PCOS, polycystic ovarian syndrome, happens when the ovaries stop working normally and no longer ovulate on a regular monthly basis. This causes a buildup of a large number of small eggs that have not matured properly and then turn into cysts.
PCOS is the most common cause of reproductive health issues, including fertility challenges, across all age groups.
How do you know if you have PCOS?
- Cycles that are over 40 days long
- Fewer than 8 cycles per year
- Excessive facial hair
- Excessive body hair
- Loss of head hair (male pattern baldness)
- Weight gain
- Depression, anxiety, or other moodiness
PCOS is a syndrome, so there is not one test that is used to diagnose PCOS, rather, we look for two out of the following three tests to be positive:
- Periods – 8 or less per year
- Hormone levels (blood test) – elevated levels of free testosterone
- Ultrasound – ovaries showing many cysts; it looks like the ovary is wearing a “necklace of pearls”
We can also evaluate other fertility hormones including:
What causes PCOS?
PCOS is caused by a disruption of the normal hormonal signals that govern menstrual cycles and ovulation. Specifically, there is an increase of testosterone, which is the “boy” hormone that supports male reproductive function, including sex drive and sperm production. Women need only a small amount of testosterone.
High testosterone levels in women:
- suppress ovarian function
- inhibit the proper development of eggs
- stop ovulation
- create ovarian cysts
Why do I have high testosterone?
The most common cause is abnormal blood sugars. Blood sugars that are either too high or too low will result in the overproduction of testosterone in women and cause significant hormonal disruption of the normal menstrual cycle.
How do you know if your blood sugars are abnormal?
You may have symptoms:
- Crave sweets during the day
- Eating relieves fatigue
- Irritable if meals are missed
- Feeling shaky, jittery
- Must have sweets after meals
- Fatigue after meals
- Difficulty losing weight
Lab tests are a good way to diagnose blood sugar issues:
- Fasting glucose
- Hemoglobin A1c
- Lactase dehydrogenase (LDH)
- Uric acid
- Cholesterol levels
- Glucose tolerance test
How do you treat PCOS?
The conventional western approach to treating PCOS typically involves drugs; birth control pills for women not trying to conceive, and fertility drugs for women who want to get pregnant. In addition, women may be prescribed diabetes drugs used for managing blood sugars, such as metformin.
We take a functional medicine approach to treating PCOS and focus on healthy eating. This means paying close attention to the amount of carbs one is consuming, as carbs turn into blood sugars. Carbs include sugar, candy, anything sweet, bread, pasta, muffins, starchy vegetables such as potatoes and corn, and more.
A healthy diet starts with balancing the macronutrients of carbs, protein, and fat, so that you are getting more or less an equal number of calories from each macronutrient. A balanced ratio is 40% carbs, 30% protein, and 30% fat. Some women have a metabolism that struggles to digest carbs, and they may need to reduce their carb intake to only 20% – 30% of their total calorie intake. Using an app makes it convenient to track this information.
In our work with women’s health and fertility, blood sugars are something we look at with all of our patients, as abnormal blood sugars are the leading cause of hormonal disruption of any type. Addressing blood sugar issues via healthy eating, along with acupuncture, can go a long way in resolving hormonal imbalances. Not only is this approach effective at treating the immediate concerns of regulating menstrual cycles, reducing symptoms, and getting pregnant, it addresses the long-term issues associated with blood sugar problems, including obesity, diabetes, and heart disease.