Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome is a common endocrine disorder affecting 5% to 10% of women of reproductive age all around the world. Many women with endometriosis are also diagnosed with PCOS. Symptoms vary from irregular menstrual cycles with months between, hirsutism, acne, frontal hair loss, skin tags and acanthosis nigrans (a velvet-like skin patch often found in the groin, neck, and under the breast and arms). Weight accumulates on the stomach, thighs and hips. Though PCOS is independent of obesity, skinny and overweight women show signs of decreased insulin sensitivity.

In PCOS, hormone messengers from the pituitary gland to the ovary seem to be at abnormal levels, which upset the normal hormonal balance. Lutenizing hormone (LH) levels are often abnormally raised, which stimulates the ovarian follicle, but the follicle is unable to mature fully as follicle-stimulating hormone (FSH) measurements are then at the wrong levels. High LH causes the ovarian follicle to produce more testosterone than is normal. This testosterone changes the oestrogen level and triggers menstrual dysfunction.

These scrabbled hormones lead to the ovary’s ending up with many small cysts ‐ having between 6 to 10 cysts constitutes a diagnosis of PCOS. Some contain eggs, others are dormant and the rest may secrete hormones. Unlike endometriotic (chocolate) cysts, these PCOS cysts remain small and do not grow (8mm diameter is maximum). They appear, are reabsorbed and others come to take their place, all due to receiving the wrong hormonal messages?

PCOS tends to run in families. Some women with endometriosis also appear to develop PCOS, but not every woman.

Menstruation should occur at least three times each year with PCOS; otherwise there may be cellular changes in the endometrium due to the unrelenting levels of elevated oestrogen, which could lead to cancer. Normal menstruation is once each month.

It is a sad state of affairs that so little is understood of the normal hormonal balance of a normal reproductive system. However, nutritional therapy may help bring hormones back into balance, improve the quality of life, bring the menstrual cycle back into normallity and improve the chances of fertility.