Poly Cystic Ovary Syndrome is characterised by the presence of small cysts growing on the ovaries which influence an imbalance in the production of the hormone androgen. PCOS is primarily an endocrine and metabolic disorder that can result in symptoms such as insulin resistance, infertility and excess hair growth.
PCOS is a systemic endocrine and metabolic disorder. It can influence the onset of excessive androgen production, adrenal hyperplasia, insulin resistance, hyperplipidemia, weight gain, anovulatory, hirsute and acne.
The onset of PCOS can be determined by assessing insulin resistance and blood glucose levels. Measuring basal body temperature is also a good indicator as this will identify whether an individual is ovulating healthily; ovulation will often become impaired in PCOS, so this can provide a good assessment.
Key Signs and Symptoms:
- Irregularities in menstrual cycle and mild pain on ovulation
- Irregular appetite
- Disordered gonadotropin output
- Insulin resistance and elevated fasting blood insulin levels
- Increased ovarian androgen production
- Lack of regular ovulatory cycles (ie no ovulation), menstrual irregularity and infertility
- Excessive hair growth(hirsutism) and hair loss
The Role of Insulin in PCOS
Hyperinsulinemia (elevated serum insulin levels) appears to cause the hyperandrogenism by increasing testosterone and androstenedione. High levels of androgenic hormones interferes with the ovarian axis, leading to increased lutenising hormone levels, anovulation, amenorrhoea and infertility.
The term "insulin resistance" means that your body is more resistant to the action of insulin than normal. Insulin is the hormone that keeps your blood sugar within "normal" limits. If you are insulin resistant, your pancreas has to make more insulin to keep your sugar normal. If your pancreas cannot keep up with the increased demand, your blood sugar will rise and you will become diabetic.
It has been thought that insulin resistance may be due to an inherited abnormal form of insulin that is inefficient at regulating blood sugar levels. It may also be caused by problems with the insulin receptors not allowing insulin to facilitate the entrance of glucose into the body’s cells
It is fairly easy to determine whether someone is insulin resistant. One of the most common ways to find out is simply to measure the fasting blood sugar and fasting insulin level in the morning. Most women will also need to undergo a Glucose Tolerance Test, measuring both blood sugar levels and insulin levels. If the insulin levels are higher than they ought to be, this indicates insulin resistance
Health Risks Associated with PCOS
As PCOS has a close link with insulin resistance, the majority of health risks associated with this condition affect the cardiovascular system, such as cardiovascular disease, diabetes and high cholesterol. However, the alteration to ‘normal’ female hormone production and an increase in testosterone and androgens increases the risk of the onset of uterine abnormalities and uterine cancer
Conventional Treatment Strategies
Most treatment strategies are centred around reducing insulin resistance. The most common drug prescribed are Metformin and oral contraceptives.
Alternative Treatment Strategies
Alternative treatment strategies will look to restore hormonal balance, balance the metabolism, including blood sugar levels and aid the liver in breaking down steroidal hormones like androgens.
Core herbs for managing PCOS
- Hemp Seed Oil, Cannabis sativa, is packed with essential fatty acids that help to process cholesterol and support the metabolism
- Karela/Bitter melon, Momordica charantia, reduces fasting & postprandial blood glucose without increasing insulin & appears to enhance tissue sensitivity to insulin
- Fenugreek, Trigonella foenicum-graecum, reduces fasting blood glucose without increasing insulin.
- Gurmar, Gymnema sylvestre, stimulates insulin production
- Guggul, Commiphora mukul, supports thyroid function, clears stagnations and fluid accumulation from the pelvic area.
- Vitex agnus castus, regulates progesterone levels
- Psyllium Plantago ovatum reduces postprandial glucose and insulin levels whilst also increasing fibre levels which reduces fasting blood glucose without increasing insulin
- Turmeric, Curcuma longa, for regulating the metabolism and clearing congestion within the pelvis through improving circulation
- Shatavari, Asparagus racemosa, to help clear congestion in the female reproductive tract and support healthy ovulation and improve fertility
- Ashwagandha, Withania somnifera, to support and strengthen the nervous system during periods of stress
Exercise is also important to mention when considering treatment strategies. Exercise enhances tissue sensitivity to insulin; 80% of the body’s insulin mediated glucose uptake occurs in muscles, so regular exercise can help to keep the blood sugar balanced.