Symptoms of PCOS
Polycystic Ovarian Syndrome (literally, multiple ovarian cysts) presents with a few key signs and symptoms, though not all of them are present in every case.
- Overweight. Classically this is part of the picture, though about half of the women who have PCOS are not overweight. When patients are overweight, however, the syndrome is also associated with elevated blood sugar, insulin resistance, or even Type 2 Diabetes.
- Anovulation or irregular periods.
- Infertility (this is a common cause of it).
- Hirsuitism (abnormal hair growth)
- Hypertension (high blood pressure)
Causes of PCOS
Estrogen dominance is always a problem in these women, often due to toxic exposures to endocrine disrupting chemicals such as phthalates, Bisphenol A, cadmium, and mercury. Arguably, insulin resistance may also be a cause: too much insulin decreases Sex Hormone Binding Globulin (SHBG), which leads to more circulating androgens (see below).
Diagnosis of PCOS
Labs tend to show an elevated ratio of LH:FSH (the hormones in your brain that tell your ovaries to produce estrogen), too-high androgens (usually testosterone, free and total, as well as DHEA, leading to acne and hirsuitism and suppressing ovulation). Insulin is also sometimes (but not always) elevated, and cholesterol can be elevated as well, as part of the metabolic syndrome picture.
Diagnosis is a combination of symptoms, biochemical signs (those that show up on the labs), and imaging (an ultrasound showing multiple ovarian cysts), combined with exclusion of other possible causes.
Natural Treatment Options: Inositol
Some of the classical treatment options include Metformin (a diabetes medication, for those women whose PCOS symptoms include metabolic syndrome) and birth control (to regulate LH:FSH production and suppress over-production of androgens).
From a naturopathic standpoint, the treatment will look somewhat different depending on the woman’s symptoms (for example, if she doesn’t have metabolic syndrome then we won’t be focusing on regulating blood sugar, and if she’s clearly had a toxic exposure to endocrine-disrupting chemicals, then detox will be a big part of the protocol). But one treatment I almost always include is inositol.
Present in muscle tissue as myoinositol, inositol regulates both FSH and TSH (thyroid stimulating hormone). It also plays a role in regulating insulin levels. Here are a few impressive studies:
- In 2007, this study demonstrated a higher ovulation rate (25% compared to 15%) and a shorter time to first ovulation (24.5 days compared to 40.5 days) in women who received inositol versus those who received placebo.
- In this study, women in the group receiving inositol saw a significant decrease in serum testosterone (both free and total), plasma triglycerides, blood pressure, and insulin levels.
- In 2010, this study compared Metformin treatment with inositol, showing a significant increase in ovulation (65% compared to 50%) and in pregnancy (30% compared to 18.3%) in the group receiving inositol.
The Bottom Line
Combined with appropriate protocols to address blood sugar, cholesterol, insulin levels, hypertension, and clinical symptoms of high androgens, there are definitely good treatment options out there for PCOS. Inositol is high on my list.
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