POLYCYSTIC OVARIAN SYNDROME (PCOS)

 

What is PCOS?

Polycystic ovarian syndrome is a hormonal disorder that is multifactorial, with its signs and symptoms varying between patients.Common signs and symptoms include:
  • Weight gain / obesity
  • Infertility
  • Irregular or absent menstrual periods
  • Acne
  • Abnormal hair growth on the face and/or body
  • Male pattern baldness
  • Insulin resistance
  • Small cysts on the ovaries
 

What is insulin resistance and what is its role PCOS?

Insulin is a hormone produced by the pancreas, which is secreted in response to glucose in the blood. It allows cells of the body to take in glucose and convert it into energy.  Insulin resistance results when the body does not respond to insulin sufficiently. As a result, the pancreas keeps producing insulin as it attempts to reduce blood sugar.

The excess glucose in the blood is taken up by the liver and converted into fat. PCOS patients are therefore more prone to being overweight, however insulin resistance can still be present in lean patients.

Insulin resistance may also affect the ovaries. High amounts of insulin in the blood may stimulate testosterone production from the ovaries resulting in delayed or absent ovulation. 

How is PCOS diagnosed?

The Rotterdam criteria is used to diagnose PCOS. A diagnosis is made when 2 of 3 criteria have been met:
 
  1. Irregular or absent ovulation: This is often seen in women with menstrual cycles that are greater than 35 days or less than 21 days. It is possible to have irregular or absent ovulation with regular menstrual cycles.
  2. High androgen levels: This can be present through clinical symptoms (acne, face or body hair growth, and male pattern baldness) or measured through lab testing
  3. Polycystic ovaries as seen on transvaginal ultrasound: This occurs when an ovary contains at least 12 enlarged follicles or an ovary has a volume of greater than 10 centimeters.
Other diagnoses that could cause irregular/absent of ovulation or high androgen levels must be excluded. 

It is important to note that based on these diagnostic criteria, it is possible to have polycystic ovarian syndrome without having cysts on the ovaries.

Naturopathic Treatment for PCOS:

  • Weight loss support: Weight loss is particularly important in PCOS in those that are overweight or obese. This alone may restore ovulatory function in women with PCOS.
  • Reducing insulin resistance: Accomplished through dietary changes, exercise, in addition to supplemental support. Exercise is beneficial in managing insulin levels regardless of weight.
  • Reducing androgen levels: When androgen levels are reduced, symptoms such as acne, excess hair growth, and male pattern baldness will improve.
  • Evaluating and correcting other hormonal imbalances: Some women with PCOS may experience high estrogen and low progesterone ratios, thyroid dysfunction, and adrenal fatigue. These hormonal imbalances need to be corrected as part of the overall PCOS picture.
These treatments should subsequently lead to improvement in ovulation, the regularity of menstrual cycles, and fertility.  

Why seek advice from a Naturopathic Doctor for PCOS:

  • An ND will be able to investigate your hormonal imbalances to determine whether or not you have PCOS.
  • PCOS is a multifactorial syndrome and therefore an ND will customize the treatment plan to your individual needs. Treatment may include supplements, acupuncture, and dietary or lifestyle changes. An ND will check supplement interactions with current medications before prescribing to ensure there are no interactions.
  • Hormone testing can be ordered through a ND to identify imbalances that may be contributing to symptoms.
  • An ND will be able to help the patient prevent common sequelae of PCOS including metabolic syndrome and type 2 diabetes. PCOS patients are at higher risk of developing these conditions.