Polycystic Ovary Syndrome
Overview
Polycystic ovary syndrome (PCOS, also known as Stein-Leventhal syndrome) is a hormonal imbalance that causes irregular menstrual periods, weight gain, increased body hair, breast shrinkage, acne, infertility, diabetes, high blood pressure and cardiovascular disease. Some women with PCOS also have darkened skin on the nape of the neck, armpits, inner thighs, vagina and beneath the breasts.
Each month follicles grow on a woman’s ovaries. When the follicles do not develop properly they can turn into cysts on the surface of the ovaries, which, if accompanied by an imbalance of hormones, can lead to polycystic ovary syndrome, or PCOS.
Normally, several follicles develop per cycle on the ovaries’ surface. A single egg matures more quickly in one of the follicles than in the others, and that egg is then released into the Fallopian tube. The remaining follicles die away.
In women with PCOS, a number of undeveloped follicles remain on the surface of the ovaries, giving the ovaries the appearance of being enlarged. Typically, this does not cause a problem – many women have this condition, have regular menstrual cycles and do not have issues in becoming pregnant.
Symptoms
However, for those women who also have higher-than-normal levels of certain sex hormones, such as androgens (male hormones, including testosterone) and luteinizing hormone (LH), they are said to have polycystic ovary syndrome, a condition that can trigger such symptoms as absent or irregular periods, excess hair, acne, and weight gain.
Causes of PCOS
PCOS and its causes continue to confuse even the experts who specialize in this condition. Although there seems to be a genetic and hereditary link for PCOS, many of the problems which occur stem from the fact that the ovaries do not produce hormones in the proper proportions. The pituitary gland then receives the message that the ovaries are not working as they should be and it releases even more LH.
Women who suffer from PCOS frequently have more problems with blood-sugar swings, which causes the pancreas to release more insulin, which then alerts the ovaries to produce more testosterone. The liver and adrenal glands are also affected, producing more male hormones in the system. At this stage, a vicious cycle is in control.
Diagnosis
Any woman who believes she may have PCOS should see a physician as soon as possible to help prevent long-term complications associated with this condition, such as diabetes and infertility. If the following tests confirm the presence of PCOS, the patient may be referred to a doctor who specializes in endocrinology (hormones) or to a gynecologist.
An ultrasound scan may be used to establish the presence of undeveloped follicles on the ovaries. Blood tests can also be performed to check levels of follicle-stimulating hormone (FSH) and LH, androgens, and sex-hormone-binding globulin (SHGB). High levels of androgens or LH and/or low levels of SHGB indicate a problem may be present. Not all of these hormones need to be imbalanced to have PCOS. One of them plus polycystic ovaries indicate PCOS is present.
Conventional Treatments
Because PCOS is mainly a problem with balancing the body’s hormones, the first step in treatment may be hormone treatments. For those women who are not planning on becoming pregnant any time soon, an anti-testosterone pill may be prescribed to eliminate some of the “male” symptoms that may be present. However, this pill does not treat the cause.
For women trying to become pregnant, clomiphene citrate may be used. This drug stimulates ovulation but can also hamper a woman’s ability to carry a baby to term.
Insulin sensitizers are often recommended, as there seems to be a link between PCOS and insulin resistance. Most women are offered the drug metformin. This is a powerful medication that causes upset stomach in up to a fifth of the women who use it.
As a last resort, a physician may turn to surgery to perform a laparoscopic ovarian diathermy, also known as ovarian drilling. The procedure is used to reduce the estrogen level, thus stimulating the release of an egg from the ovaries. While this type of surgery works in the short-term, it is likely the PCOS will return.
Natural Treatments
As in many conditions, there is overwhelming evidence that diet can play a significant role in the management of PCOS. For a natural approach, try a healthy diet for six months. If no improvements are noted in this time frame, see a physician.
For those women who are overweight, it is important to bring the weight down to a height-appropriate level. Being overweight causes insulin levels to rise dramatically increases the symptoms of PCOS. Losing weight will result in the lowering of insulin levels, as well as testosterone levels. An increase in exercise should also take place.
Eating habits should be adapted to keep the blood-sugar levels on an even keel throughout the day. If the adrenal glands are always over-stimulated by sugar highs and lows, too much adrenaline (the stress hormone) is produced. More androgens are also produced, which can completely prevent ovulation.
For this type of treatment, avoid eating just three meals a day: try to break the meals down into six smaller, well-balanced meals.
Phytoestrogens should also be eaten. These include chickpeas, soya and lentils. Such foods control the levels of testosterone in the blood.
Many supplements can also aid in fighting this condition. They include:
- B-complex vitamins – A deficiency in the B vitamins can worsen the symptoms of PCOS.
- Chromium – Low levels of chromium are known to trigger insulin resistance.
- Magnesium – Adequate magnesium levels are required for controlling blood sugar and insulin levels.
- Zinc – This substance is important for appetite control, as well as insulin regulation and hormonal balance.
- Alpha lipoic acid – This powerful antioxidant releases energy by burning glucose.
- Co-enzyme Q10 – A nutrient that is important for normal carbohydrate metabolism, Co-enzyme Q10 is also vital for the body’s energy.
References
- Canas, M. et al. (2006). Women's health. Barcelona, Spain : Rebo
- Glenville, M. (2010).The natural health bible for women : the complete guide for women of all ages.London : Duncan Baird Publishers
- Jarvis, S.(2009).Women's health for life : medical advice you can trust : symptoms, treatment, prevention. London : Dorling Kindersley
- Northrup,C.(2009). Women's bodies, women's wisdom : the complete guide to women's health and wellbeing. London : Piatkus
- Timyan, J. et al. (1993).The Health of women : a global perspective. Boulder : Westview Press
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