Polycystic Ovarian Syndrome (PCOS) - What is it?

October 15, 2004

JoAnn Guest

Oct 14, 2004 16:53 PDT

Polycystic Ovarian Syndrome

What is it?

http://www.weightcontroldoctor.com/healthtopics/a-z/pcos.asp

This is the most common endocrine problem in women. Around one in

every six women probably has the tendency to polycystic ovaries. The

condition is often triggered and has a strong genetic tendency.

PCOS is a jumble of conditions and symptoms making it a difficult

condition to pinpoint the cause of. How it manifests itself is very

complex - it has no one cause or trigger. The understanding of this

syndrome by the medical fraternity is still in its infancy and until

recently it was thought to be a specifically a gynecological

problem.

However, Doctors now recognize that the disorder is associated with

insulin resistance in 30 - 60% of cases. There is variation in

different

racial groups. African Americans, indigenous groups, Islanders and

people of Indian sub continental or Chinese origin are at a higher

risk.

The term Polycystic Ovarian Syndrome is derived from the presence of

small fluid filled sacs or cysts which accumulate in the ovaries

from trapped eggs, which were never released from the ovaries. In a

normal ovary, a single egg develops and is released each month. In

PCOS normal ovulation or release of the eggs at the middle of the

menstrual cycle is inhibited. A woman may have PCOS without actually

having the ovarian cysts.

It is partly due to a hormonal imbalance.

These three hormones are produced in the ovaries-estrogen, androgen

and

rogesterone.

Because ovulation does not occur very often, these women do not

produce adequate amounts of the hormone progesterone but do produce

oestrogen. This results in infertility and very infrequent menstrual

bleeding.

This lack of progesterone can also result in heavy irregular

menstrual bleeding.

As a result, the follicle, the fluid filled sac that develops around

the egg before it ovulates, never develops. Instead, it turns into a

cyst on the ovary.

It is the abnormal progesterone level that prevents the follicle

from developing. Two more hormones -follicle stimulating hormone

(FSH), and luteinizing hormone (LH) - are produced in the pituitary

gland in the brain.

The hormones produced in the brain regulate the production of the

hormones produced in the ovaries.

For whatever reason, production of FSH and LH is irregular, so

problems develop with the other three hormones as well.

Women with PCO Syndrome usually have higher levels of male hormones

or androgens, which are produced in their ovaries, adrenal glands

and also in their upper level body fat. Therefore it is desirable

for women with this condition to avoid carrying too much body fat.

Weight excess will aggravate the hormonal imbalances of PCO

Syndrome, and is often associated with Syndrome X ( see Dr Cabots

book 'Can't lose Weight? You Could Have Syndrome X " ). Women with PCO

Syndrome have a much

higher risk of Syndrome X and a sevenfold increased risk of becoming

a Type 2 diabetic, especially if they are overweight.

The excess of male hormones will increase insulin resistance so that

blood glucose problems, high cholesterol, and hypertension may

result, especially in overweight women.

Is it common?

Polycystic Ovarian Syndrome is quite common, affecting 6-10% of

menstruating women.

What causes it?

The exact causes of the hormone imbalance that leads to PCOS is

unclear.

It runs in families, so the tendency to develop the syndrome may be

inherited. The underlying cause is thought to possibly be a genetic

defect. It is suspected that insulin resistance is due to a defect

in the processes which occur after insulin binds to a resistant

cell.

What are the symptoms?

The numbers and types of PCOS symptoms that appear vary between

women.

These include:

• Hirsutism - Excess facial and body hair related to excess androgen

production (hyperandrogenism) - this occurs in 70% of women.

• Obesity - Approximately 40-70% of PCOS patients are overweight.

Weight

Problems or obesity that is centered around the midsection.

• Irregular or absent periods - Anovulation appears as lack of

periods

(amenorrhea) in 50% of patients, and as heavy uterine bleeding in

30% of

patients; however, 20% PCOS patients menstruate normally.

• Male-pattern hair loss - particularly the temples and crown area.

this is known as androgenic alopecia.

• Infertility-Achieving pregnancy is difficult in many women with

PCOS.

• Polycystic ovaries- Most, but not all, women with PCOS have

multiple cysts on their ovaries.

• Skin discoloration.-Some women with PCOS have dark patches on the

skin

around the neck, groin and under the arms.

• Abnormal blood chemistry- Women with PCOS have high levels of

low-density lipoprotein (LDL or " bad " ) cholesterol and

triglycerides,

and low levels of high-density lipoprotein (HDL or " good " )

cholesterol.

• Hyperinsulinemia - Some women with PCOS have high blood insulin

levels, particularly if overweight.

• Acne and other skin problems - Acne is seen in about 1/3 of PCOS

patients. This is caused by the increased secretion of sebum

stimulated

by the excess male hormone.

Skin tags, thick lumps of skin that can be as large as raisins, can

form and usually are found in the armpits or neck. These can easily

be removed. Darkening and thickening of the skin also can occur

around the neck, groin, underarms, or skin folds. This condition,

called acanthosis nigricans, is a sign of an insulin abnormality.

