Dr. Tina's Blog

The Real Deal with PCOS

PCOS

PCOS, Polycystic Ovarian Syndrome, is a disorder that stems from a young woman’s inability to produce enough estrogen. There, I’ve said it!

I’ve read many articles about PCOS, and while many of them explain in detail the signs and symptoms, none of them are providing definitive treatment for the underlying problem. That is because the core deficiency is never addressed. The fundamental fact is that in PCOS the estrogen-progesterone-testosterone axis is completely unbalanced. This needs to be recognized and treated by the practitioners. Identify the cause and you will find the remedy!

{ This article first appeared on MindBodyGreen.com }

In women with PCOS, the ovaries appear to make more androgens than normal. Androgens are male hormones that females also make. High levels of these hormones affect the development and release of eggs during ovulation.

Insulin and cortisol (both are hormones) are also linked to PCOS. Insulin controls the change of sugar, starches, and other food into energy for the body to use or store. Many women with PCOS have too much insulin in their bodies because they have problems using it and because of Progesterone irregularities.

Excess insulin appears to increase production of androgen. High androgen levels looks like this:

  • Acne
  • Excessive hair growth
  • Weight gain
  • Problems with ovulation

The symptoms of PCOS can vary in type and severity from woman to woman. Below is a list of commonly know symptoms:

  • Infertility—Not able to get pregnant because of not ovulating, in fact, PCOS is the most common cause of female infertility.
  • Periods—Infrequent, absent, and/or irregular menstrual periods
  • Hair—Hirsutism, or increased hair growth on the face, chest, stomach, back, thumbs, or toes. Male-pattern baldness or thinning hair.
  • Skin — Acne, oily skin, or dandruff. Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black.
  • Weight gain or obesity, usually with extra weight around the waist
  • Skin tags — excess flaps of skin in the armpits or neck area
  • Ovarian Cysts
  • Pelvic pain
  • Anxiety or depression

The ovaries, where a woman’s eggs are produced, have tiny fluid-filled sacs called follicles, or cysts. As the egg grows, the follicle builds up fluid. When the egg matures, the follicle breaks open, the egg is released, and the egg travels through the fallopian tube to the uterus (womb) for fertilization. This is called ovulation.

In women with PCOS, the ovary doesn’t make all of the hormone (ESTROGEN) it needs for an egg to fully mature. The follicles may start to grow and build up fluid but ovulation does not occur. Instead, some follicles will remain as cysts. Therefore, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman’s menstrual cycle is irregular or absent—plus, the ovaries make male hormones, which also prevent ovulation. In a nutshell, no estrogen, poor progesterone, testosterone takes over.

Does PCOS get better at menopause?
Yes and no. Some of the symptoms and signs will lessen in severity. That does not mean that the core-underlying problem is gone. When the sex hormone balance is not addressed—PCOS increases risk for diabetes, which will increase risk for heart attack and stroke. PCOS patients have higher incidence of endometrial cancer, post-menopausal. PCOS patients, post-menopausal, have higher than normal risks for dementia, osteoporosis, and degenerative joint disease.

PCOS can be treated. Yes, it can!

1. Hormones. Replace the estrogen with Bio-identical Estradiol. Do this in a cyclical fashion. Provide progesterone too. Fix the cycle, and the testosterone levels will go down. Do for the body what the body is unable to do for itself.
2. Diet. Limit processed foods and foods with added sugars. I believe all diets should be whole food, unprocessed, and as green and raw as possible. Adding more whole-grains unprocessed, raw fruits, raw vegetables, and lean protein to your diet. This helps to lower blood glucose (sugar) levels, improve the body’s use of insulin, and normalize hormone levels in your body. Even a 10 percent loss in body weight can restore a normal period and make your cycle more regular. This is mostly true for women with PCOS of a lesser degree. For overall health, this is a smart diet plan.

3. Medication. The medicine Metformin (Glucophage) is used to treat type 2 diabetes. It has also been found to help with PCOS symptoms, although, it isn’t approved by the U.S Food and Drug Administration (FDA) for this use. Metformin affects the way insulin controls blood glucose (sugar). It slows the growth of abnormal hair and, after a few months of use, may help ovulation to return. Recent research has shown metformin to have other positive effects, such as decreased body mass and improved cholesterol levels. I have seen many cases of PCOS progress to Gestational Diabetes and Type II Diabetes. I always use Metformin as early as possible.

I also find that the earlier a controlled and cycled Bio-Identical Hormone Replacement program is implemented, the easier it is to control cortisol and insulin; therefore, halting progression towards diabetes.

My beautiful PCOS ladies, it is not all in your head, and this condition is not your fault. Find a practitioner that is well versed in cyclical Bio-Identical Hormone Therapy. Recreate your cycles. Create hormonal harmony within your bodies. For some it may be easier than for others, but do not despair.