fertility challenges

Hormonal Imbalance: Polycystic Ovarian Syndrome

A bit technical but helpful!

Polycystic ovary syndrome (PCOS) is considered the most common endocrine disorder of premenopausal women (5-10% occurrence » 3 million in US).  According to 2012 study it affects 5 million women in US.[i]

Signs of excess androgen stimulation (high amount of sex hormones, in particular testosterone) can range in severity from mild (such as increased acne production) to severe (male-pattern body hair distribution). Darker pigmented areas over the skin and multiple upper body skin tags.  Weight gain is a frequent (though not universal) part of PCOS. Menstrual irregularities such as long menstrual cycles, absence of menstrual cycles, sometimes heavy uterine bleeding are also common. On ultrasound imaging, multiple (over 10) small ovarian follicles (2-10 mm diameter) and overall enlargement of the ovary can be seen.

Hormonal blood or saliva testing can show elevated estradiol and testosterone hormonal levels. Insulin resistance is common in women with PCOS, and insulin stimulates ovarian androgen hormonal production. The increased hormoneal levels cause the developing ovarian follicles to be arrested leading to the cycles that lack ovulation (release of follicles from the ovaries during ovulation).

PCOS is a metabolic syndrome now seen as encompassing two interrelated metabolic phenomena: insulin resistance and high levels of androgens (sex hormones). Complex metabolic, hypothalamic, pituitary, ovarian and adrenal interactions characterize the syndrome.[ii] Fertility challenges (inability to conceive) can be part of the condition.

This condition is usually addressed through the use of Metformin (to decrease insulin resistance and high glucose levels), Spironolactone (to decrease testosterone production) and other pharmaceuticals to manage different symptoms of this metabolic condition.

In naturopathic medicine, naturopathic doctors focus on the whole person. Life style factors are addressed along with specific diets that were researched for patients with PCOS. There are a number of nutritional supplements that can be of assistance to help ovaries release follicles and improves ovarian function (myo-inositol, folate, and melatonin combination). Menstrual cycle is also balanced with the helps of herbs and homeopathics. Insulin resistance and high androgen production can be mediated with the help of herbal/nutritional supplements along with the PCOS specific diet.

PCOS patients are usually encouraged to see natural medicine practitioners to help address the condition along with conventional treatments. Patient with PCOS can balance their hormones and conceive naturally.

1. [i] Rizza R, Johnson. PCOS Criteria Clarified; Name Must Change. Medscape. 2013.
2. [ii] Rizza R, Johnson. PCOS Criteria Clarified; Name Must Change. Medscape. 2013.