What is it?
Polycystic ovarian syndrome (PCOS) is the most common anovulatory disorder and the single most common hormonal cause of female infertility. About 10% of women have PCOS.
When a woman has PCOS, she ultimately has a hormonal dysfunction that results in her ovaries not being able to FULLY mature an egg. Multiple follicles begin to develop and build up with fluid, but they can’t QUITE develop into a mature egg. Because they cannot fully mature, these semi-developed follicles turn into fluid-filled sacs called cysts. These cysts produce androgens which can prevent ovulation and cause a host of other symptoms (excess hair growth, acne, ect).
We know that ovulation is necessary for a woman to conceive. If a follicle doesn’t release an egg, there’s no chance of the woman getting pregnant. Thus, it makes sense that anovulatory disorders are among the most common causes of infertility in women.
There are some women with PCOS who do ovulate; however, it is usually late in their cycle and the egg may be of poor quality. Poor egg quality increases that chance of having a miscarriage and other complications when using fertility drugs.
It’s not that women with PCOS cannot get pregnant, it just may take longer. The majority of women with PCOS CAN get pregnant naturally if they follow a protocol similar to the one described below and if they work with a health practitioner well-versed in hormone balancing. Don’t think that you’re out of luck just because you receive a diagnosis of PCOS. This type of thinking will only make matters worse. Instead, think of it as another motivator for getting your health in check. Your mindset is half the battle in making your body work for you, not against you.
Along with the issue of anovulation, women with PCOS may not even menstruate, or have irregular cycles. This is because mature follicles help produce progesterone which helps orchestrate the whole process. A lack of progesterone messes everything up.
So to repeat all of this information: The primary reason for the anovulation and irregular cycles stems from hormonal imbalances (you guessed it!). Excess testosterone and estrogen dominance, whether it’s due to too much estrogen or too much estrogen relative to progesterone, is commonly seen in individuals with PCOS.
End result: irregular cycles and a tough time getting pregnant.
Some women can identify with all of the typical symptoms of PCOS, while others may have no symptoms at all! Here is a short list of common symptoms:
- Irregular or missed periods
- Hirsutism – Hair in unwanted places (face, back, thumbs, toes, lower abdomen, chest)
- Acne, oily skin, or dandruff
- Struggles with weight gain
- “Apple shape” – excess weight is mostly stored around the waist
- Male-pattern baldness or thinning hair
- Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown
- Skin tags
- Pelvic pain
- Anxiety or depression
Side note: you do NOT have to be overweight to have PCOS. This is a common myth and may cause doctors to dismiss the possibility of PCOS in lean women. Repeat: you do not have to be overweight to have PCOS. Don’t let your doctor ignore the possibility of PCOS just because you are lean.
What are some of the potential causes of PCOS?
One of the first things that comes to mind is insulin resistance and blood sugar dysregulation.
Having blood sugar levels that are all over the map, as is commonly seen with diets high in refined carbohydrates (aka sugar), can send your blood sugar levels sky high. Since high blood sugar is toxic to the body, a hormone called insulin is called upon to drive the sugar into your cells. If you call upon insulin too often, you can develop insulin resistance. This is a state in which your body may be secreting insulin, but the message isn’t getting “heard” and your cells are not able to use the insulin. Your body creates more and more insulin to drive the sugar into the cells. Too much insulin, like too much blood sugar, leads to many, many health complications including weight gain, PCOS, and suboptimal fertility.
Of course there is always the possible genetic link to developing PCOS. As we know with genetics, you are in more control of your genes than you may think. Just because you have the genes for a condition does not automatically mean you will develop the condition. Your lifestyle factors switch that genetic light switch on/off.
You are the ultimate driver in your health, so step up to the plate and take control.
Chinese Medicine perspective
Cysts on the ovaries are considered a result of stagnation (impaired blood flow) which can impede ovulation and cause a long follicular phase, or prevent ovulation entirely.
Acupuncture can help as it calms the sympathetic nervous system and relaxes the neuroendocrine system. Essentially, acupuncture helps stabilize the hormonal system.
