Polycystic ovarian syndrome (PCOS) is the most common endocrine (hormone) disorder in women of reproductive age. PCOS not only impacts fertility but is also associated with a number of different health issues. Many of the long-term health effects of PCOS are even more alarming than its effect on fertility.
Signs and symptoms
Classic PCOS symptoms include polycystic ovaries (multiple cysts on the ovaries that usually look like a string of pearls), irregular or absent menstrual cycles, obesity, and elevated androgen levels. However, not all women with PCOS present with the same symptoms and not all women with these particular symptoms go on to be diagnosed with PCOS.
A comprehensive list of potential symptoms includes:
- History of ovarian cysts
- Polycystic ovaries
- Excessive facial or body hair
- Oily skin
- Heavy and/or painful periods
- Irregular periods
- Absent periods
- Lack of ovulation
- Difficulty getting pregnant
- Recurrent miscarriages
- Mood disorders (such as depression and/or anxiety)
- Thinning hair or loss of head hair
Getting a diagnosis
A diagnosis of PCOS can only be made by a physician. If you feel you have some of the symptoms listed above then you should schedule an appointment with either your general practitioner or OB/GYN.
The diagnosis is typically made when you have at least two out of three of the following criteria and other causes have been ruled out.
- You have irregular, infrequent, or absent periods – this shows that you do not ovulate regularly.
- An ultrasound shows polycystic ovaries.
- Blood tests show you have excess androgens (male hormones).
Tests your doctor may run in order to diagnose PCOS include:
- Pelvic exam
- Ultrasound (usually transvaginal)
- Blood work to check:
- Both male and female hormone levels
- Thyroid function
- Lipid panel
- Glucose Tolerance test
The most well known effect of PCOS is infertility and recurrent miscarriages. This happens due to a hormone imbalance that starts at the very beginning of the cycle. With PCOS the hypothalamus releases a higher amount of gonadotropin-releasing hormone (GnRH), which results in a higher than normal release of luteinizing hormone (LH) and lower follicle-stimulating hormone (FSH). Since LH is already quite high (often higher than the FSH) no LH surge happens. Since the LH surge is what causes ovulation, no LH surge equals no ovulation.
As we’ve discussed time and again, no one hormone can be off without causing a cascade effect. In this case, the higher GnRH causes high LH and low FSH. This in turn leads to increased androgens, lack of egg development, and increased estrogen. The increased androgens and estrogen result in chronic low progesterone levels.
Are you starting to see how all our hormones work together to create balance or imbalance? And why you can’t just fix one hormone and solve the problem?
Other health risks
More than half of women with PCOS will end up with prediabetes or diabetes by the age of 40. This is because of the link between PCOS and insulin resistance.
Insulin is a hormone produced by the pancreas. It’s main job is to signal cells to turn glucose into energy and to control their size. With insulin resistance, the cells become resistant to insulin. As a result, the levels of insulin needed to do the job become much higher. As the pancreas pumps more and more insulin, more glucose is driven into the cells causing more fat to be stored. This is why obesity and difficulty losing weight is so common for those with PCOS. Also, unchecked insulin resistance can, and often does, lead to pre-diabetes and diabetes.
Women with PCOS are at a much higher risk of cardiovascular issues. This is because PCOS is linked to elevated insulin levels and elevated insulin levels are linked to cardiovascular risk factors such as:
- High blood pressure
- High cholesterol
- Low HDL (good cholesterol)
- High triglycerides
- Atherosclerosis – build-up of plaque in the arteries
Endometrial and breast cancer
PCOS is also associated with a possible increased risk of endometrial and breast cancer. This is because of the unopposed estrogen that results from anovulation (lack of ovulation). Excess estrogen is a known risk factor for both endometrial and breast cancer. In fact, one study involving 8155 women with PCOS found these women had over a 17-fold higher risk of developing endometrial cancer than women without PCOS.
Several medical treatments for the symptoms of PCOS exist. None of these are cures, but some can reduce symptoms and lower secondary risks.
Birth control is the most commonly prescribed treatment to regulate the female menstrual cycle, both in PCOS as well as for other reasons. While birth control will help regulate your cycle and may help with some of the other symptoms of PCOS, it will also stop you from getting pregnant and comes with a whole host of other side effects.
Clomid is a medication used to stimulate ovulation. While clomid does not do anything to resolve the PCOS or treat the symptoms, it may help you get pregnant. It’s not a miracle cure though. One study that followed 4,000 cycles of clomid and doing intrauterine insemination (IUI) found the success rates to be:
- 11.5% for women 35-37
- 7.3% for women 38-40
- 4.3% for women 41-42
- 1.0% for women over 42
Outside of birth control, the most prescribed medication for PCOS is Metformin. Metformin is a diabetic medication that is used to decrease glucose production and absorption and increase cell insulin sensitivity. Doctors often prescribe this medication for women with PCOS regardless to whether or not they have insulin resistance or signs of type two diabetes.
