Polycystic Ovarian Syndrome (PCOS) Symptoms and Causes
Millions of women may be suffering from one of the most common endocrine disorders in the world and not even know it. As more and more celebrities speak out about living with Polycystic Ovarian Syndrome (PCOS) it’s finally bringing awareness to this debilitating condition.
It is estimated that more than 5 million women of reproductive age are affected by PCOS,1 an endocrine disorder commonly the result of hormonal imbalances. Conventional medicine underdiagnoses PCOS because they are only looking at and treating the symptoms you’re experiencing and not looking at you as a whole person. As a functional medicine doctor, I understand that it’s key to get to the root of your condition rather than just treat your symptoms. This is also true for PCOS.
There are many causes of PCOS and hormone imbalances in women, including chronic stress, diet, heavy metals, birth control medications, and even personal care products. I will talk more about how to recognize the symptoms and give you the tools to balance your hormones without synthetic hormone replacement medication. First, let’s talk about what PCOS is.
What is PCOS?
Polycystic Ovarian Syndrome (PCOS) is a problem or imbalance with your hormones. As the name suggests, PCOS affects your ovaries, where estrogen and progesterone are produced, and ovulation occurs, which is the monthly process of releasing an egg. These hormones regulate a woman’s menstrual cycle and facilitate reproduction. Your ovaries also produce a small amount of androgens – or male hormones.
When you have PCOS the ovaries may produce many small cysts or follicles – the word polycystic means “many cysts”. These can be detected during a pelvic examination through an ultrasound. However, some women who suffer from PCOS do not have cysts and still experience symptoms such as infrequent or heavy periods, which is the most common sign of PCOS.
Whether there are cysts present or not, hormonal balance is disrupted. Levels of estrogen and progesterone are lowered while androgen is higher than normal. This causes a range of symptoms and complications we will explore later.
PCOS and Fertility
Many women discover they have PCOS in their 20s and 30s when they start trying to have children. Because there is a direct link between PCOS and fertility problems, this is the period of time women typically get diagnosed with PCOS. However, it can develop any time after you go through puberty.
Although PCOS is the most common cause of infertility in women, having PCOS does not mean you can’t get pregnant.2 It just means that it may take longer to get pregnant.
What Causes PCOS
Medical professionals don’t know exactly what causes PCOS. However, there is evidence that high levels of androgens – those male hormones – prevent the ovaries from producing estrogen and progesterone.3 In healthy women, the ovaries produce about 40% to 50% of the body’s testosterone. PCOS can lead to excess male hormone production. 4 Insulin resistance, inflammation, and genetics have been linked to this excess androgen production.
Insulin is a hormone produced by the pancreas that is used to regulate your glucose levels. Just like estrogen and androgens, it can also get out of balance if the pancreas over- or under-produces insulin. Insulin resistance happens when cells in your muscles, fat, and liver don’t respond to insulin and can’t use glucose from your blood for energy. To compensate for the high glucose in your blood, your pancreas produces more insulin, which increases the production of androgenic hormones as well and can lead to PCOS.
One way to reverse insulin resistance is through diet. Make sure you are getting enough protein and eating a nutrient-dense diet full of leafy greens, organic fruits and vegetables, and grass-fed beef, pasteurized poultry and wild-caught fish. I trust ButcherBox for their devotion to clean, high-quality meats.
Studies have shown a link between PCOS and inflammation. Inflammation is your body’s response to an injury or infection. When your immune system is working optimally, acute inflammation is a critical weapon that protects you against severe and immediate stressors—for example, fighting off a bacterial infection or healing a wound. This type of inflammation is localized (think a sore throat or red, inflamed skin around a cut), and subsides once the threat is gone.
However, chronic inflammation in your body is a big problem. Chronic inflammation is systemic and ongoing, and puts your body in a state of constant alert. This type of inflammation sets you on the path to chronic illness including autoimmune disease. Because inflammation is a common symptom for several conditions, conventional medicine often does not link it to PCOS.
