POLY-CYSTIC OVARIAN SYNDROME (PCOS)

What is PCOS?

Poly-cystic Ovarian Syndrome  is a common  problem.   The way different women experience it is complex and it often associated with insulin resistance. The name  Poly-cystic Ovarian Syndrome is  from the presence of small fluid filled  or cysts which build up  in the ovaries from trapped eggs, which were not  released. In a normal ovary, a single egg develops and is released each month. In PCOS normal ovulation and  release of the eggs  stops and  a  hormonal imbalance occurs.

The ovaries produce 3 hormones- estrogen,  androgens and progesterone. Because ovulation does not happen  often adequate amounts of the hormone progesterone are lacking, but there is plenty of estrogen. This is estrogen dominance and  results in infertility and infrequent menstrual bleeding, or irregular periods.

As a result, the follicle, the fluid filled sac that develops around the egg before it ovulates, fails to develop and it becomes an ovarian cyst. It is the abnormal progesterone level that prevents the follicle from developing. Two more hormones -follicle stimulating hormone (FSH), and luteinizing hormone (LH) - are produced by  the pituitary gland in the brain- then to the ovaries.. The production of FSH and LH becomes irregular and this creates  problems with the other three hormones.

Weight excess will aggravate the hormonal imbalances of PCO  and is often associated with PCOS   and an  increased risk of becoming a Type II diabetic.The excess of male hormones will increase insulin resistance so that blood glucose problems, high cholesterol, and high blood pressure may result.  Women with PCO  usually have higher levels of male hormones  which are produced in their ovaries, adrenal glands and also in their belly/waist  body fat. Therefore it is desirable for women with this condition to avoid carrying middle fat.  If your weight goes up you risk moving from poly-cystic ovaries to the full blown dangerous to health PCO-Syndrome.

What are the symptoms?
The numbers and types of PCOS symptoms vary – among them are-
    •     Excess facial and body hair related to excess androgen production (hyperandrogenism) - this occurs in 70% of women.
    •    Obesity - Approximately 40-70% of PCO(S) patients are overweight round the waist.. .
    •    Period problems -No period happens in half  of patients, and  heavy  bleeding in one third patients; Some have irregular periods, few have normal periods.
    •    Male-pattern hair loss - particularly the temples and crown area.  This is known as androgenic alopecia.
    •    Infertility - Achieving pregnancy is difficult for most women with PCOS.
    •    Poly-cystic ovaries-  women with PCOS have multiple cysts on their ovaries.
    •    Skin discoloration.-Some women with PCOS have dark patches on the skin. 
    •    Abnormal blood chemistry- Women with PCO-S have high levels of low-density lipoprotein (LDL or "bad") cholesterol a and low levels of high-density lipoprotein (HDL or "good") cholesterol, plus high tryglicerides (blood fats)
    •    Hyperinsulinemia - Some women with PCOS have high blood insulin levels.
    •    Acne and other skin problems - Acne is seen in about 1/3 of PCOS patients. This is caused by the increased secretion of sebum stimulated by the excess male hormones. Skin tags, thick lumps of skin that can be small or as large as raisins can form.  
    •    Insulin Resistance or Diabetes

Insulin resistance and PCOS
Insulin resistance is common in PCOS patients, and can occur in both obese and lean patients - it is, however, exacerbated in obese patients.

Insulin resistance is often hereditary and usually made worse by a high carbohydrate diet. Insulin resistance and high levels of insulin stimulate the ovaries to produce androgens and these hormones  may exacerbate the collection of symptoms known as PCOS. This interaction of excessive insulin production and excess male hormone is believed to play a role in the lack of ovulation in susceptible women.

This is the important part to understand-Insulin resistance occurs in the cell. Some types of cells - most commonly muscle and fat - in the body can be insulin resistant, while other types of cells and organs are not. As a result, the pituitary, ovaries, and adrenal glands of an insulin resistant patient will be stimulated by far higher levels of insulin than would be desired, with the consequences of elevated luteinizing hormone and androgens.

