PCOS Awareness Month

September marks PCOS Awareness Month. PCOS, or Polycystic Ovarian Syndrome, is a term used to describe a range of symptoms such as anovulation (lack of ovulation), excess androgen activity, polycystic ovaries (identified by ultrasound) and elevated insulin. Clinical features include acne, excessive facial hair, menstrual irregularities, infertility, weight gain, anxiety, and depression.

PCOS can be difficult to diagnose due to varying symptoms, as well as constant changes in testing and diagnostic guidelines, however it CANNOT be diagnosed by ultrasound alone. The current gold standard for diagnosing PCOS is:

〰️ Testing: LH, FSH, Testosterone, DHEA, Androstenedione, FAI, SHBG

〰️ 2 hour glucose tolerance test with insulin

〰️ Ultrasound

There are 4 main types of PCOS, underpinned by 4 main drivers:

〰️ insulin resistant

〰️ inflammatory

〰️ post-pill

〰️ adrenal

Understanding the driver of your PCOS will help to identify the best course of treatment.

A little on the 4 types of PCOS…

Insulin Resistant PCOS: this correlates to high levels of insulin in the body, also known as hyperinsulinemia. This can lead to elevated levels of androgens, impaired ovulation, fertility troubles, weight gain, heart disease, osteoporosis, and diabetes.

Inflammatory PCOS: chronic inflammation throughout the body and in the reproductive organs can cause the ovaries to produce higher levels of testosterone. This may be a result of underlying health conditions or issues.

Post-Pill PCOS: this is caused by a temporary surge of androgens that occurs when coming of the oral contraceptive pill (OCP).

Adrenal PCOS: unrelated to inflammation and insulin resistance, the increase of adrenal androgens (hormones created by your adrenal glands such as DHEA-S) can cause PCOS. The main culprit behind this type of PCOS is underlying stress and early exposure to endocrine-disrupting chemicals.

Treatment depends on the type of PCOS, however dietary & lifestyle adjustments, stress management and supplementation and herbal medicine are an important part of treatment.