Polycystic Ovarian Syndrome

Polycystic ovarian syndrome is one of the most common conditions among women of reproductive age. As a syndrome it can look different for everyone patient, thus no prescription should look the same. There are many tools we can use to improve symptoms naturally.

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The first step to treating PCOS is understanding how it occurs.

Two major hormones, estrogen and progesterone, control a women's menstrual cycles. While estrogen tends to elevate throughout the full cycle, progesterone levels rise in the second half (after ovulation). In women with PCOS often ovulation does not occur and as a result progesterone production suffers and cycles become irregular. Additionally there is often overproduction of Androgen hormones which contributes to many symptoms.

PCOS is a complex disorder that can have an array of symptoms that are unique to the individual. These symptoms include:

  • Irregular menstrual cycles. Women with PCOS will have long cycles (often longer than 35 days), missed periods, or have no period at all.
  • Ovarian cysts (not always)
  • Abnormal hair growth on the chin face and chest
  • Hair loss on the scalp
  • Acne on the face, chest, and upper back. That is often cystic
  • Darkening of skin on neck creases, under the arms, under the breasts, and in the groin.
  • Skin tags
  • Weight gain and difficulty losing weight
  • Fertility issues

Assessment and Diagnosis of PCOS:

The traditional diagnostic criteria for PCOS includes:

  • Hyperandrogenism (high androgen levels)
  • Amenorrhea or Oligomenorrhea (absence of menstruation or elongated cycles)
  • Polycystic ovaries

But... we know as a syndrome it is not all black and white, it is important to look at other diagnostic parameters to get to the root cause. This includes:

  • FSH and LH levels
  • Estrogen levels
  • Progesterone
  • Cortisol
  • Free testosterone, total testosterone (androgen levels)
  • Prolactin
  • DHT – dihydrotestosterone
  • SHBG – sex hormone binding globulin
  • HbA1C, fasting glucose, fasting insulin
  • Ferritin
  • TSH, free T4, free T3
  • 25-hydroxy Vitamin D

Treatment of PCOS:

Goals of treatment include understanding the root cause through proper screening and implementing individualized treatments to meet the needs of the patient. Treatment options include:

  • Dietary modification
  • Exercise prescription
  • Stress Management
  • Nutrient supplementation
  • Herbal Medicine