A woman with Polycystic Ovarian Syndrome (PCOS) is often met with the birth control pill, maybe an androgen blocker and then sent along her merry way. Told there is nothing that can be done. Told she will never conceive naturally. And told that it’s just in her genes.
And since she is more likely to experience anxiety or depression at some point in her life, she’ll also likely be offered the opportunity to join the ranks of the 1 in 4 women who are prescribed an antidepressant for a physical condition rather than a purely mental one.
But I’m here to tell you that I work with the exceptions to this conventional narrative every day. A job for which I am grateful for. An opportunity to help women understand their bodies and create lives of vitality that don’t involve drugs.
What exactly is PCOS?
The diagnosis of PCOS is based on clinical diagnosis, which means you need to have the symptoms AND have ruled out other underlying disorders.
Sure, there is a genetic component to PCOS, but that doesn’t mean your fate is sealed. You may have to work a little harder to create hormonal and metabolic balance, but it is entirely possible to do so through nutrition and lifestyle interventions.
Do we know exactly what causes PCOS?
Not quite. It was once thought that this was a hormonal disorder alone with the consequences of the disease progression being solely hormonal— acne, weight gain, excessive hair growth, irregular periods, ovarian cysts, and infertility.
But as we’ve begun to learn more about PCOS it has become apparent that insulin resistance plays a very large role and that PCOS has many metabolic ramifications. This makes a quick fix with birth control without regard for the root cause of the condition downright dangerous.
Insulin resistance is a state in which your cells no longer respond to insulin in the way that they should, i.e. bringing sugar into the cell. With all that sugar left to wander your blood stream, your tissues begin to suffer damage. In short, insulin resistance can lead to type 2 diabetes.
Since insulin stimulates secretion of testosterone in the ovaries, we also see an increase in male pattern hair loss on the scalp, increased hair growth on the face and the rest of the body, and acne.
Insulin also inhibits the secretion of sex hormone binding globulin (SHBG), a protein made in the liver that binds to sex hormones to ensure there isn’t excess available in the body. The increase in testosterone, plus the decrease in SHBG means there is plenty of excess testosterone circulating in the body. So, again, this presents as a hormone-only issue, when it really has roots in a metabolic disorder.
What kind of lab tests are available?
Lab testing can help your doctor make the diagnosis of PCOS, but this is definitely one of those conditions where the lab tests can leave your doctor with the wrong impression.
Luteinizing hormone (LH), Follicle-stimulating hormone (FSH), and Testosterone may be normal, especially if tested at the wrong time of the month. It is a common occurrence for a woman to come to my office stating that her doctor ruled out PCOS with a random hormone test, meaning they did not correlate the lab results to the patient’s menstrual cycle.
That said, these labs can vary, despite getting the labs drawn on the correct day of your menstrual cycle. To make matters even more complicated, not every woman with PCOS will have abnormal hormones or cysts on her ovaries.
Some symptoms of PCOS include:
- Irregular periods
- Long cycles (we’re talking months)
- Facial hair
- Thinning hair
- Hair loss
- Dark skin on the back of your neck
- Adrenal and blood sugar imbalances
- Underlying inflammation
Risks associated with PCOS
What’s more alarming than you missing some periods? Hello heart disease and stroke! (Although if you are not ready for a baby, missing your period may feel like your heart might just stop.)
Now, I’m totally with you when you say, “Dr. Brighten I really want to have a regular period.” If it’s important to you, then it is important to me. And you know what I say: “Fertility is a sign of vitality!”
But here’s the deal, having a regular period is awesome, but having a heart that works and a really high probability it’ll keep working is pretty much necessary for life.
Yes, you can be thin with PCOS AND have heart disease. I have plenty of ladies as patients who are fit and simultaneously struggling with PCOS.
Not only is your heart at risk, but for those who are concerned with fertility, there is a 20-40% increase risk of miscarriage for those with PCOS. (2)
How should you approach treatment?
Well, it’s no coincidence that we are seeing increases in insulin resistance, inflammation, hormonal disorders, autoimmune disease, and PCOS. It all comes down to the root cause and individualized medicine… and a bit of what I’ve been preaching for years— we must take care of our moms!
Your mom’s health influenced your genes. What she served you for dinner, how much play you got, and what habits you carried with you when you left home all had an impact on your current state of health.
No, this is not the time to go call your mom and criticize her. She was operating with the best information she had at the time. (And this is from the gal that was raised on margarine.)
But this all laid the foundation for your health today. And what you do now will make all the difference.
Top 3 Ways to Regulate Blood Sugar and Support Hormonal Health
- Exercise. Moderate exercise in the form of walking, biking, jogging, yoga, and resistance training reduces insulin resistance and helps modulate the stress response. (3) Do be aware, though, that too much exercise can create stress on your adrenal glands leading to blood sugar dysregulation and increased inflammation. If you’re running marathons or powerlifting, you may want to talk about your routine with your doctor.
- Eat regular meals. Keeping your blood sugar well regulated is a key to reversing this condition. And eating regular, whole foods based meals every 3-4 hours can do wonders for your blood sugar. Make sure that every meal contains a balance of healthy fats, protein, and carbohydrates (mostly in the form of colorful veg!). Read 5 Strategies for Balancing Blood Sugar with PCOS.
- Support natural detox. Your body is detoxifying right now. That’s it’s job. It’s our job to support those detox pathways with plenty of filtered water, deep breathing, cruciferous vegetables, and high quality protein. The more we nurture our bodies in these ways, the more inflammation will lessen, arresting the vicious cycle of blood sugar dysregulation → inflammation!
For more natural treatments for great hormones and amazing health, download a free copy of my hormone eBook HERE.
The Hormones Matter
PCOS is more than just a hormonal disorder — it’s a metabolic disorder. But I know the hormonal symptoms can be uncomfortable, embarrassing, and are what often drive women to seek help.
As women, our hormones have a large role to play in how we experience and enjoy life. It is important that you work with a doctor who will help you achieve great hormones, while also taking care to look out for you as a whole person.
I want to share with you a copy of my hormone eBook to help you get on your way to balancing your hormones, improving your health and feeling your best every day.