Polycystic Ovary Syndrome (PCOS) is the most common metabolic and hormonal disorder in women of childbearing age. It is the leading cause of female infertility and is sadly becoming more common. Women must meet at least 2 of the following 3 criteria to be diagnosed with PCOS:
Absent or irregular menstrual cycles (Oligo- or amenorrhea).
Clinical or biochemical signs of hyperandrogenism (such as high testosterone)
Polycystic ovaries (confirmed via ultrasound)
There are different types of PCOS and it can look different from person to person. It’s important to remember not to get too caught up with what type you are because there are overlap with symptoms among all types of PCOS. But this shows how PCOS is a collection of symptoms and can show up very differently depending on the person.
1. INSULIN-RESISTANT PCOS
This is the most common type. This is when you have issues to manage your blood sugar, might have weight-loss resistance, water retention and an ongoing appetite that is hard to manage. Too much insulin can impair ovulation and tells the ovaries to produce more testosterone instead of estrogen. It also stimulates your pituitary gland to make more luteinizing hormone. Balancing blood sugar is very important here with an insulin-resistant type of PCOS.
For a deeper read about insulin resistance; click here
2. INFLAMMATORY PCOS
PCOS is essentially an inflammatory condition, low-grade inflammation can result in a hidden cause type of PCOS include thyroid disease because hypothyroidism affects ovulation and can worsen insulin resistance, deficiencies in vitamin D, zinc, or iodone, because your ovaries need these nutrients, or elevated prolactin because it can increase DHEA. With these hidden drivers once you fix the root cause your symptoms should improve pretty quickly.
Signs in your body of inflammation include digestive issues like IBS and bloating, unexplained chronic fatigue, headaches, joint pain, eczema or psoriasis, or even food sensitivities that start to develop suddenly. You can test a marker called high sensitivity C-reactive protein (hsCRP) to check for the level of inflammation in your body if you suspect you may have an inflammatory type of PCOS.
3. PILL-INDUCED PCOS
If your periods were normal before taking hormonal birth control and now you meet the diagnostic criteria for PCOS you may have the post-pill type of PCOS. If you had experienced PCOS symptoms before going on the pill, but never received a formal diagnosis it’s possible you had PCOS before going on the pill.
4. ADRENAL PCOS
Women with PCOS also have higher rates of anxiety and depression, either caused or exacerbated by the embarrassing physical changes that often occur with the condition.
The pituitary gland, stimulated by the brain via the hypothalamus, secretes adrenocorticotropic hormone (ACTH) in response to stress. ACTH then stimulates the adrenal glands to produce cortisol, adrenaline, and noradrenaline. In addition to these stress hormones, ACTH also stimulates the production of adrenal androgen hormones, including DHEA, DHEA-S, and androstenedione.
The adrenal type of PCOS is driven by an abnormal stress response versus an impaired insulin or blood sugar response as seen in the insulin-resistant type of PCOS.
In order to effectively treat PCOS, we need to treat the root cause of the condition and work to reduce the systematic level of inflammation using a personalized and holistic approach. Some women take the drug Metformin to help with insulin resistance and to improve their menstrual cycle, but this drug can with many side effects - for more about this read this
Hormonal birth control is often used as a treatment, but this is more of a “band-aid” approach and isn’t truly getting to the root of the problem. It can be helpful in certain cases but I always urge clients to dig deeper and not depend on the pill. When you go off birth control you will be right back where you started.. that is why you need to address the root cause. It’s also important to note that the bleeding you get when you take the pill is not truly a period; it is called “withdrawal bleeding,” meaning withdrawal from the synthetic hormones.
There certainly is a genetic component of the syndrome, but it’s important to highlight that PCOS is significantly affected; and possibly caused by lifestyle factors including diet, exercise, and stress. So there is a lot that we can do to manage it.
Proper nutrition and lifestyle management are key; an individualized approach while taking into account a woman’s relationship with food and readiness to change when creating such protocol and treatment plans. Some general recommendations often include:
Manage insulin dynamics with eating a lower glycemic index diet and adding proper exercise.
Being mindful of the amount and type of carbohydrates you consume and balancing out meals with adequate protein and fat
Include anti-inflammatory foods and explore supplementing with NAC, glutathione and sulforaphane
Heal the gut with diet and possibly using pre/probiotics, L-Glutamine and Colostrum
Support your adrenals; reduce caffeine, fix sleep cycles and letting go of stress and take vitamin C and adaptogenic herbs
Eating adequate healthy fat and abstain from trans fats and vegetable oils
Support detoxification pathways and hydrate properly
Taking supplements proven to help with PCOS symptoms (such as Myo-insitol, Magnesium, Berberine and Fish oils)
Plug in nutritional deficiencies – especially vitamin D, B’s, zinc, and Ferritin
Discuss with your practitioner how to balance your Estrogen dominance using Calcium D-Glucarate, DIM, Curcumin, and lowering testosterone using: Zinc, Saw Palmetto, Resveratol.
*All these tips are general - for a more personalized approach please discuss with your practicioner.
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