Polycystic Ovarian Syndrome is a multifaceted problem in that it causes various hormonal imbalances, creating a wide range of symptoms due to interrupted normal physiological function of the reproductive organs. It is estimated that upwards of 25% of Women and 60% of teenage girls have polycystic ovaries on ultrasound.
Typically, PCOS is diagnosed by the Rotterdarm Consensus Criteria, which are:
Multiple cysts present on the ovaries (>12) by ultrasound imaging
Decreased frequency or absence of menstrual periods (can also be cycles that are greater than 35 days)
Symptoms of increased androgens: hirsutism (unwanted hair growth), acne, balding, or elevated androgens on a blood test
If two of the above criteria are present, then the diagnosis of PCOS can be given. So this leads to the possibility that even though a Women may have multiple cysts on her ovaries, she may not have ‘Polycystic Ovarian Syndrome,’ assuming that criteria #2 and #3 are not present.
Causes
Although the exact cause of PCOS has not been clearly defined, here are some consistent patterns that have been identified:
The first pattern is genetics: A Women born in to a family that has a history of type 2 diabetes mellitus or where the Men in the family have a history of male pattern baldness predisposes the Women to an increased likelihood of developing PCOS.
Womb care: Vitamin D deficiency in Women while they are pregnant may predispose the female fetus to develop PCOS in the future, so supplementing if you are a risk of Vitamin D deficiency may be helpful. Also, common pesticide exposure when pregnant may increase the likelihood of the female fetus developing PCOS in the future as well.
Diet: Although the research is not clear-cut on this, it might be possible that prenatal exposure to soy-based foods (which contain compounds known as phytoestrogens) may affect the fetal ovaries during a very sensitive time in their development.
Lifestyle: The ovaries have a specific kind of cell called the ‘theca’ cell. When there are consistently high levels of insulin (a hormone released by the Pancreas used to help the body store energy after we eat) can cause the theca cells in the ovary to enlarge and produce more testosterone as a result, which can create the hormonal imbalance seen in PCOS. So sedentary lifestyles and unhealthy diets (i.e. ones with lots of sugars or excessive processed white flour) that can lead to elevated levels of insulin can also contribute to the development of PCOS. In fact, even gaining an additional 10% of your body weight as fat can be enough to affect the ovaries, especially if it is stored around the waist as abdominal/visceral fat.
Stress: it has been observed that Women who are working 9-14 hours a day, especially in stressful careers, have increased stress levels that can cause symptoms very similar to PCOS. High levels of stress hormone (cortisol) can also create an imbalance at the Hypothalamus and Pituitary by altering their secretion of hormones that specifically affect the reproductive system.
Using the Oral Contraceptive Pill (OCP): There is a link between the use of the OCP and elevated levels of insulin and promoting inflammation, which can lead to the development of PCOS. Although it is usually prescribed as one of the many treatment options for adolescent Women to reduce excessive acne, it may just be masking early stages of PCOS and contribute to its development down the road. As a result, it is recommended that women who are at risk of developing PCOS consider another type of contraception.
Treatment of PCOS in its earlier stages can prevent a lot of its long-term consequences. Since this article is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about PCOS should speak with their Family Physician and/or Naturopathic Doctor.
References:
1. Beers, M. (2006). The Merck manual of diagnosis and therapy (18th ed.). Whitehouse Station, N.J.: Merck Research Laboratories.
2. Lyttleton, J. (2013). The treatment of infertility with Chinese medicine (2nd ed.). Oxford: Churchill Livingstone.