Polycystic ovarian syndrome - Part 1

Polycystic ovarian Syndrome (PCOS) is a term used to describe a cluster of symptoms which is ultimately deemed a metabolic condition. It can effect ovulation, fertility, and weight.

PCOS occurs when the ovaries produce multiple (poly) follicles, and greater than normal androgen levels.

Androgens are hormones which are normally produced by both sexes, but are higher in men. Hormone irregularity from the ovary and pituitary gland in PCOS may result in menstrual irregularities and male pattern hair growth.

Insulin resistance is also a key factor in PCOS.

Why do I have PCOS?
It is largely unknown why women suffer from PCOS, but it seems to be a combination of:

• Genetic factors
• Insulin resistance
• Being overweight - overweight or obese women are more likely to develop PCOS

Why is my cycle so irregular or non-existent?
Although it is still unclear, it is believed that women who suffer from PCOS may have an inability to convert androgens to oestrogen in the ovary.

Furthermore, women with PCOS may also convert a greater amount of androgens to the stronger androgenic hormone, testosterone. Less oestrogen and more testosterone inhibits normal ovulation.

Infrequent or non-existent ovulation results in not having a period, or irregular periods.

What are the signs and symptoms of PCOS?

• Irregular or non-existent periods
• Heavy or erratic bleeding during your period
• Hirsutism – male pattern hair growth, on face, around the nipples, chest, buttocks, back and abdomen
• Acne
• Delayed onset of menstruation
• Tendency to be overweight or obese. Also a tendency to carry weight around the abdominal region.
• Insulin resistance. This is a term used to describe cells that are less sensitive to the signal of insulin. Fifty to seventy percent of women with PCOS will have insulin resistance whether they are overweight or not.

Treatment
The basic approach to treatment of PCOS is to adopt simple dietary and lifestyle changes.

Evidence has shown that staying within a normal weight, decreasing insulin resistance and focusing on a healthy diet and lifestyle are key to healthy ovulation, fertility and reduced androgen levels. You should always consult your healthcare professional if you have any of the symptoms listed above.

Improve insulin resistance
Poor insulin resistance seems to aggravate PCOS, therefore managing blood glucose levels is important. The following tips may help:

• Regular aerobic exercise. Try for at least 20-40 minutes 3 times a week
• Eating carbohydrates that have a low glyacemic index (GI). Low GI foods allow a steady supply of fuel and insulin to cells. Low GI foods can also be of help with weight loss.
• Minerals: magnesium and chromium are needed for healthy uptake of carbohydrate into the cells.

Weight loss
Not all women who suffer from PCOS are overweight. Those who are overweight should aim to attain a normal body mass index (BMI), and a healthy waist circumference (80 cm or less).

For more information on how to calculate BMI and waist measurements, visit the Australian Government website ‘Measure Up’: http://www.measureup.gov.au/internet/abhi/publishing.nsf/Content/home

Often women who lose as little as five percent of their weight will find that their cycle returns to normal. Furthermore they may improve insulin resistance, establish ovulation and have improve fertility.

Improving the menstrual cycle
There are herbal remedies and prescription medicines to help improve ovulation and decrease androgen levels, but these treatments should be established and recommended by your healthcare practitioner.

Focusing on weight loss, healthy eating and exercise will help treat the cause naturally and help the body to reach a more healthy rhythm.

References available on request