Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) is the most common reproductive endocrine disease among women of childbearing age. It impacts many young women. In fact 5-10% of teens and young women have this diagnosis. Symptoms of PCOS may begin shortly after puberty, but can also develop during the later teen years and early adulthood. Because symptoms may be attributed to other causes or go unnoticed, PCOS may go undiagnosed for some time.

Women with PCOS typically have irregular or missed periods as a result of not ovulating. Although some women may develop cysts on their ovaries, many women do not.
Other symptoms include:
• Weight gain. About half of women with PCOS will have weight gain and obesity that is difficult to manage.
• Fatigue. Many women with PCOS report increased fatigue and low energy.
• Unwanted hair growth (also known as hirsutism). Areas affected by excess hair growth may include the face, arms, back, chest, thumbs, toes, and abdomen. Hirsutism related to PCOS is due to hormonal changes in androgens.
• Thinning hair on the head. Hair loss related to PCOS may increase in middle age.
• Infertility. PCOS is a leading cause of female infertility. However, not every woman with PCOS is the same. Although some women may need the assistance of fertility treatments, others are able to conceive naturally.
• Acne. Hormonal changes related to androgens can lead to acne problems. Other skin changes such as the development of skin tags and darkened patches of skin are also related to PCOS.
• Mood changes. Having PCOS can increase the likelihood of mood swings, depression, and anxiety.
• Pelvic pain. Pelvic pain may occur with periods, along with heavy bleeding. It may also occur when a woman isn’t bleeding.
• Headaches. Hormonal changes prompt headaches.
• Sleep problems. Women with PCOS often report problems such as insomnia or poor sleep. There are many factors that can affect sleep, but PCOS has been linked to a sleep disorder called sleep apnea. With sleep apnea, a person will stop breathing for short periods of time during sleep.

PCOS is caused by an imbalance in the hormones secreted by the pituitary gland that in turn affects the ovaries.

Many women/girls with PCOS also have higher than normal levels of insulin from the pancreas.

PCOS usually happens when the luteinizing hormone (LH) levels or the insulin levels are too high, which then causes the ovaries to make extra amounts of testosterone. Normally:
1. The pituitary gland in the brain makes the hormones luteinizing hormone (LH) and follicle stimulating hormone (FSH).
2. After getting the signal from the hormones LH and FSH, the ovaries make oestrogen and progesterone, the female sex hormones.
3. All normal ovaries also make a little bit of the androgen testosterone, a male sex hormone. The pancreas is an organ that makes the hormone insulin. High levels of insulin can also cause the ovaries to make more of the hormone testosterone.

PCOS can result in a number of symptoms I have addressed just a couple below.

PCOS and irregular menstrual cycles?
Normal menstrual cycle:
1. The menstrual cycle starts when the brain sends LH and FSH to the ovaries. A big surge of LH is the signal that tells the ovaries to ovulate, or release a ripe egg.
2. The egg travels down the fallopian tube and into the uterus. Progesterone from the ovary tells the lining of the uterus to thicken.
3. If the egg isn’t fertilized, the lining of the uterus is shed and the menstrual period will start.
4. After the menstrual period, the cycle begins all over again.

Having PCOS means that your ovaries are not getting the right (hormonal) signals from the pituitary gland.

1. LH and FSH message is not sent to the ovaries.
2. With PCOS, LH levels are often high when the menstrual cycle starts. The levels of LH are also higher than FSH levels.
3. Because the LH levels are already quite high, there is no surge. Without this LH surge, ovulation does not occur, and periods are irregular

PCOS and Acne
Acne and extra hair on the face and body can happen if your body is making too much testosterone. All women make testosterone, but with PCOS, the ovaries make more testosterone than they are supposed to. Skin cells and hair follicles are extremely sensitive to the slight increases in testosterone found in young women with PCOS, which contributes to excess hair growth in areas such as the upper lip, chin, sideburn area, chest, and stomach.

Research carried out at South Australia’s University of Adelaide and published in The Lancet in 2007 has predicted that the global scale of this disorder, which currently affects 1 in 15 women (of reproductive age), is set to worsen, as obesity rates continue to soar. Still some women who are a normal weight may have PCOS. Many teens effected by PCOS may become distressed with how the symptoms impact their life and self-esteem.

From a clinical perspective, nutrition has much to offer. Whilst every case is unique, and requires an individualized and multi-factorial approach, effective treatment protocols commonly centre around the nutritional support of these key areas:

• Weight management
• Blood sugar balance and insulin function normalization
• Hormone balance
• Ovarian health support

Patients often experience significant improvement in symptoms when these areas are addressed with targeted dietary strategies and supplementation with specific nutrients and botanicals.

If you have 2 or more of the symptoms listed above, I recommend being tested for PCOS. Or at least discuss with a health care professional. If you have been diagnosed with PCOS addressing the nutritional support of key areas with a trained health professional may be key to addressing symptom management and underlying causes.