Two main problems exist with this medication; 1. Again, it does not solve the underlying issues (hormone imbalance) associated with PCOS. 2. It comes with a very hefty list of side effects. Things such as physical weakness, muscle pain, nausea, vomiting, severe B-12 depletion, chest discomfort, chils, dizziness….on and on.
Diet and Lifestyle
Diet, diet, diet! I know you probably get sick of hearing us say this, but we’ll never BS you. Diet is the single most important thing you can do to restore your hormone balance and improve your chances of getting and staying pregnant.
This is no difference with PCOS. After all, PCOS is just one huge hormone imbalance. Eating to promote blood sugar balance, bring your hormones back in line, support your liver, aid your digestion, better metabolize estrogen, and promote ovulation is the absolute best action you can take to get PCOS under control and improve your odds of conceiving and carrying to term.
Combining the right diet with daily stress management activities and physical activity will take it even further. These diet and lifestyle changes can aid in reducing the chronic inflammation, insulin resistance, irregular cycles, and infertility that are associated with PCOS.
*It is important to note that it typically takes 6 -12 months of consistent diet and lifestyle changes to make real, impactful change if you suffer from PCOS.*
Herbs and Supplements
*Please note, herbs and supplements are not a replacement for diet and lifestyle changes with any condition, including PCOS. Starting an herb or supplement regime without also making the necessary adjustments to your diet and lifestyle will not lead to results.*
We always recommend taking a whole food prenatal vitamin, such as MyKind Organics Prenatal Multi, when trying to conceive. This helps ensure you’re getting the nutrients needed to support a healthy cycle, thick uterine lining, and growing embryo. A good prenatal can also help with any nutrient depletions you may experience from birth control or other medication use.
Research indicates that getting ample magnesium may improve insulin sensitivity, which is a known factor in PCOS. In fact, one study of overweight, insulin resistance patients who took 300 mg of magnesium each evening showed significant improvement in both their fasting glucose and insulin levels.
Chromium is a mineral known to be essential in regulating glucose and insulin levels. Research has shown that 200 mcg of chromium picolinate reduced fasting blood sugar and insulin levels in subjects at a rate comparable to Metformin (a diabetic medication).
Omega-3 Fatty Acids
While we have long known omega-3 fatty acids are good for our health, and our fertility, researchers now also believe they can be beneficial in treating PCOS. Some research has shown that omega-3 fatty acids can reduce androgen levels in women with PCOS. One study actually found that women with PCOS who took 3 grams of omega-3 fatty acids a day for eight weeks were more likely to resume menses and had lower testosterone levels than those who got the placebo.
Click here for a high-quality omega supplement you can try.
Maca is actually a root that is mostly found in the mountains of Peru. It also happens to be a hormone and fertility superfood. Maca is known as an adaptogen and works by balancing estrogen and progesterone in the body, helping to support a natural menstrual cycle. Yellow maca is extremely nourishing for the female endocrine system and is available in both powder as well as capsule form.
Chaste Tree Berry
Also known as Vitex, this herb is incredibly potent and useful when it comes to female fertility and menstruation. Vitex has long been used to treat PMS, irregular menstrual cycles, and infertility. This herb acts directly on the hypothalamus-pituitary-ovarian axis, which is the hormone feedback loop. Because of this, vitex is thought to balance hormones by going straight to the root of the issue.
Did you know one of the most common spices in our cupboard can actually have a significant impact on PCOS. Well, it’s true. The extremely common spice, cinnamon, is well known to reduce insulin resistance in women with PCOS. So go ahead, add some to your recipes or even sprink some in your morning tea or coffee.
Licorice’s medicinal benefits are many and varied. This amazing herb has anti-inflammatory properties, anticancer effects, helps support and protect the liver, aids in maintaining insulin levels, and may help reduce testosterone levels in women with PCOS. Talk about a power-packed herb! You might just want to try adding a cup or two of this tea to your day and see what it does for you.
PCOS is the most common hormone disorder in women of child-bearing age and a major contributor to infertility and miscarriage. While it might be a daunting diagnosis there are many things you can do to reduce or even eliminate the effects and risks of PCOS.
It’s important to first make sure you have an accurate diagnosis. If you haven’t already been diagnosed, schedule an appointment with your doctor to find out what you’re dealing with. If it is PCOS then start taking the steps necessary today to bring it under control. With the right diet and lifestyle, along with the right supplements, you can beat this. Remember, only you have the control to change your future.