What is PCOS?

Are you one of the 12-18% of women with PCOS?  Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in reproductive aged women – it is estimated 12-18% of Australian women have PCOS.  You might experience one or more of these symptoms if you have PCOS:-  Excessive hair growth in areas which are unusual for women and common for men such as the face or chest, the medical name for this is hirsutism.  Acne – like hair growth this can be a sign of excess levels of hormonal androgens.  Overweight / obesity – around 40% of women with PCOS are overweight.  Menstrual irregularities – a history of irregular periods where the length of a menstrual cycle can be short, e.g. less than 21 days (sometimes with periods of no ovulation) or long cycles, e.g. more than 35 days. It is estimated that menstrual irregularities effects 90% of women   Abnormal bleeding patterns – a third of PCOS women have abnormal menstrual bleeding patterns.  Fertility issues – a failure to ovulate regularly, 70% of women with PCOS develop infertility.  Prediabetes – 50-70% of women with PCOS have insulin resistance and metabolic syndrome.  PCOS symptoms often start in teenage years with menstrual irregularities, and change over time with infertility and signs of androgen excess (male pattern hair growth and acne) and weight issue. This can then lead to insulin resistance and the progression into type 2 diabetes, which can lead to cardiovascular health issues.  Your health care practitioner is likely to investigate further with the following tests:-  Blood test – measure free testosterone and also likely to check the function of your thyroid and pituitary by looking at TSH, prolactin and FSH levels. A check of blood glucose, insulin and blood lipids would be likely also, as these can elevate in PCOS.  Vaginal ultrasound – in women over 18 years to check for polycystic ovaries, however this alone is not enough for a diagnosis as it is a common presentation especially in young women.      So why does it happen?  It’s thought to be a mix of hormonal and metabolic dysfunction causing a dysregulation in ovarian function. Certain factors like lack of exercise, poor diet, obesity, genetic predisposition, smoking, steroid drug use can heighten insulin resistance and the likelihood of PCOS. Also, stress can exasperate it, as it effects hormonal dysregulation, cortisol and blood regulation.  One interesting theory is that PCOS is a result of a ‘thrifty gene’, which in times of food shortage would provide an advantage (increasing muscle strength, moderate abdominal fatness and decreased insulin sensitivity), the trouble is in times of unlimited food supplies and a sedentary lifestyle (a norm for many) a negative response is the result leading to the modern presentation of PCOS.     Management of PCOS  The presentation of PCOS can vary greatly from woman to woman; therefore the management of PCOS will vary greatly too. There are advantages in an integrated approach - involving both your GP and naturopath, specialist referral might also be necessary e.g. endocrinologist or fertility specialist.    Further resources  Jean Hailes for Women’s Health –  www.jeanhailes.org.au  If you think you might have PCOS and would like a naturopathic approach, call us on 02 9976 5466 for a consultation.    Next SeedPod News:  A Naturopathic perspective on treating PCOS.