Poly cystic ovarian syndrome, often abbreviated to PCOS, is a common female hormonal disorder. It is characterised by irregular periods (or even no periods for some women), reduced fertility, polycystic ovaries, acne, hirsutism (increased hair growth especially on the face). There is a strong connection with insulin resistance (see the following blog) which is associated with obesity, type 2 diabetes, and dyslipidaemia (elevated cholesterol and triglyceride levels). PCOS is diagnosed based on the presence of features noted above, blood tests, and a pelvic ultrasound that may demonstrate the polycystic ovaries. It should be noted that not all women with this condition will show polycystic ovaries on ultrasound.
During the normal cycle, the pituitary gland releases follicle stimulating hormone (FSH) and luteinising hormone (LH) that act upon the ovaries. Immediately after a woman has her period the FSH stimulates the ovaries to produce more egg follicles and ultimately one follicle becomes dominant. A peak of oestrogen at day 12 then typically causes a peak of LH which results in release of the egg on day 14 of the cycle and subsequent development of the corpus luteum. Following this, progesterone levels rise in preparation for conception. If conception does not occur then hormone levels fall and the cycle starts all over again with another period.
PCOS develops when either an excess of LH is produced by the pituitary gland or there are increased levels of insulin (hyperinsulinaemia). This results in excess production of testosterone by the ovaries. This hormonal disturbance results in the egg follicle failing to mature. The follicle then becomes a cyst and the normal increase in progesterone that should happen at this stage fails to occur. The hypothalamus in your brain notes the lack of progesterone that follows ovulation and sends a message to the pituitary gland to send a message to the ovaries. The ovaries then produce more oestrogen and testosterone so that more follicles can be produced in the hope that they will produce an egg and the cycle is repeated producing more cysts resulting in poly cystic ovaries.
So what causes these dysfunctional follicles?
- Genetic disposition
- Poor nutrition (too many processed carbohydrates contribute to insulin resistance)
- Lack of exercise
- Stress (high levels of cortisol – see cortisol post at www.antiageingdoctor.com)
- Oestrogen dominance with a relative low progesterone.
What can you do about it:
- Follow a very strict Paleolithic diet (see insulin handout). Absolutely nothing made from any flour (except coconut flour) and no sugars (except for coconut sugar which doesn’t spike your blood sugar levels).
- Exercise most days, preferably first thing in the morning. This is when your cortisol levels are at their peak and you can take advantage of this (see post on cortisol on Antiageingdoctor.com)
- Modify / manage your stress levels to prevent your cortisol from becoming too elevated.
- Visiting your anti-ageing specialist who can help you balance your hormone levels.