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Polycystic Ovarian Syndrome

Updated: Aug 4, 2023

This one is complex and multifactorial. Its metabolic and involves your endocrine system. It impacts your cycle and your fertility, your long term wellness and certainly your happiness. #PCOS affects about one in ten women of childbearing age and is the most common endocrine issue in the United States. It has significant consequence, yet about half of women suffering are thought to be undiagnosed.

When women suffer PCOS, their #insulin is triggering their ovaries to secrete while also inhibiting their sex-hormone binding globulin production, leading to the increased circulating testosterone that causes frustrating weight gain, distressing hair loss or male patterned growth, and cystic #acne. These symptoms significantly impact a woman's confidence and self-esteem. Additional symptoms too that often go unrecognized are sleep apnea, which causes significant fatigue and exhaustion, even depression. Long term risks are obesity, higher blood pressure, elevated cholesterol, #diabetes, and heart disease.

When suffering PCOS, your brain continues to tell your ovaries to mature follicles, but high androgen levels interfere with this effort and ovulation doesn't occur. Menstrual cycle disruption is a big part of this clinical picture; more often they are longer cycles, skipped for months at a time. When they do occur, they are often heavy and painful. When we have eight or fewer each year, this causes the endometrial lining to get thicker within the uterus increasing our incidence for cancer. When we lose more blood during our flow, we are also at risk for #anemia and all its sequelae. Infertility is quite common in women with PCOS and difficulty becoming pregnant pretty much expected. Sadly, miscarriage is 20 to 40 percent more likely in women with PCOS.

Functional medicine clinicians recognize various body shapes as often being ascribed to specific underlying pathologies, and having smaller waists but larger hips and thighs is often the build of a woman with PCOS. Insulin causes your body to store body fat, which is why it's difficult to lose weight and why self-esteem is often challenged for these women. The inflammatory changes also lean into #anxiety and depression, only compounding issues with body image. Add to that #acne and hair loss, and the sad reality that many of these women are fat-shamed by their own clinician, and these women are often avoidant and heartbroken when they reach our office.

PCOS is associated with binge eating and subclinical hypothyroidism, and elevated thyroid antibodies. They have higher cholesterol typically and more often have an autoimmune conditions, such as metabolic syndrome or diabetes by the age of 40. Fatty liver disease is part of this unhealthy spiral of events when PCOS goes unmanaged, and ultimately, heart attacks are four to seven times more common. This one is a big deal but the good news is that this one is reversible.

Stress & PCOS

When we are under chronic stress, we are much more likely to suffer blood sugar problems and insulin resistance - a key factor in PCOS for at least 70 percent of women with this condition. When we are stressed we eat more sugar and carbohydrates because we want the dopamine and energy. Our #insulin elevates to manage all this sugar and this triggers our ovaries to produce more testosterone.

When we're under #stress, our adrenals increase their production of DHEA and androstenedione production because these hormones help to buffer the brain from the impact of cortisol, our stress hormone. When elevated they also contribute to PCOS and its symptoms. We aren't quite sure why, but women with PCOS are especially sensitive to the effects of cortisol, so these reactions are all a bit exaggerated.

As if this isn't enough, other hormones are also a bit awry which creates additional sequelae. Leptin for example controls our #appetite and satiety, but can be higher in women with PCOS, so these women are more susceptible to cravings and binge eating and having a tougher time losing weight. Getting out of chronic stress to reset the brain-ovary and adrenal-ovary connections are important secrets to halting PCOS. We have programs for our members that address just this!

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