PCOS or Polycystic Ovarian Syndrome is an endocrine disorder that can affect hormones, metabolism and the immune system. Since PCOS is known as a syndrome it can become very complex to determine what is truly going on. Each and every person who has PCOS will experiences it differently. This is why it is important to seek out help from a doctor to determine the exact treatment protocol that will work for your case. Below are what I consider the four PCOS Pillars. These pillars are a guide in understanding what is really triggering your symptoms.
In this pillar, the main issue with one’s PCOS is testosterone. It can show up as high free/total testosterone or DHEAS. Even if testosterone on your blood test is not high but you have signs of high testosterone you may still benefit from treatment. Typically, if free testosterone is elevated we can assume it is affecting the ovaries, whereas if DHEAS is elevated on lab work we can assume your adrenal glands (where cortisol is produced – our stress hormone) are affected. This is because the majority of free testosterone comes from the ovaries and DHEAS mainly comes from the adrenal glands.
– Increased hair growth on your body in places such as your chin, upper lip etc. Check out my article on hair growth here!
– Cystic acne on jawline, cheeks, and upper back
– Thinning of hair
Inflammation is known to be a key component for PCOS in the body. What exactly is inflammation? Inflammation is key to the immune system. When our immune system is under attack inflammatory molecules will be released to gather other immune cells in order to fight off foreign bacteria and viruses. This process is normal for our bodies under certain circumstances. Think of it like the secret service for your body. However, if constantly present it can cause the inflammatory cascade to be on all the time.
Inflammation in PCOS can lead to autoimmune conditions such as leaky gut syndrome, Hashimoto’s thyroiditis.
– Pain in muscles or joints of your body
– Skin rashes such as eczema or psoriasis
– Long term digestive concerns such as bloating, diarrhea, or indigestion
The metabolic pillar is all about insulin resistance. What exactly is going on with insulin resistance? Well…. when you eat food – such as a piece of bread, your body breaks down the bread into individual glucose molecules. This triggers insulin to be released from your pancreas. Insulin’s job is to bring the glucose into all of your cells to be used as energy. When your cells become resistant – this means that they do not listen to insulin. Therefore, you will have high amounts of insulin and glucose in the blood. It is important to note that even though your fasting insulin and glucose can be within the reference range you can still have insulin resistance. Using the HOMA-IR calculator, we can determine how well your pancreas is functioning and how well your cells are responding.
– Weight gain, cravings for sugar, skin tags, dark skin folds on the neck
– History of diabetes in your family
– Symptoms of hypoglycemia – shakiness, irritability, dizziness if you haven’t eaten in a while (aka feeling hangry)
4. Female Hormones
Last but not least, are female hormones. I am talking about the functioning of not only estrogen and progesterone but Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH). LH and FSH hormones are released from the pituitary gland that sits in our brain. During the first half of your cycle when your period starts, FSH is released and this signals to the ovaries to produce estrogen and the follicles in the ovaries also grow. As estrogen peaks, LH is released and spikes which will cause the egg to be released from the follicle – this is known as ovulation! Making sure this whole process is working is key! It is important to get lab work completed on Day 3 of your cycle to determine the ratio of LH to FSH, since women with PCOS can have an elevated ratio of LH:FSH. Check out my article on top PCOS lab reports to ask your doctor to run.
By Dr. Samina Mitha, ND