Understanding The Polycystic Ovarian Syndrome
Most women are absolutely overwhelmed when they first get the diagnosis Polycystic Ovarian Syndrome. Doctors usually do not have enough time to explain what exactly PCOS is and what it means to live with this syndrome leaving women frustrated, confused and scared. In order to treat PCOS correctly, it is important to understand the disorder first. Education is the key and in this post I will talk about what PCOS means to me and how I am keeping my symptoms under control. This post is part of a PCOS series which will hopefully help a lot of women to regain control of their bodies.
The Polycystic Ovarian Syndrome is an endocrine disorder which means that it influences the hormones in the female body. The endocrine system is a collection of several different glands such as the pituitary gland, thyroid gland, parathyroid glands, adrenal glands, pancreas and ovaries. These glands are responsible for many different functions in the body: reproductive organs, metabolism, mood, sleep, body temperature and insulin levels. Once the body’s hormone system gets out of balance there is a variety of symptoms that women experience, which I will explain later in this post.
Women with PCOS are often struggling to get a diagnosis for two reasons: doctors are either not aware of PCOS or the patient does not report all of the symptoms, thinking that they are normal or maybe even being embarrassed to talk about them. Doctors are slowly becoming more aware of PCOS worldwide, which is now leading to some women being diagnosed for simply not having a regular cycle and being obese. When diagnosing PCOS there are three factors that should be looked at, called the Rotterdam criteria. According to the Rotterdam criteria women should have at least two out of three symptoms to be diagnosed with PCOS:
1. Amenorrhea (absence of menstruation) and anovulation (absence of ovulation)
2. Polycystic ovaries (having a minimum of twelve cysts on each ovary, 2-9mm.)
3. Hyperandrogenism (excessive levels of androgens, such as testosterone)
When trying to get a diagnosis there are several different doctors that are worth seeing to get a blood test and ultrasound. A gynaecologist is specialised in womens’ reproduction organs and most of them are able to diagnose PCOS. The gynaecologist can do the vaginal ultrasound where the ovaries are checked for immature follicles, however according to the Rotterdam criteria is also possible to have polycystic ovarian syndrome without having actual cysts. The gynaecologist can also give an referral to an endocrinologist. An endocrinologist is a hormone specialist who focusses on endocrine disorders and women’s health including infertility and menstrual problems. The endocrinologist can order blood or saliva hormone tests checking all the sex hormones to confirm hyperandrogenism. Consulting a reproductive endocrinologist may even be a better choice as they are specialised in female hormones. When trying to conceive it is also good to see a reproductive specialist.
There are many different symptoms that come with PCOS and most women only have a combination of symptoms, but not all of them. Some of the most common symptoms with PCOS are:
1. Polycystic ovaries
2. Irregular or no periods
3. Infertility caused by irregular or no ovulation
4. Easy weight gain and obesity caused by an insulin resistance
5. Acne and oily skin
6. Excessive hair growth on the face, chest and back
7. Thinning hair and hair loss
8. Skin tags
Less common symptoms are:
1. Fatty liver
2. Sleep apnea
3. Abnormal uterine bleeding
4. Cardiovascular issues
5. Type 2 diabetes
6. Darkening skin areas on neck
7. Painful abscesses in the groin
8. Endometrial cancer
Many women only seek help once they are trying to conceive, however leaving the symptom untreated can lead to severe problems. Women with PCOS have an increased risk of cardiovascular disease, uterine cancer, insulin resistance and type 2 diabetes. The increased risk for all these conditions makes it so important to manage the symptoms.
Unfortunately the exact cause of the endocrine disorder is unknown, some researches believe that it is a genetic defect which can be triggered by an unhealthy lifestyle and other environmental factors. There is no cure for PCOS, but it is possible to manage the symptoms with either pharmaceutical medicine, a natural approach or a combination of both.
Due to the possibility of side effects I personally prefer to treat my PCOS with completely natural supplements, a healthy diet and exercise, however there two different medicines that are most commonly prescribed: the birth control pill and metformin.
I highly advise against taking the birth control pill, the synthetic hormones may cover up the symptoms temporarily, however they will cause a lot of issues longterm. The risks associated with taking the birth control pill are digestive issues, bad gut health, blood clots, increased insulin resistance and an increased risk of a heart attack or stroke. To find out more about PCOS and the birth control pill click here.
Metformin is a medication that is usually used to treat diabetes. It is prescribed to women with PCOS because it helps to regulate insulin. Combined with a healthy diet and exercise, metformin can help to lose weight, lower blood pressure and decrease testosterone levels. A lot of women report a vitamin B12 deficiency, so it is important to monitor the body’s vitamins closely while taking it.
Women who are trying to conceive are prescribed clomid and provera.
Clomid is commonly used for women with or without PCOS who are unable to conceive. This drug works by blocking oestrogen receptors and causing the pituitary gland to secrete high levels of follice-stimulating hormone. The success rates of clomid are fairly high and it is often prescribed in combination with metformin.
Provera contains the female hormon progestin which is similar to progesterone. Progesterone is responsible for ovulation, for implantation of the fertilized egg in the uterus and for maintaining pregnancy. Instead of taking provera orally I recommend using bio-identical progesterone cream, which does not harm the liver. I have had good experience with Ona’s 10% progesterone cream and now foods unscented 20 mg cream sold on iHerb.
I am treating my PCOS symptoms with all natural remedies, as this is what works best for me. A combination of good food, herbal supplements and a healthy lifestyle has helped me to overcome infertility and regulate my periods. There are three different factors which have a huge impact on the severity of the symptoms: diet, exercise and environmental toxins.
When it comes to diet everyone has their own personal preference which works for them. Three of the most popular PCOS diets are a ketogenic diet, lowcarb diet and a plant-based diet. I am doing very well on a plant-based diet without refined sugar, simple carbohydrates and processed foods. When starting any diet it is good to rule out food intolerances and allergies first. A lot of people are sensitiv to dairy, wheat and gluten. It is also important to keep the gut healthy, so all of the nutrients can be absorbed properly. This can be achieved by eating probiotic foods, such as sauerkraut, kimchi, pickles, miso, kombucha and water kefir.
Daily exercise is important to keep body and mind healthy, just like the diet not everything works for everyone. Some women may do well doing a short walk every day, others enjoy lifting weights. I enjoy doing light yoga sessions and going for regular walks.
Another important factor are endocrine disrupters, which are chemicals that interfere with with the human hormone system. Environmental toxins are directly related to reproduction issues, cancer development, thyroid issues and obesity. I started by banning all bisphenol-A containing plastic items from my household. I only use all natural and organic cleaning and hygienic products and eat as much organic food as possible, to avoid pesticides.
Throughout all of it, it is important to stay positive and relaxed. Eliminating all stress factors is not realistic, so it is good to have natural destressers such as a relaxing hobby, yoga or meditation. I let my PCOS diagnosis take over my life thinking that I will never be able to have children. After doing extensive research I decided to take things into my own hand. I realised that nobody is responsible for my health, except for myself and I make sure to take the best care of my body.