POLYCYSTIC OVARIAN SYNDROME (PCOS)
Sarah had only three periods in the past year and had started noticing more hair on her upper lip and chin. She wrote to me asking if she could have PCOS? And what could natural therapies do to help?
If you have PCOS and are tired of getting no answers, it may be time for a more natural or integrative approach. Read on to find out more about PCOS and ways it can be treated naturally.
WHAT IS PCOS?
PCOS is a complex endocrine disorder characterised by excess levels of male hormones in women, called androgens, and alterations to menstruation and ovulation.
It affects up to 10 per cent of reproductive-aged women and is the most common cause of ovulation issues contributing to infertility.
The main symptoms of PCOS include:
• irregular periods (late, infrequent, too many days of bleeding, heavy or totally absent menstruation)
• acne (not teen acne)
• hirsutism (excess hair on face, belly, nipples)
• hair loss or thinning on the scalp
• polycystic appearing ovaries (numerous follicles and enlarged ovaries)
• weight gain (particularly excess weight carried around the middle)
But PCOS is not just a period problem. It is a whole body hormonal condition that brings anything from annoyance to heartbreak, especially if you’re trying to have a baby. It also has longer lasting health implications that can continue into later stages of life, such as diabetes and cardiovascular disease, therefore getting to the bottom of your PCOS is important.
HOW IS PCOS DIAGNOSED?
Firstly, PCOS cannot be diagnosed with an ultrasound of polycyctic ovaries alone. Yes you can definitely have polycyctic ovaries with PCOS, but they are not specific to a PCOS diagnosis. Only about 20% of women are found to have ovarian follicles (cysts) on ultrasound screening, and of these only 7-8% have PCOS. Normal, healthy women get polycyctic ovaries, as do women on the pill, and teenage girls. You can also have normal ultrasound of ovaries (not polycystic) but still have PCOS. When you see polycystic ovaries, it is likely that you didn’t ovulate that month… but it doesn’t explain why! This is what you need to find out to determine the cause of your PCOS.
The true diagnosis for PCOS is:
- Ovarian disfunction / irregular periods
- Androgen excess on blood tests (not saliva as these aren’t accurate for these tests) or symptoms of increased androgens (hirsutism)
- Other reasons for increased androgens are ruled out – such as the pill, high prolactin levels, or rare pituitary or adrenal issues.
WHAT CAN CAUSE AN EXCESS OF ANDROGENS AND A PCOS DIAGNOSIS?:
1. Insulin resistance – it’s he most common driver of PCOS and 70% of women with PCOS have this. You have insulin resistant PCOS if you meet the criteria for PCOS (irregular periods and high levels of androgens) plus you have insulin resistance. Being overweight is a common symptom of insulin resistance, however you could also be normal weight or even underweight and have insulin resistant type PCOS. The best way to test for this is a fasting insulin test which looks at the hormone insulin – not a blood sugar or blood glucose test.
2. Post-pill PCOS – the pill can actually worsen insulin resistance, and it also obviously suppresses ovulation. For some women it takes months for your period to return, which can cause a PCOS diagnosis. Some pills can even cause an increase in androgens temporarily, contributing to PCOS. There is not a genetic tendency in this case of the ovaries to cause high levels of androgens as in other types of PCOS and it should go back to normal relatively quickly.
3. Inflammatory PCOS – can be driven by inflammation and environmental toxins, which can disrupt hormone receptors and suppress ovulation. It can be caused by smoking, inflammatory foods, environmental toxins and digestive issues. You might also have fatigue, headaches, eczema or psoriasis and joint pain.
4. Adrenal PCOS – if you have none of the above types, and you have normal ovarian androgens, then you may have elevated adrenal androgens (such as DHEAS). If you have high levels of DHEAS on a blood test, then you should rule out any reasons, but once these are ruled out then adrenal PCOS may be the cause. It accounts for around 10% of all PCOS cases and is not driven by insulin resistance or a problem with ovulation – but instead it is caused by the HPA (hypothalamic pituitary adrenal) axis – or more commonly known as our stress response system.
If you don’t think you fit into any of these causes above, then many other things can affect ovulation, lack of periods or contribute to high androgens; including thyroid disease, a vegetarian diet, a reduced carbohydrate diet, undereating, or even a zinc deficiency.
The good news is that once you know the hidden drivers of your PCOS, and these are corrected, your symptoms should improve relatively quickly.
NATURAL TREATMENTS FOR PCOS
Naturopathy for PCOS provides treatment that’s specific to your individual cause. It includes diet and nutritional support, supplements, herbal medicine and lifestyle changes to improve insulin resistance and metabolic function, re-establish hormone balance, regulate menstruation and improve fertility naturally. It also helps to reduce any associated risks such as cardiovascular disease.
Two herbs I use often with PCOS clients are Paeonia lactiflora (Peony) and Glycharriza glabra (Licorice), which in combination help to reduce excess androgens like testosterone, restore ovulation and relieve symptoms such as excess facial hair growth. Liver herbs such as Schisandra or St Marys Thistle are sometimes used too, to improve detoxification of excess hormones from the body.
If you’d like more information on PCOS or if you think you may have it and would like to investigate natural treatments, you can message me or book an appointment at www.wellnesshubeltham.com.au