Women’s Health: PCOS (poly cystic ovarian syndrome)

What is PCOS, what causes it and what are the symptoms. We explain.

Poly cystic ovarian syndrome (PCOS) is an endocrine disorder affecting hormonal functioning in women. Hormones are chemical messengers that tell the body what to do. Women and men have the same hormones, just different hormone concoctions. Women typically have more estrogen and men more testosterone. In PCOS, a woman’s hormonal concoction is out of balance, giving rise to multiple symptoms.

What causes PCOS?

Although there is much debate about the cause and origin of PCOS, the principal cause remains unknown.  Most researchers and experts agree that there may be a genetic link, and women who have a mother or sister with PCOS, are more likely to develop PCOS (National Women’s Health Information Center, 2010).  According to Futterweit & Ryan (2006), the following are proposed causes of PCOS that are universally acknowledged as the most plausible:

  1. A malfunction in the brain which stimulates the ovaries to secrete higher than normal amounts of male hormones, specifically testosterone.
  2. A defect in the production of male hormones in the ovaries due to abnormal enzyme activity on the pathways leading to high circulating testosterone. Excess hair growth, oily skin, and acne are symptoms of high testosterone levels.
  3. Insulin resistance, which results in higher than normal levels of circulating insulin. This causes the body to store fat, thus, weight gain in a complaint in many women.
  4. Genetic factors: “Forty percent of women with PCOS have a sister with PCOS, and 35% have a mother with PCOS” (Futterweit & Ryan, 2006).

PCOS: The physiology

Among the first organs to form in a female fetus, are the ovaries, whose job is to produce egg cells.  A female fetus, only a few weeks old, is already equipped with over 6 million egg cells, and by the time a girl reaches puberty, she is left with approximately 300,000 egg cells.  Each egg cell will flourish and ripen in a fluid-filled sac, surrounded by a layer of support cells, conjointly called a follicle.

During a woman’s reproductive years, about 300 of those eggs will develop into mature follicles, triggered by the release of hormones (Futterweit & Ryan, 2006).  The hormones which control a woman’s monthly menstrual cycle and ultimately, reproduction, are produced in a small gland in the brain, the pituitary gland.  The pituitary receives ‘regulatory instructions’ from the ‘master gland’, or the hypothalamus (also located in the brain).  The pituitary produces 2 hormones: FSH (follicle stimulating hormone) & LH (luteinising hormone).

In PCOS, FSH and LH, are produced out of proportion.  In a healthy ovary, FSH stimulates the development of an egg into a mature follicle, as well as estrogen secretion.  The increased levels of estrogen in the blood cause an LH surge, triggering the release of the egg, from the ovary; in other words, ovulation (Bussell, 2007).

In PCOS, multiple ‘cysts’ develop in the ovaries.  These ‘cysts’ are follicles which never release their eggs and remain rooted in the ovary.  A common manifestation of this syndrome is absence of ovulation.  In women with PCOS, the ovaries produce higher than normal levels of androgens, or male hormones, which disrupt normal development and release of the egg (National Women’s Health Center, 2010).  The imbalance in female sex hormones can also account for menstrual irregularities, such as mid-cycle bleeding, or long menstrual cycles.

Insulin, a hormone which controls blood sugar levels and carbohydrate/fat metabolism in the body, has also been linked to PCOS.  Specifically, insulin causes body cells to take up sugar (glucose) as an energy source.  A significant number of women with PCOS have high levels of insulin, which appears to increase the production of androgens (National Women’s Health Center, 2010).  High levels of circulating insulin have the potential to develop into insulin resistance.

With insulin resistance, an individual is less able to decrease blood sugar levels, and eventually, the body may become completely desensitized to insulin.  Consequently, insulin desensitization leads to high levels of blood glucose, and excess blood sugar being deposited in fat cells. A typical complaint of many women who suffer from PCOS is significant weight gain and the inability to lose weight, which, according to Futterweit & Ryan (2006), puts these women at a much greater risk for acquiring heart disease and diabetes in the long run.

Signs and symptoms

  • No periods, or periods that are irregular, frequent or heavy
  • Difficulty becoming pregnant
  • Multiple cysts in the ovaries
  • Excess facial and/or body hair
  • Acne on the face and/or body
  • Loss of hair (alopecia)
  • Darkened skin patches
  • Depression
  • Anxiety

If you are experiencing several of the symptoms above, it may be a good idea to complete further health investigations. Diet and nutrition are pivotal factors to control/manage blood sugar levels and maintain a healthy body weight. Elevate’s Integrated GP Sandy Eun and Naturopath and Nutritionist Amanda Harasym specialise in women’s health, working together to bring women’s hormones back into balance.

For more information contact Elevate on 9252 2225 or click here to make a booking.

 

REFERENCES
Bussell G. (2007). Managing pcos for dummies. West Sussex, England: John Wiley & Sons, Ltd. p. 15-22.
Canadian Women’s Health Network (2005). Polycystic ovarian syndrome (pcos). Available at: http://www.cwhn.ca.
Futterweit W, & Ryan, G (2006). A patient’s guide to pcos: understanding and reversing polycystic ovary syndrome. New York: Henry Holt and Company. p. 7-13, 19, 27, 31, 48, 62-73, 80, 139, 160-165, 178, 184-186, 205-207.
United States Department of Health and Human Services: Office on Women’s Health (2010). Polycystic ovarian syndrome (pcos): Frequently asked questions. Available at: http://www.womenshealth.gov.
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