Every month, follicles grow on a woman’s ovaries. When the follicles don’t develop properly they can form cysts on the ovaries’ surfaces, which, when accompanied by hormonal imbalance, can lead to PCOS.
In a normal cycle, several follicles develop on the surfaces of your ovaries. In one of those follicles, a single egg matures more quickly than the eggs in the others, and is released into the Fallopian tube. All the remaining follicles then die away. If you have polycystic ovaries, you have a number of undeveloped follicles remaining on the surfaces of your ovaries, making the ovaries appear enlarged. In itself, this isn’t necessarily a problem – many women have polycystic ovaries and have regular cycles and no problems getting pregnant. However, if you also have higher-than-normal levels of certain sex hormones, such as androgens (“male” hormones, including testosterone) and luteinizing hormone (LH), you have polycystic ovary syndrome, a condition that triggers symptoms such as irregular or absent periods, excess hair, and weight gain.
The causes of PCOS continue to perplex even the experts who specialize in it. Although there’s a strong genetic and hereditary link for the condition, many problems stem from the simple fact that the ovaries can’t seem to produce hormones in the correct proportions. The pituitary gland then gets the message that the ovaries aren’t working properly and releases more LH. Women with PCOS often have problems with blood-sugar swings, which cause the pancreas to release more insulin, which in turn targets the ovaries to produce more testosterone. The adrenal glands and liver are then affected, producing more male hormones in your system. All in all, you’re in a vicious cycle.
If you suspect that you have PCOS, it’s important you see your doctor as soon as possible, as early diagnosis can help prevent long-term complications of the condition, such as infertility and diabetes. If, after performing the following tests, your doctor confirms diagnosis of PCOS, you may be referred to a specialist in endocrinology (hormones) or to a gynecologist.
Ultrasound Your doctor may decide to give you an ultrasound scan, which he or she will use to establish whether or not there are undeveloped follicles that remain on the surfaces of your ovaries.
Blood tests Your doctor will perform a blood test to check levels of follicle-stimulating hormone (FSH) and LH, androgens (male hormones), and SHBG (sex-hormone-binding globulin). High levels of LH and/or androgens, and/or low levels of SHGB can indicate a problem. Note that you don’t’ have to have all these hormone imbalance to have PCOS, just one of them, plus the polycystic ovaries that showed on an ultrasound.
There’s no question that it’s crucial to manage PCOS. Your doctor will probably offer you the following conventional treatments.
Hormone treatments As PCOS is essentially a problem with the balance of hormones in your body, it stands to reason that your doctor will offer you some medication to regulate your body’s hormone production. The standard treatment for women who aren’t planning to have a baby is the anti-testosterone contraceptive pill. This drug can help eliminate some of the more “male” symptoms of PCOS, such as acne and excess hair, but it doesn’t treat the cause.
If you’re aiming to get pregnant, your doctor may offer you clomiphene citrate. Most women find that this stimulates ovulation, but it can also hamper your ability to carry your baby to term. Use clomiphene for a maximum of six months. If it’s unsuccessful, your doctor may try medications such as gonadotrophins.
Insulin sensitizers The link between PCOS and insulin resistance means that some doctors prescribe type II diabetes medication to treat PCOS, too. You’ll most likely be offered metformin. For some women, metformin doesn’t work at all; while several studies show that it increases the efficacy of clomiphene, so you may be prescribed both medications. A powerful drug, metformin causes stomach upsets in up to a fifth of the women who take it.
Surgery As a last resort, your doctor may advise a laparoscopic ovarian diathermy, also known as ovarian drilling. The procedure causes your levels of testosterone to fall in the hope that this will stimulate your ovary to release an egg. Although surgery works in the short term, it’s likely the PCOS will return, which is why doctors use it only when all other treatments have failed.
There is overwhelming evidence to suggest that diet plays a significant role in the natural management of PCOS. Therefore, before you go on any medication for the condition, try the nutritional approach to managing it. Follow the nutritional recommendations below for six months (including taking the supplements). If, after this time, you see no signs of improvement (for example, if your hair growth hasn’t slowed down, if your periods aren’t more regular, and so on), go back to your doctor.
If you’re overweight, it’s crucial that you bring your weight down to the appropriate level for your height. Being overweight increases insulin levels dramatically and makes the symptoms of PCOS worse. Losing weight, on the other hand, results in lower insulin levels, which in turn reduce the testosterone levels that are interfering with ovulation. So follow the hormone-balancing diet and increase the amount of exercise you get. Aim to get your BMI in the right range for your age and height.
Adapting your eating habits so you keep your blood sugar levels on an even keel throughout the day is an essential component of the natural approach to treating PCOS. If your adrenal glands are over-stimulated by ever-fluctuating sugar highs and lows, they produce too much adrenaline – the stress hormone – and also too much androgen (male hormone), preventing ovulation altogether. Although in the West, we tend to base our day around “three square meals”, this isn’t the best way to eat if you suffer from PCOS. Try six smaller, well-balanced meals (ideally comprising low-GI foods) a day, instead.
Phytoestrogens Eating foods, such as soy, chickpeas, and lentils, that contain natural estrogens can be beneficial for women with PCOS because phytoestrogens help control levels of testosterone in the blood.
Pregnancy and PCOS
Many women with PCOS can achieve pregnancy following the natural approach. However, never stop taking any prescribed medication without letting your doctor know first and asking for his or her support.
If you’re under 35 Once you stop taking your medication, give your body six months using all the natural advice from the experts. Then stop taking the co-enzyme Q10 and the herbs and start trying for a baby.
If you’re over 35 Follow your doctor’s advice about which medications to take. On top of this, take a reputable multi-vitamin and mineral supplement and follow all nutritional advice from the experts in the industry. DO NOT take the herbs or co-enzyme Q10.