Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) affects about 12 percent of women in the U.S. The syndrome is typically characterized by an increase in male or androgenic hormones, such as testosterone and dehydroepiandrosterone (DHEA). The cause of PCOS is unknown.Back to Top
Symptoms of polycystic ovarian syndrome include:
- Deepening of the voice
- Hirsutism (male pattern hair growth)
- Smaller breasts (However, the estrogen level is often raised if the aromatase enzyme is active)
- Muscle enlargement
- Acne on face or back
- Poor menstrual history (Patient may go without having a period for months, which is then followed by heavy bleeding)
- Weight gain, despite exercise
- Infertility or difficulty getting pregnant
Testing for Polycystic Ovarian Syndrome
Elevated testosterone levels may be caused by ovarian or adrenal androgen-secreting tumors. When testing for PCOS, in additional to measuring testosterone and DHEA levels, it is prudent to also measure 17-Hydroxyprogesterone and androstenedione. Congenital adrenal hyperplasia (CAH), which usually appears in infancy, can affect the production of testosterone levels.
A number of tests need to be done in order to narrow down the diagnosis to PCOS, including measuring insulin, prolactin, progesterone, estrogen, testosterone, DHEA, FSH and LH levels. Often with PCOS, the LH to FSH ratio exceeds two to three.
Since lipids, such as cholesterol and triglycerides may go up, a lipid profile should be done. In about 60 percent of PCOS cases, multiple cysts are seen in the ovary. (These are essentially “failed” corpus luteum cysts, so progesterone is often low, and ovulation usually does not occur.) Also, menses may have decreased or be absent.
Since hypothyroidism presents on occasions in a similar manner as PCOS, a full thyroid profile that includes reverse T3 and thyroid antibodies, TSH, Free T3 and Free T4 is advisable. A hair analysis can ensure there is no lack of minerals or vitamins, including critical vitamins B, E, A and C, and minerals magnesium and chromium. Finally, testing for the anti-Müllerien hormone (AMH) is one of the most sensitive tests for PCOS.Back to Top
A program for managing PCOS may include:
- Herbs and supplements to correct progesterone and estrogen levels
- Herbs and homeopathic remedies to correct menstrual irregularities and estrogen and progesterone levels
- Saw palmetto to manage hirsutism
- Reduced intake of meats and dairy products to promote health omega 3 and 6 ingestion
- Reduced intake of gluten
- Reduced intake of sugars and refined carbohydrates
- Antioxidants to reduce inflammation
Insulin resistance also gives rise to higher levels of testosterone, so treating insulin resistance if it is present is mandatory. There are supplements that can do this effectively.
Natural estrogen-blockers are very effective in reducing estrogen levels. It is important to remember that estrogen metabolism occurs fairly actively in the liver, so a healthy liver is important.Back to Top