• High blood pressure

• Insulin Resistance or Diabetes

Someone with PCOS may have any or all of these symptoms.

The following shows the prevalence of PCOS symptoms in a study (*)

on a

group of 1741 UK women :

• Polycystic Ovaries on ultrasound 100%

• Menstrual cycle disturbance 66%

• Absence of periods 19%

• Obesity 38%

• Infertility 20%

• Excess male hormones (hirsutism, acne, androgenic hair loss) 70%

* Balen & Colleagues, UK.

These symptoms may be found singularly or in combination.

Body Types

Do you know what body type you are? Do the body shaping

questionnaire.

The Android body type are more susceptible to conditions such as

PCOS due to excess male hormone. Androids commonly suffer from the

metabolic imbalance known as Syndrome X.

This term refers to a constellation of symptoms/conditions that are

associated with excess abdominal fat, raised insulin, raised fasting

blood glucose, elevated BP, blood fat abnormalities, raised

testosterone levels and the symptoms that accompany this including

excess facial and

body hair, adult acne, and the development of PCOS.

Insulin resistance and PCOS

Insulin resistance is common in PCOS patients, and can occur in both

obese and lean patients - it is, however, exacerbated in obese

patients.

Insulin resistance is often hereditary and usually aggravated by a

high carb diet. Insulin resistance and hyperinsulimia (high levels

of insulin) stimulate the ovaries to produce androgens and the

androgens may exacerbate the collection of symptoms known as PCOS.

This interaction of excessive insulin production and excess male

hormone is believed to play a role in the lack of ovulation in

susceptible women.

The root of insulin resistance is believed to be in the protein-

related events occurring within the cell. Some types of cells - most

commonly muscle and fat - in the body can be insulin resistant,

while other types of cells and organs are not.

As a result, the pituitary, ovaries, and adrenal glands of an

insulin resistant patient will be stimulated by far higher levels of

insulin

that would be desired, with the consequences of elevated luteinizing

hormone and androgens (male hormone)In previous studies of women

with PCOS most where found to have elevated levels of insulin and a

glucose metabolism that was resistant to the effects of insulin.

The primary role of insulin is to regulate blood-sugar levels. After

you eat carbohydrates, they will be broken down into their component

sugar molecules and transported into the bloodstream. Your pancreas

then

secretes insulin, which shunts the blood sugar into muscles and the

liver as fuel for the next few hours.

However the more abdominal body fat you have, the more insulin your

pancreas will pump out per meal, and the more likely you'll develop

what's called ''insulin resistance,'' In effect, your cells become

insensitive to the action of insulin, and so you need ever greater

amounts to keep your blood sugar in check.

So as you gain weight, insulin makes it easier to store fat and

harder to lose it. To date the belief is that insulin resistance

occurs mainly in muscle, but is also present in the liver in obese

women with PCOS.

Insulin resistance leads to hyperinsulinemia (elevated insulin

levels) because the pancreas will pump out more and more insulin to

try and

'force the blood sugar into the resistant cells. Elevated insulin

has been shown to stimulate ovarian androgen production as the

ovaries retain their sensitivity to the insulin even though the

muscles and liver have not.

Excess insulin may also stimulate fat storage and alter cholesterol

metabolism leading to elevated cholesterol and triglyceride levels.

Because PCOS is such a complex jumble of symptoms and conditions not

all women with PCOS will have insulin resistance - however for obese

suffers who hold their weight in the abdominal area it is more or

less a given. PCOS is very commonly suffered by women with the

metabolic disorder

called " Syndrome X " which has many overlapping symptoms with PCOS

Is it curable?

With proper diagnosis and treatment, most PCOS symptoms can be

adequately controlled or eliminated.

Infertility can be corrected and pregnancy achieved in most patients

although, in some, the hormonal disturbances and ceasing of

ovulation may recur - especially of they return to old lifestyle and

dietary habits.

Diagnosis

Different diagnostic criteria for PCOS is used in different

countries.

The UK defines PCOS as the appearance of the follicle cysts on an

ultrasound of the ovaries in combination with one or more of the

symptoms listed above. In the US the definition is tighter. It

requires

the combination of irregular periods and excess androgen production

but does not take into consideration the ultrasound picture.

It is thought that there are varying levels cases ranging from most

severe where the women suffers from all the listed symptoms, to a

'normal' woman with only the characteristic cysts on the ultrasound

and no other symptoms. It is likely that genetic factors play a part

in where a women will be placed along this 'spectrum' of symptom

combinations.

It is also likely that a 'trigger' will push her from 'normal' to a

more severe expression of symptoms. The most likely triggers are

obesity and increased food intake particularly highly processed

starchy carbohydrate foods, lack of exercise and excess male hormone

perhaps from the prescription of oral contraceptive pills or hormone

replacement containing 'masculine' type progesterones. The lack of

ovulation may lead to irregular heavy menstrual bleeding or lack of

periods altogether and hirsutism.

PCOS can be diagnosed by blood tests and a transvaginal sonogram.

