All About PCOS: Testing, Root Causes, and Management

As an acupuncturist working mainly with menstrual issues, it’s important that I address Polycystic Ovarian Syndrome, or PCOS. Many people with menstrual issues eventually discover that their problems stem from PCOS.

Common symptoms include irregular periods, acne, mood swings, unwanted weight gain, and increased facial hair growth. For many of my acupuncture patients coming in with fertility concerns, a PCOS diagnosis can get them much closer to conceiving.

Testing for PCOS

To be diagnosed with PCOS, here is what is taken into account:

1. High levels of androgens, the hormones that males typically produce in higher amounts than females (such as testosterone)
2. Irregular ovulation or lack of ovulation, or presence of ovarian cysts with an ultrasound
3. Ruling out other disorders that have high androgens and disordered ovulation

You may have noticed that this means that you can be diagnosed with a condition whose name implies ovarian cysts, without actually having cysts. This is because back in the day, as soon as doctors found ovarian cysts, the diagnosis was slapped on. And you can have ovarian cysts without having PCOS.

Unfortunately, some doctors still jump to a diagnosis as soon as they find cysts without further investigating. And conversely, if they don’t find cysts, some may decide that everything is normal.

Before anything can be determined, a hormonal panel should be carried out through a blood test or saliva test, and an ultrasound should be scheduled to look for ovarian cysts.

Root causes

PCOS can develop for many different reasons. While this is still under research, a few possible causes have already been determined.

Insulin resistance

You’ve probably heard of insulin before. It’s that hormone that tells your cells to take in sugar when there’s too much sugar in your blood. However, when your body produces high levels of insulin for long periods of time, cells becomes desensitized to insulin. Your body responds by secreting more and more insulin so that your cells can continue to respond.

High levels of insulin actually send a message to your ovaries to produce more testosterone and stop ovulating normally. Those whose PCOS is rooted in insulin resistance tend to be the ones who experience uncontrollable weight gain, acne, and facial hair growth.

Inflammation

Chronic inflammation can also interfere with normal ovulation. Inflammation uses up a lot of your body’s resources. When there aren’t enough resources to go around, the body becomes choosy in how it spends those resources.

Because the reproductive system isn’t needed for immediate survival, it’s the first system to receive a smaller supply of resources. Your body especially doesn’t want to share limited resources with a second human life. Therefore, your body makes it difficult to conceive.

Synthetic hormones

When stopping the pill, many people notice that it takes several months for their period to come back. Others find that their period doesn’t start again on its own.

This happens partly because when taking synthetic hormones for years on end, your body “forgets” how to get your hormones back on track.

Hormone disruptors

Our environment is loaded with hormone disruptors. Tap water, plastics, cleaning products, and cosmetics all contain compounds that can mess with hormones. I’m sure I don’t have to tell you that that’s bad for you.

As hormone levels become wonky, cysts can develop, and periods can become less and less frequent.

Odds are that those with PCOS don’t only have a single one of these factors. All of these factors can combine in different ways to create different types of PCOS. These different types all manifest themselves differently. This can make PCOS particularly difficult to identify in some cases.

Management of PCOS

Typical mainstream treatment of PCOS involves taking synthetic hormones to mask symptoms. However, these symptoms will most likely return when coming off the hormones. In cases of insulin resistance, many doctors prescribe Metformin, a medication for Type 2 Diabetes.

An often overlooked component of PCOS management is nutrition. Diet impacts how our bodies produce hormones, and how we react to the hormones in our bodies. Additionally, in cases of insulin resistance, changing the diet can make a world of difference. And finally, while it may not be possible to fully eliminate hormone disruptors from your environment, your diet can affect how your body processes them.

While there is no one-size-fits all diet for PCOS, certain changes seem to show consistent results. Gluten, dairy, and sugar are the most inflammatory components of the Standard American Diet. By reducing or eliminating these 3 ingredients, your body is better equipped to do some repairs to reduce inflammation.

In order to keep blood sugar levels stable to reduce insulin resistance, it’s important to eat healthy fats and good quality protein with each meal. And finally, make sure to eat a generous portion of vegetables with every meal. Yes, I even encourage eating more vegetables with breakfast.

Acupuncture is also a helpful tool to help reduce inflammation and regulate hormones. If you’re located in Ottawa and are curious about acupuncture, book an appointment with me!