The primary role of insulin is to regulate blood sugar levels. After you eat carbohydrates, they will be broken down into glucose and  into the bloodstream. Your pancreas then secretes insulin, which shunts the blood sugar into muscles and the liver as fuel for the next few hours.

However the more abdominal body fat you have, the more insulin your pancreas will pump out per meal, and the more likely you'll develop insulin resistance.  In effect, your cells become insensitive to the action of insulin, and so you need ever greater amounts to keep your blood sugar in check. So as you gain weight, insulin makes it easier to store fat and harder to lose it. Catch 22. To date, the belief is that insulin resistance occurs mainly in muscle, but is also present in the liver in obese women with PCOS.

Insulin resistance leads to elevated insulin levels because the pancreas will pump out more and more insulin to try and force the blood sugar into the resistant cells. Elevated insulin has been shown to stimulate ovarian androgen production as the ovaries retain their sensitivity to the insulin even though the muscles and liver have not.

Excess insulin may also stimulate fat storage and alter cholesterol metabolism leading to elevated cholesterol and triglyceride levels. Because PCOS is such a complex jumble of symptoms and conditions, not all women with PCOS will have insulin resistance - however, for obese sufferers who hold their weight in the abdominal area it is more or less a given.

How will I treat you?
The program I use for PCOS is very effective if you are committed  to follow it. Most women with PCOS are happy to make changes.. Using  natural treatment, including some organic herbs and a few  simple supplements, most PCOS symptoms can be adequately controlled or eliminated. Sometimes some cysts remain. Infertility can be corrected and pregnancy achieved in almost all  women.  The hormonal disturbances and ceasing of ovulation may recur  if you return to old lifestyle and dietary habits.

Because insulin sensitizing medications such as Metformin and hormone pills given by doctors  can create more problems than they cure , I won't treat any woman for PCOS if she is taking these drugs. Also I can't regulate the menstrual cycle naturally while medication is controlling it.  Dietary and lifestyle changes are important  for long term success. 

IUD's if used should be the plain copper coil. Do not use hormonal ones. It is a synthetic hormone – you will likely gain weight and again I cannot regulate your hormones naturally if you use the Mirena

Diet
Dietary changes are vital.
    •    Basically, you need to avoid processed carbs and sweet foods (except fruit) and have protein such as nuts and seeds, low fat cheese, with every meal and snack.
    •    You should  eat only organic poultry and meats free of growth promoting hormones.
    •    PCOS  can be controlled very well with weight loss, lifestyle changes and the use of natural and nutritional supplements.
Introduce buckwheat into your diet it contains very high levels of an important nutrient- .inositol. Why is inositol important? Inositol might help you in two ways.

1)  First, it improves the quality of your eggs. Inositol plays a central role in preparing the egg for successful activation at the time of  fertilization. An inositol deficiency can disrupt the egg's ability to properly mature.

2)  Second, it helps you reduce PCOS symptoms related to insulin resistance. Research is showing that inositol helps insulin to do its job and thus you can reduce insulin resistance.  My  review of the medical research suggests that some  women would benefit by increasing inositol in their diet.

Improving liver function is important and I will give you herbs and hints to help. Also you should limit dairy products - dairy foods contain high levels of antibiotics, steroids and artificial growth hormones, as this is what cows  are treated with in today's factory farm dairies to prevent disease and increase  milk production. As with humans substances go  into the breast milk of cows- only they neglect to tell you this in the advertisements. Organic milk and yoghurt are available and a good choice although soy replacements are fine.

Don't forget to walk or exercise everyday
Meditation is also a helpful practice especially if you are trying to conceive. I can teach you if you wish.

14 Aug 2010

Diana Thurbon Profile | Email | Website Diana Thurbon - Keysborough Clinic - Victoria Cost Effective and Confidential Consultations. Naturopath, Nutrition, Stress management, Lifestyle Advice Specialising in Female Health: Pre-Conception - Fertility - Chronic Conditions I can help you balance hormones, lose weight, have a healthy family, enjoy vibrant health; and get the most out of your life. Keysborough Keysborough VIC Australia 3000 03 9798 6862 - 0400 979 868