The

blood tests are essential. The doctor should take a complete medical

history, including questions about menstruation and reproduction,

and weight gain. Physical examination includes a pelvic examination

to determine the size of the ovaries, and visual inspection of the

skin for hirsutism, acne, or other changes. An ultrasound

examination of the

ovaries may be performed to evaluate their size and shape.

Tests

• This disease is often called a mystery disease and is often

misdiagnosed because of its varied collection of symptoms.

• Many PCOS patients will have abnormal levels of one or more of

these

tests, although normal values do not rule out a PCOS diagnosis. PCOS

can be difficult to diagnose since its symptoms are similar to those

of

other diseases, and since all of its symptoms may not occur.

• Patients should be monitored for endometrial cancer. A endometrial

biopsy is essential to rule this out if the woman has missed several

periods.

• Because of the high rate of hyperinsulinemia seen in PCOS, women

with

the disorder should have their glucose levels checked regularly to

watch

for the development of diabetes.

• Blood pressure and cholesterol screening are also needed because

these

women also tend to have high levels of LDL cholesterol and

triglycerides, which put them at risk for developing heart disease.

• Blood tests should include serum levels of:

.. Total testosterone

.. Free Androgen Index

.. Estrogen

.. SHBG (Sex Hormone Binding Globulin)

.. LH (Luteinising Hormone)

.. FSH (Follicle Stimulating Hormone)

.. A glucose tolerance test with accompanying insulin levels.

Treatment

Although insulin-sensitizing medications such as Metformin can help

those with PCO Syndrome, dietary changes remain the best strategy

for long term success.

Some women with PCO Syndrome are treated with the oral contraceptive

pill, which produces a regular menstrual bleed.

However long term use of the contraceptive pill, especially pills

containing masculine synthetic progesterones, may aggravate insulin

resistance and weight gain in some women with PCO Syndrome.

PCO Syndrome can often be controlled very well with weight loss, and

the use of natural progesterone and nutritional supplements.

Natural progesterone is given in the form of lozenges or creams.

Natural progesterone does not aggravate insulin resistance or

increase weight, and may help to relieve many symptoms of PCO

Syndrome.

Women with Polycystic Ovarian Syndrome are generally deficient in

the hormone progesterone. and will benefit from its supplementation.

Use 'Dr Cabots Natural Progesterone Cream with MSM " daily. This

delivers a 35mg dose of real progesterone.

Diet

Dietary changes and supplements are vital. It is recommended to

follow Dr Cabots " Syndrome X " program. Patients will be able to

control their weight by following the basic eating principles on p

244 of this book:

" Can't Lose Weight? Unlock the secrets that are keeping you fat " by

Dr

Cabot.

NOTE: All the books mentioned in the FREE A-Z sections are available

for instant reading online if you are a paying member of this

website. You may also purchase them directly from our online shop.

• Basically, you need to reduce processed starchy carbs and have

first class protein with every meal and snack.

• Women with PCO Syndrome should eat only organic poultry and meats

free of growth promoting hormones.

• PCO Syndrome can often be controlled very well with weight loss,

and the use of natural progesterone and nutritional supplements.

Natural progesterone does not aggravate insulin resistance or

increase weight, and may help to relieve many symptoms of PCO

Syndrome X.

• If you want to improve liver function you must avoid ALL dairy

products - dairy foods contain high levels of antibiotics, steroids

and artificial growth hormones as this is what the herds are treated

with in

today's high tech dairies to prevent disease and boost milk

production.

As with humans where substances go through into breast milk it is

the same for cattle - only they neglect to tell you this in the

advertisements when they are telling you how great milk is.

If you need further info on this please visit www.notmilk.com.

• When reducing sugar intake, avoid artificial sweeteners see

www.dorway.com

Healthy Sweetener Use Guide

Sweeteners to avoid:

Aspartame

Neotame

Sucralose (Splenda)

Acesulfame-K (Sunette, Sweet & Safe, Sweet One)

Cyclamates

Saccharin

Sweeteners to Use:

Stevia * Call 188875LIVER to obtain this

_________________

JoAnn Guest

mrsjo-

DietaryTi-

www.geocities.com/mrsjoguest/Genes

October 27, 2004

Thank you for posting this. I have a question. My 15 yo old daug. has skin

discoloration under both of her arms. It is getting darker and darker. Her

Dr. said he thought it was yeast infection and had us use cortisone which

did absolutely nothing. This article mentions this problem. What other

conditions may be causing this?

What should be my first step in determining.

Thanks,

Kathy

http://vanokat.wholefoodfarmacy.com/

LOVE PEOPLE AND USE THINGS -

NOT LOVE THINGS AND USE PEOPLE.

Have nothing to do with the evil deeds of darkness,

but rather expose them. Ephesians 5:11

" For our struggle is not against flesh and blood, but against the rulers,

against the powers, against the world forces of this darkness, against the

spiritual forces of wickedness in the heavenly places. " (Eph. 6:12).

----

JoAnn Guest

10/14/04 19:57:04

Polycystic Ovarian Syndrome (PCOS) -