Understanding Polycystic Ovarian Syndrome (PCOS)

May 7, 2018 0 Comments

One of the most common concerns from young women about their reproductive health is having irregular cycles.  Women are naturally in tune to a basic regularity of the menstrual cycle and when it gets off track, they want to know what the underlying cause is. 

Though there are multiple causes of irregular cycles, one of the most common is a disease called Polycystic Ovarian Syndrome (PCOS), when symptoms manifest that indicate abnormal ovulation patters and cysts on a woman’s ovaries.  Overtime, a lack of ovulation leads to an enlargement of the ovary and the presence of small immature cysts within it; eggs have essentially not been developing and releasing normally.  PCOS comes with significant hormonal repercussions and short and long-term health consequences. PCOS affects 5-10% of women of reproductive age, who suffer significantly from the disrupted endocrine system.

PCOS is the leading cause of infertility.  The body stops ovulating, therefore preventing conception and stopping normal menstruation.  PCOS has additional long-term health consequences including an increased risk for obesity, type 2 diabetes, cardiovascular disease, mood disorders, and a three times higher increased risk of endometrial cancer.[1]

There are also short-term physical and psychological manifestations of this disease can affect a woman’s quality of life.  Physically, PCOS can lead to increased acne, hair loss or excess hair growth (particularly on the face) and difficulty losing weight.  PCOS can also be considered an inflammatory condition because research has shown increased inflammatory markers in women with PCOS (6).  Psychologically, studies have shown that women with PCOS have decreased self-confidence and poor body image, which affects health, relationships, and social life.[2]

Although the cause of polycystic ovaries is unknown, it is thought that both genetic and environmental factors can play a role in the development of PCOS and the disruption of hormonesAnywhere from 30-60% of women with PCOS will have Insulin resistance.[3]

It is likely that the increased insulin is what causes the other hormone disturbances in PCOS, including higher testosterone, lower sex-binding hormone globulin (SBHG), and higher LH levels.  This domino effect of insulin pushing other endocrine hormones off balance is what can lead to a significant disruption in the woman’s cycle.

PCOS can be difficult to diagnose, since not every woman will have the “classic” characteristics of the syndrome. The obesity, acne, hair growth, and irregular, prolonged, or absent cycles are all signs of PCOS, but these signs often present differently across women, and not every woman has every sign. Thus it takes an educated and skilled provider to recognize and correctly diagnose this disease.  There are also different philosophies of treatment that require the careful selection of one’s medical provider.

Women with PCOS are often told they should take birth control pills to regulate their cycle and treat PCOS, which according to research may actually be exacerbating the inflammation problem. A recent study found that the use of oral, transdermal and vaginal birth control impairs glucose tolerance and induces chronic inflammation.[4]

The conventional treatment – use of birth control – is doing little to solve underlying problems and restore a natural cycle.

There are other healthier and more cooperative treatments for PCOS.  Addressing obesity and insulin resistance in PCOS should be the first line of defense.  By therapeutically targeting insulin resistance and obesity through lifestyle modification and medical intervention, the likelihood of normal return to fertility increases while the risk of developing diabetes decreases.[5]

Other treatments include anti-inflammatory diets, bio-identical progesterone, and insulin controlling agents like myo-inositol and metformin, vitamin D, and other vitamin supplementation.  For example, Myo-inositol is one newer treatment for insulin resistance in PCOS.  This is a supplement sometimes referred to as a B vitamin, which has been proven to reduce fasting insulin levels and even improve the acne and hair growth problems in PCOS if taken for 6 months or longer.[6]

Improving insulin sensitization will also lead to improved ovulation so the proper regulation of cycles can occur.  It not only works well, but it also has an much better tolerability profile than other medications to treat insulin resistance, such as metformin, which can lead to stomach cramps and other digestive side effects.

These treatments are not only holistic and healthier than synthetic hormones, but they seek to treat the underlying cause of the disease rather than suppressing the menstrual cycle.

A woman should be empowered to read the signs and language of her own body, so she may be the best advocate for her own health. We recommend that women learn to chart and understand their cycles, as the women’s reproductive cycle reveals hormone and body function and is indicative of overall health and wellness.

Certified Pro Women’s Healthcare Centers ensure knowledgeable providers are trained in fertility awareness based methods which allow for accurate tracking of the menstrual cycle.  Some Pro Women’s Healthcare Centers offer corrective surgery as well, or can point you to surgeons that can help.  There is a procedure called an Ovarian Wedge Resection and it corrects the physical abnormality of a polycystic ovary.  This procedure, offered by NaproTechnology surgeons, has up to an 80% success rate at helping couples achieve pregnancy within 18 months of having the procedure.[7]

A PWHC could be a path towards healing, help, and hope for restoring your lifestyle, your fertility, and your family.

Teresa Kenney WHNP is a Women’s Health Nurse Practitioner who has practiced for the last 18 years in Omaha Nebraska for both the Pope Paul VI Institute and Sancta Familia Medical practice. She is trained as a medical consultant practicing NaproTechnology, which seeks to cooperate with women’s bodies and solve the underlying issues in women’s health. She is a strong advocate for young women to learn about their fertility and their bodies and speaks frequently in her community. She is married to Daniel Kenney and has 8 kids, 5 fish, and a gecko lizard named Gilligan.

 

[1] Cancer risk and PCOS, Daniel A.Dumesica, Rogerio A.Lobob https://doi.org/10.1016/j.steroids.2013.04.004

[2] Amini, L., Valian, K., Sdeghi Avvalshahr, H., & Montaeri, A. (2014). Self-Confidence in Women with and without Polycystic Ovary Syndrome. Journal of Family & Reproductive Health, 8(3), 113–116.

[3] The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 12, 1 December 2007, Pages 4546–4556, https://doi.org/10.1210/jc.2007-1549. and Marin DeUgarte, Catherine & Bartolucci, Alfred & Azziz, Ricardo. (2005). Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertility and sterility. 83. 1454-60. 10.1016/j.fertnstert.2004.11.070.

[4] Oral, transdermal and vaginal combined contraceptives induce an increase in markers of chronic inflammation and impair insulin sensitivity in young healthy normal-weight women: a randomized study. Hum Reprod. 2012 Oct; 27(10):3046-56. doi: 10.1093/humrep/des225. Epub 2012 Jul 18.

[5] Unfer, V., Facchinetti, F., Orrù, B., Giordani, B., & Nestler, J. (2017). Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocrine Connections, 6(8), 647–658. http://doi.org/10.1530/EC-17-0243

[6] Unfer, V., Facchinetti, F., Orrù, B., Giordani, B., & Nestler, J. (2017). Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocrine Connections, 6(8), 647–658. http://doi.org/10.1530/EC-17-0243

[7] The Medical & Surgical Practice of NaProTECHNOLOGY 2004 by Thomas W. Hilgers, M.D.

 

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