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Poly cystic ovaries (PCO)and Poly Cystic Ovarian Syndrome (PCOS) are conditions affecting people with ovaries during their reproductive years.

While these conditions are known for their affect on menstrual cycles, they originate as metabolic disorders affecting insulin sensitivity, which spills into menstruation due to it’s impact on oestrogen.

PCOS is a multifaceted condition, and your experience with it is unique. In this article, we will explore the causes, symptoms, diagnosis methods, the spectrum of PCOS experiences from lean to mean, its impact on fertility and pregnancy, and how to manage PCOS naturally. We’ll also discuss why the birth control pill isn’t a one-size-fits-all solution.

Understanding the Causes of PCOS

Polycystic Ovary Syndrome (PCOS) is a complex condition with a variety of contributing factors:

  • Genetic Factors: There is evidence that PCOS can run in families. If your mother or sister has PCOS, you may be at a higher risk.
  • Hormonal Imbalances: PCOS is characterized by an excess of androgens (male hormones) in the body, which can lead to irregular menstrual cycles and other symptoms.
  • Insulin Resistance: Many women with PCOS have insulin resistance, a condition where the body’s cells don’t respond effectively to insulin. This can lead to elevated insulin levels and increased androgen production.
  • Environmental Factors: Exposure to certain environmental pollutants and endocrine-disrupting chemicals may also play a role in the development of PCOS.

Navigating the Maze of Symptoms

PCOS can manifest in various ways, and not all women will experience the same symptoms:

  • Irregular Menstrual Cycles: Missed periods or unpredictable menstrual cycles are common.
  • Anovulatory cycles: Due to oestrogen dominance ovulation may be suppressed.
  • Miscarriages: PCOS sufferers may experience a higher rate of miscarriage than average.
  • Hirsutism: Excessive hair growth in places like the face, chest, and back.
  • Acne and Oily Skin: Increased androgens can lead to acne and oily skin.
  • Weight Gain, especially around the middle: Many women with PCOS struggle with weight management.
  • Cravings: Poor insulin sensitivity can lead to cravings and binge eating.
  • Mood Swings and Depression: Hormonal imbalances can affect mood.
  • Hair Loss (Alopecia): Thinning hair or hair loss on the scalp.

Methods of Diagnosis: Piecing Together the Puzzle

The Rotterdam criteria, established in 2003 by the Rotterdam Consensus Group, are used in Western medicine to diagnose PCOS and require the presence of at least two out of three of the following features:

  1. Oligo-ovulation or anovulation: This refers to irregular or absent menstrual periods, which may manifest as infrequent periods or complete absence of menstruation (amenorrhea).
  2. Clinical and/or biochemical signs of hyperandrogenism: Clinical signs include hirsutism (excessive hair growth in a male pattern), acne, or male-pattern balding. Biochemical signs involve elevated levels of androgens, such as testosterone, in the blood.
  3. Polycystic ovaries on ultrasound: This criterion is met when an ultrasound examination reveals the presence of polycystic ovaries. Polycystic ovaries typically exhibit multiple small follicles (cysts) in the ovaries.

So you don’t necessarily need to have actual multiple cysts in order to have this condition and not having multiple cysts does not exclude this diagnosis. I like to add the Functional medicine approach of using the LH/FSH ratio from Day 2 blood tests. A typical LH/FSH ratio in women without PCOS is around 1:1. In PCOS, the ratio may be higher, often greater than 2:1.Using this criteria I prefer to factor PCOS in as a possibility rather than rule it out. The women I work with are mostly trying to conceive, so they don’t want to waste time trying things that don’t work so it is best to get to the root of the problem as quickly as possible.

The Poly Cystic Ovarian Spectrum: From Lean to Mean

PCOS can affect women of all body types. It’s not solely related to weight. Lean PCO refers to women with a normal or lower body mass index (BMI) who still experience PCO symptoms. This highlights the diversity of the condition.

Frustration with Weight Management:

  • Many women with PCOS experience significant challenges when it comes to weight management. The hormonal imbalances associated with PCOS can make it harder to lose weight and easier to gain it.
  • Despite their best efforts, including calorie restriction and regular exercise, some individuals may see limited progress or no weight loss at all.

Feeling Misunderstood:

  • One of the most significant frustrations for people with PCOS is the feeling of being misunderstood by healthcare providers, friends, and even family members. Some may hear insensitive comments like “just eat less and exercise more” without recognition of the unique challenges posed by PCOS. The weight gain is not always a result of consuming additional calories, but in the body processing insulin ineffectively.
  • The struggle to lose weight is often perceived as a lack of willpower, which can be disheartening and isolating.

3. Emotional Impact:

  • PCOS can have a profound emotional impact, leading to feelings of frustration, sadness, and even depression. The constant struggle with weight can erode self-esteem and body image.
  • The emotional toll of PCOS can affect relationships, work, and daily life.

While the frustration of weight management is significant, it’s vital to remember that PCOS is more than just a weight issue. It’s a complex hormonal condition that affects various aspects of your health, including menstrual cycles, fertility, and metabolism. Embracing a holistic approach to health, one that focuses on overall well-being rather than just weight loss, can empower you.

