Polycystic Ovarian Syndrome
by Teresa Richter,ND
Many women have irregular cycles, ovarian pain, and problems with fertility. Some of these issues have been linked to PCOS (polycystic ovarian syndrome). What is PCOS you may be thinking? PCOS is group of clinical presentations characterized by ovarian cysts present on both ovaries, possible absence of menses, absence of ovulation, infertility, insulin resistance, central obesity, and hirsutism (hair growth on the face, chest, breasts, abdomen of women). Women with PCOS may also experience a variety of symptoms with their monthly cycle including: breakthrough bleeding between periods, painful periods with heavy bleeding, or shortened cycles. Women with PCOS can range from no monthly bleeding (amenorrhea) to heavy painful periods (menorrhagia).
PCOS is relatively common and affects a significant number of women of reproductive age in the United States affecting anywhere from 4%-10% of women. PCOS accounts for almost 8% of women who either have absence of menses or infertility issues. The underlying cause of PCOS remains controversial, but there is growing awareness of multiple hormone imbalances that are seen with PCOS. It is believed to stem from one or more of the following hormonal imbalances: HPO axis (Hypothalamus-pituitary-ovary) dysregulation, HPA (hypothalamus-pituitary-adrenal) axis dysregulation, insulin excess, metabolic syndrome, Androgen (testosterone) excess, sex hormone-binding globulin (SHBG) deficiency, progesterone deficiency, and Prolactin excess. One hypothesis regarding possible causes involves a central nervous system dopamine deficiency. Maladaptive Stress Syndrome Type 2 is also associated with PCOS. Among other causes, being overweight or obese poses a high probability as adipose tissue (fat) secretes estrogens. These estrogens that are now being produced in excess can be easily converted to testosterone increasing the body’s androgens and perpetuating the cycle.
PCOS is usually diagnosed by blood tests to look at hormones additionally basal body temperatures are usually low, elevated BMI and waist-to-hip ratios, and measuring body fat percentage. Evidence of cysts may be found on a pelvic ultrasound but this alone is not diagnostic. Hormonal imbalances must be present.
Treatment of PCOS usually includes weight loss programs, hormone balancing, work with adrenal glands, stress management, and in severe cases progestational agents, androgen antagonistic drugs or steroids may be used. To find out if you may have PCOS please see your local Naturopathic Doctor for the correct testing and treatment options.
Dr. Teresa Richter
Dr. Teresa Richter is a graduate of Bastyr University. She completed her Doctorate of Naturopathic Medicine as well as a Bachelor of Science in Herbal Sciences at Bastyr University.