Acupuncture can be used with specific Chinese herbs. Some of these herbs have been clinically tested to be more effective at inducing ovulation in PCOS than Metformin. These herbs may help reduce the number of cysts.
So what’s a gal to do?
- Get your blood sugar levels (fasting blood glucose and HbA1c) and androgen levels (testosterone and DHEAs) checked. This will help determine what the main contributor is.
- Lose some weight, but only if you need to. Losing just 10% of body weight can result in normal ovulation in women with PCOS.
- N-acetyl cysteine (NAC) supplementation may help reduce circulating testosterone and insulin levels. I like Nutrient 950 with NAC by Pure Encapsulations.
- A comprehensive detox program can help shuttle excess estrogen from your system as well as clear out any other potential toxins that may be disrupting your health/hormones. Please do not buy the junky ones over the counter. I recommend health practitioner brands only.
- Vitex can be a helpful supplement in creating a more favorable estrogen:progesterone ratio.
- Bump up the antioxidants in your diet by consuming plenty of organic fruits and vegetables.
- Get regular exercise.
- Practice stress management.
- See an acupuncturist – Acupuncture helps balances hormones including LH, FSH, and testosterone.
- See an herbalist that can help create a formula specific to you to help reduce cysts.
- Give your adrenal glands love! Work on stress-management techniques such a deep breathing, meditation (even if it is only for a few minutes), yoga, and ladies night!
- Embrace being a woman. Kick your masculine energy to the curb every now and then. Ask for help, treat yourself with some self-love, and let yourself be taken care of by others.
- Toss the toxic skin products you’re using and be mindful of food-based and environmental estrogens (plastic containers, pharmaceuticals, pesticides, heavy metals, household products, soy, and conventional dairy/meat). Purchase organic and grass-fed/pastured animal products and organic produce whenever possible.
- Please think twice before taking hormonal therapy (such as going on the birth control pill) to correct this condition.
This list could go on forever. Don’t become overwhelmed with all of these suggestions. Shoot for 1 or 2 at a time, master those, and move on. Remember, stressing yourself out over making all of these changes overnight is counterproductive. Free yourself from self-judgment and take it piece by piece. You’ve got this!
Re: Blood sugar levels
Evaluate your diet. Are you eating balanced meals or are they carbohydrate heavy? Examples of carbohydrate-rich foods include: grains (rice, corn, bread, pasta, quinoa, oats, ect.), starchy vegetables (squash, potatoes), fruits, treats (cookies, cakes), snack foods (chips, crackers), or sugary yogurts.
By no means must you eliminate all carbohydrates from your diet- just pay more attention to how much you are eating them. You may consider oatmeal with fruit on top and a glass of orange juice to be a healthy breakfast; however, this meal is jam-packed with carbohydrates and hardly any protein or fat. Maybe your lunch of a chicken sandwich, yogurt, and fruit sounds like a good idea, but again this is a carbohydrate rich meal. In both of these situations you may want to consider shedding some of the carbohydrate rich foods in favor of more protein and fat. That oatmeal + fruit + and orange juice could be substituted with a vegetable omelete with some berries. That sandwich combination could turn into lettuce wrapped chicken sandwich with a few sweet potato fries and a side salad. Again, small changes make big improvements.
Here’s what you can do NOW to improve your blood sugar levels from a dietary perspective:
Step #1 = Cut out junk food/processed foods and added sugars
Step #2 = Cut out gluten containing grains in addition to step #1
Step #3 = Cut out all grains in addition to step #1
*Your doctor may ask you to take Metformin (Glucophage) as well to help your insulin resistance. Following a lower-carbohydrate diet may be all that you need to kick this, but the Metformin may be a necessary addition for some women.
Re: Excess androgens
Your doctor may ask you to take Clomid to stimulate ovulation and/or other medications to suppress male hormone levels. Please just be mindful if you choose to take these medications if you are looking to get pregnant. Some of these medications, such as Spironolactone and Finasteride, should be avoided during pregnancy. The lifestyle factors discussed previously will certainly help to bring those excess androgen levels down.
That’s all for now! PCOS is a hot topic so there will definitely be more to come. Feel free to share your story/experiences/comments below!