Polycystic Ovarian Syndrome (PCOS) affects millions of women around the world. It is considered an endocrine and metabolic disorder.
Women with PCOS have a tendency to have a greater production of androgens, and results from blood tests may show elevated levels of luetinizing hormone (LH) due in part to reduced levels of follicle stimulating hormone (FSH).
While PCOS is found to originate primarily in the ovaries, other factors can increase the risk of development. These include obesity, thyroid disorders, and blood sugar abnormalities. It may also have a genetic component.
An indicator of a primary ovarian problem is where only one ovary is polycystic, while hormone imbalances from other endocrine organs usually affects both ovaries.
Typical signs and symptoms of PCOS include
- Multiple cysts on the ovaries (as seen on ultrasound)
- Painful, irregular or no menses
- Hair loss/altered hair growth
- Insulin resistance/blood sugar dysregulation
Ovarian estrogen (estradiol) levels are decreased while the androgens are increased. Androgens prevent ovulation and normal follicle development, which can lead to small cystic follicles rather than mature ones.
Greater body weight and obesity causes an increase in androgens, which enhances estrone production. With this comes a higher androgen conversion in fatty tissue which may affect PCOS. High estrone production causes increased LH production and lowered FSH production. LH triggers ovarian androgen production.
Hypothalamic secretion of gonadotropin releasing hormone (GnRH) to inappropriate levels increases the pituitary production of LH and androgens. High androgens lead to high LH.
Lowered FSH reduces the capacity of follicular cells to convert androgens to estrogen, which causes imbalance.
Sex hormone binding globulin (SHBG) is the protein that carries estrogen and testosterone, while increasing androgen levels and obesity. This causes unbound testosterone to be found in serum circulation.
There is a greater risk of insulin resistance (IR) with obesity and PCOS due to the reduced sensitivity of insulin receptors to insulin. This means that insulin doesn’t have the ability to transport glucose to the cells which increases blood glucose levels.
Reducing weight by as little as 5% can alter the severity of PCOS and help regulate the menstrual cycle and blood glucose levels. Increasing protein rich, lower glycemic index (GI) foods and monounsaturated fats also helps to improve weight and regulate hormones.
Vitamin D can be helpful where there is insulin resistance. Along with calcium, vitamin D helps improve androgens and blood pressure.
Zinc and selenium may also help in improving symptoms of PCOS.
While PCOS is primarily an ovarian issue, as mentioned, other factors may increase the risks of development. If you experience PCOS, having a full thyroid hormone profile test is important to determine whether there is any thyroid involvement.