. The adrenal glands also start to produce increased amounts of testosterone. An increase in testosterone prevents ovulation and produces other symptoms linked to this syndrome such as increased body hair and/or difficulties concieving.
So what does ovarian dysfunction mean?
Ovarian dysfunction may include irregular periods, polycystic ovaries or anovulation. Polycystic ovaries are ovaries with cysts on. However it is quite common to have cysts on your ovaries without having the more complex syndrome. You may also have PCOS without having cysts on the ovaries.
Are all women who have PCOS not able to conceive?
No! Some women who have PCOS do still ovulate and go onto have successful pregnancies. Others may get regular periods but are not ovulating. Not managing to conceive may be the first indication that you are not ovulating and that you may have PCOS, but of course not managing to conceive does not conclude that you are not ovulating or that you have PCOS.
Basal temperature testing (taking your morning temperature before getting out of bed), can indicate if you are ovulating or not. But if you have concerns about your fertility it is advisable to seek advice from a professional health care practitioner.
Secondary Risk Factors
Those with PCOS and insulin resistance will be more likely to have higher levels of androgens, more menstrual cycle irregularities and other secondary metabolic syndromes that may follow PCOS, such as Diabetes type II, high cholesterol, increased cardiovascular risks, and metabolic syndrome.
An interesting thought!
PCOS is thought to have developed at times of famine when women due to poor nutrition and starvation would not be able to conceive. Women with PCOS would be more likely to conceive in these conditions due to higher fat stores. If this is true our abundant modern times have made PCOS redundant and ultimately now more about managing lifestyle and weight.
A Herbal Approach
It is important to stress that although PCOS is a complicated syndrome, that can have unwanted symptoms, every women’s experience of it is different. Symptoms such as weight gain, acne and increased facial hair may lead to poor self image and depression but other women may not experience this.
It is the women herself who knows how this syndrome is affecting her and if you visit a herbalist or alternative health practitioner this will always be taken into account when devising a treatment plan.
It is also very important to stress that many women who have been diagnosed with PCOS have gone onto have successful pregnancies and live with the condition happily.
However if sub fertility or other symptoms of PCOS are affecting you it is advisable to seek medical help from a health care practitioner such as a trained medical herbalist, especially if you are trying to conceive.
A herbal approach can really help to improve sub-fertility and other unwanted symptoms, bought on by PCOS. Orthodox treatment will consist of hormonal replacement but there are many alternative approaches that can successfully help to combat the symptoms and resulting metabolic syndromes of PCOS.
To manage PCOS there are four core aims:
- To reduce androgen excess
- Improve insulin resistance
- To improve menstrual regularity
- To address infertility and ovulation for those wishing to get pregnant
- There are three core approaches a herbalist would take:
- Dietary Modifications and Exercise
- Herbal supplementation
- Dietary Supplements
As well as helping to loose weight, following the dietary guidelines below will help to improve the sensitivity of insulin receptors, reduce insulin resistance and the risk of developing cardiovascular disease.
Dietary Modifications & Exercise
Weight gain is one of the most common symptoms of PCOS and many women who have PCOS will tell you that loosing weight is very difficult. A women with PCOS will have to do more than the average women to loose weight.
However just loosing a small amount of weight can have a huge impact on symptoms and fertility related issues.
Increase levels of aerobic exercise
Half an hour three times per week building up to one hour three times per week. (This is a guideline and each women will be different. The important thing is to find the level you need to loose the weight and then keep this going regularly.)
Reduce carbohydrate intake and increase low glycaemic load foods
The glycemic load (GL) of food is a number that estimates how much the food will raise a person’s blood glucose level after eating it. Foods that are low in glycaemic load are proteins and good fats (See below). These foods regulate blood sugar.
Increase ‘good fats’ consumption
This includes cold pressed coconut oil, olive oil, fish oils, flax and hemp seed oils
Increase phytoestrogens in your diet
These include pulses, lentils, fermented soy, lots of fruits and brightly coloured and green leafy vegetables.
Increase fibre intake
This does not mean sugary breakfast cereals! Foods that are high in fibre are whole foods like oat grouts (where porridge oats are made from), brown rice, and fruits with their skins such as apples and pears. Also psylium husks and slippery elm are good sources of fibre. We all need to increase our fibre. If you think you have enough double it again!
Increase foods high in chromium
Such as broccoli, barley and oats and black pepper.
Cut out sugar, fried foods, and hydrogenated fats
These foods will all contribute to weight gain, insulin resistance and increased risk of cardiovascular disease