Polycystic Ovarian Syndrome is a condition that affects women’s hormones.  It affects 8-13% of women of reproductive age worldwide and up to 70% of women go undiagnosed.

What are symptoms of PCOS?

If you are tracking your symptoms in your Agenda. app, you’re already one step ahead! Some of the symptoms you may be tracking are:

• Irregular menstruation or absent menstruation
• Obesity/weight gain
• Hirsutism (hair growth) on face, chest, abdomen
• Hair loss
• Fatigue
• Acne 
• Oily skin
• Thick, dark skin patches (acanthosis nigricans)
• Multiple fluid-filled sacs in ovaries (cysts)
• Infertility

How is PCOS diagnosed?

Must have TWO out of the following THREE criteria:

• Hyperandrogenism (high androgens–testosterone and/or DHEA). These particular hormones are more male-like.  They can cause hair growth in unwanted places on a woman and  male-pattern baldness.
• Ovulatory dysfunction. Anovulation or ‘lack of ovulation’ which is defined as fewer than 10 menstrual cycles a year OR cycles that are 35 days long or longer. You can still have regular cycles (every month), but if they are longer than 35 days this could indicate PCOS
• Polycystic ovaries. “Presence of 12 or more follicles in each ovary measuring 2–9 mm in diameter, and/or increased ovarian volume (>10 mL)”

There are 4 Types of PCOS:

Type A: delayed ovulation, hyperandrogenic and polycystic ovaries on ultrasound

Type B: delayed ovulation, hyperandrogenic, with normal ovaries on ultrasound

Type C: hyperandrogenic, with polycystic ovaries on ultrasound, with regular ovulation

Type D: delayed ovulation, with polycystic ovaries on ultrasound, without androgenic signs

Think you have PCOS?  What tests do you ask your doctor for?

• Insulin 
• Estradiol
• LH
• FSH
• Progesterone
• DHEA-s
• Testosterone, Free & Total
• Anti-Mullerian Hormone (AMH)–caution–can be pricy
• Sex Hormone Binding Globulin (SHBG)
• Transvaginal ultrasound
• *Make sure to have labs tested on cycle day 19, 20 or 21 if you are menstruating

What can you do if you have PCOS?

The most common conventional treatment is metformin, but by the same token, it does not treat the cause.  It’s simply a bandaid.  Here are some steps you can take to reverse your PCOS–yup, it can be reversed.

1. Treat the gut.  The best way to support this is to clean up the diet.  Reduce inflammatory foods (gluten, dairy, sugar, processed foods, alcohol).  Given that inflammation drives PCOS, it can make symptoms worse.  Consider a food sensitivity test to see which foods you are sensitive to and then begin an elimination diet.  
2. Support stress.  Let’s face it–we all have stress.  It’s unavoidable, but what’s important is how we manage stress.  If you perpetually stressed out, this is likely affecting your cortisol levels, our stress hormone.  Cortisol causes insulin to rise which causes androgens to rise.  Say hello to weight gain and acne in addition to feelings of burnout and fatigue. After all, this also can lead to anxiety and depression.  
3. Create a healthy environment.  Get rid of the junk.  Next time you need new detergent, dish soap, shampoo, toothpaste, soup or makeup–take a look at the ingredients.  A good reference for this is ThinkDirty, the Environmental Working Group or Yuka.  Many chemicals can influence our hormones–negatively, so it’s important to be aware of what we are putting into our body and on our body and even what we inhale.
4. Eat a balanced diet.  Make sure to eat protein, fat and fiber at each meal.  It goes without saying that if you eat foods that are high in carbohydrates, which is sugar, you are only going to spike your blood sugar, leading to a crash later on….and hurting those hormones.  Not all fats are bad fats.  Aim for foods, such as avocados, nuts, grass-fed butter, olive oil and fiber is extremely important for our gut, liver and hormone metabolism.  Fiber should come mostly from vegetables, fruits and beans.
5. Know you aren’t alone.  It’s estimated that 1 in every 10 women is diagnosed with PCOS and it’s the most common cause of infertility in the United States.  But, it can be treated! We need to get to the root cause, though.  Find a Naturopathic Doctor or Functional Medicine Doctor in your area.