PCOS and Fertility: Challenges and Hope

PCOS can complicate the path to fertility due to irregular ovulation. But remember, you’re not alone. There are options such as lifestyle changes, medications, and assisted reproductive technologies to help you realize your dream of parenthood. In fact a large Harvard study found an 84% improvement in anovulatory cycles with simple nutrition and lifestyle changes, reflecting the unique demands of this condition.

PCOS and Pregnancy: Navigating New Challenges

During pregnancy, women with PCOS may face an increased risk of complications such as gestational diabetes and preeclampsia. Maternal age and obesity can also add to these risks, so ideally whatever can be addressed prior to conception will make for a healthier pregnancy with fewer necessary interventions.

Managing PCOS Naturally: Reclaiming Control

Taking control of your health naturally is empowering. Consider:

  • Diet: A balanced, low glycemic index diet can be beneficial. This may switch off fat storage, reduce cravings and restart ovulation or menstruation.
  • Exercise: Regular physical activity helps manage symptoms. Simple walking can improve insulin sensitivity.
  • Stress Management: Techniques like yoga, reflexology and meditation can improve well-being.
  • Supplements: Inositol supplements may help regulate menstrual cycles, while Vitamin D may improve insulin sensitivity.
  • Gut health: A balanced and healthy gut microbiome can aid in regulating hormones and reducing inflammation, both of which are key factors in PCOS. Research suggests that a healthy gut can help improve insulin sensitivity, leading to better blood sugar control. Additionally, a well-functioning gut can support the body in processing and eliminating excess hormones, potentially alleviating some PCOS symptoms. Therefore, focusing on gut health through a balanced diet, probiotics, and lifestyle changes may complement PCOS management strategies and promote overall well-being.

Exposure to Xeno oestrogens

Xenoestrogens are synthetic or naturally occurring chemicals that can mimic the effects of estrogen in the body. Exposure to these compounds has raised concerns about their potential impact on hormone-related conditions like PCOS (Polycystic Ovary Syndrome).

Understanding Xenoestrogens and Their Sources: Xenoestrogens, also known as environmental oestrogens, are substances found in the environment that can disrupt the endocrine system by mimicking the actions of oestrogen. They can be natural or synthetic and are commonly found in various products and pollutants, including:

  1. Pesticides: Many pesticides used in agriculture contain xenoestrogens, which can end up in the food supply.
  2. Plastics: Bisphenol A (BPA) and phthalates, found in some plastics, can leach into food and beverages, especially when exposed to heat.
  3. Personal Care Products: Some cosmetics, lotions, and shampoos may contain xenoestrogens, like sodium benzoate, which can be absorbed through the skin.
  4. Processed Foods: Some processed foods contain additives and preservatives that may have xenoestrogenic properties.

The Link Between Xenoestrogens and PCOS: While research on the direct relationship between xenoestrogens and PCOS is ongoing, there are several concerns about how exposure to these compounds may contribute to the development or exacerbation of PCOS:

  1. Hormonal Imbalance: Xenoestrogens can disrupt the body’s hormonal balance by binding to oestrogen receptors, potentially leading to hormonal imbalances associated with PCOS.
  2. Insulin Resistance: Some studies suggest that xenoestrogens may contribute to insulin resistance, a key factor in PCOS development.
  3. Ovulatory Dysfunction: Exposure to xenoestrogens may interfere with normal ovulation, exacerbating fertility issues common in PCOS.
  4. Inflammation: Xenoestrogens may promote inflammation, which is often observed in women with PCOS.

Reducing Xenoestrogen Exposure: To minimize potential risks associated with xenoestrogens, individuals with PCOS and those at risk should consider taking the following precautions:

  1. Choose Organic Foods: Opt for organic produce and meats to reduce exposure to pesticides and hormones commonly used in conventional farming.
  2. Avoid Plastics: Use glass or stainless steel containers for food and beverages instead of plastic containers, especially when heating food.
  3. Check Product Labels: Read product labels for ingredients like parabens, phthalates, and BPA, and choose products that are free of these substances.
  4. Limit Processed Foods: Reduce your intake of heavily processed foods, which may contain additives and preservatives.
  5. Support Detoxification: Improving gut health and reducing gut permeability can set up a positive chain reaction.

While the relationship between xenoestrogens and PCOS is an area of ongoing research, taking steps to reduce exposure to these substances can be a proactive approach to managing the condition and supporting your overall health.

Why the Birth Control Pill Isn’t a Universal Solution

While birth control pills can provide temporary relief for some PCOS symptoms, they don’t address the underlying causes. The bleed experienced between pill packs is not a period, it is a response to the withdrawal from medication. The Birth Control Pill does not regulate your cycle.

Long-term use may also have side effects that impact your journey, particularly in relation to heart and bone health as well as gut integrity.  It’s essential to explore alternatives tailored to your unique needs and goals.

In conclusion, your journey with PCOS is a testament to your strength and resilience. You face unique challenges, but you’re not defined by them. Your experiences are valid, and your struggles are heard. As you read through this article, remember that you are not alone. Now Baby is here to support you, empower you, and inspire you to take control of your health and well-being. Together, we’ll continue to navigate the path from struggle to strength.

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