However, chronic low-grade inflammation has been found to be a key contributor to the development of PCOS.5 Insulin resistance, as I just discussed, can lead to an excess of glucose in your body, which can trigger oxidative stress and in turn, an inflammatory response.
The good news is that by finding the source of your inflammation you can prevent or reverse it. To fight inflammation at its source, I first recommend changing your diet and lifestyle, including eating anti-inflammatory foods, repairing your gut, reducing your toxic burden, healing your infections, and relieving your stress.
PCOS has been proven to be a condition passed through genetics. Although the role of genetic factors in PCOS is strongly supported, the genes that are involved in the development of PCOS were not fully investigated until recently as more awareness is being brought to this condition.6
Some studies have discovered a link between androgen genes being passed down through family members and increased male hormone production.7 As I discussed earlier, high levels of androgen hormones is the main factor in PCOS.
While you can’t do anything about your genetics, you can make the necessary lifestyle changes to reverse insulin resistance and inflammation if you have them. Even if you aren’t noticing insulin resistance or inflammation and think you may be suffering from PCOS, ask your functional medicine doctor to test your hormone levels to determine if you have increased androgen hormones. I used the DUTCH Complete test in my clinic for my patients. If you don’t have a functional medicine physician you can locate one at ifm.org.
If you have a hormone imbalance you may experience weight gain, insulin resistance, mood swings, low sex drive, and insomnia, among other symptoms. As I mentioned earlier, PCOS is drastically underdiagnosed even though it’s one of the most common endocrine disorders in women. That’s because, as you’ll see, a hormone imbalance is the number one indicator of PCOS and symptoms can be similar to other conditions. Since conventional medicine only looks at the symptoms instead of the entire body, PCOS goes undiagnosed in many cases.
PCOS symptoms typically develop when women have their first menstrual cycle. However, most women don’t notice any symptoms or simply manage them as a fact of life until they try to get pregnant or have unexplained weight gain. Some specific symptoms of PCOS include:8
- Irregular or heavy periods: If you have PCOS, you may miss periods or have fewer than 8 periods in a year. Or, periods may come every 21 days or more. Some women with PCOS stop having periods altogether.
- Excessive hair growth: The increase in male hormones can lead to hair on the face, chin and parts of the body where only men usually have hair. This affects up to 70% of women with PCOS.9
- Acne: You can see blemishes on your face, chest, and upper back.
- Thinning hair: You may notice your hair doesn’t have that vibrant, full feel to it. This can also be accompanied by hair loss on the scalp.
- Weight gain or difficulty losing weight: Putting on extra pounds or struggling to lose weight is a common sign in women with PCOS.
- Darkening of the skin: This is commonly visible in the creases of the neck, in the groin, or underneath your breasts.
- Skin tags: The tiny blemishes are small excess flaps of skin and develop in the armpits or neck area. They are typically harmless.
PCOS is usually diagnosed when irregular periods begin and is combined with excess androgens or polycystic ovaries. Let’s discuss further how PCOS is diagnosed.
Because there is not one direct cause of PCOS, there isn’t a single test that can be used to diagnose it. As I mentioned before, conventional medicine only looks at symptoms. The problem with that approach is that PCOS symptoms could potentially have a variety of causes. For example, heavy periods could be due to polyps, bleeding disorders, medications or uterine fibroids.
To get to the root of your symptoms, your functional medicine doctor will typically start by discussing your medical history, including your menstrual periods and changes in your weight.10
During your physical exam, your doctor will likely look for signs of excess hair growth, insulin resistance and acne. Lab tests can measure your hormone levels, including androgen levels. Additional blood testing can measure glucose tolerance and insulin levels. You can test your hormone levels in your home through My Labs for Life.
A pelvic exam or ultrasound can be used to look for cysts on the ovaries and other abnormalities, such as the thickness of the lining of your uterus. If your periods are irregular, the lining of the uterus could be thicker than normal.11
Conventional medicine offers treatments for PCOS through hormone replacement therapy (HRT), birth control pills, diabetes medications, and other medications to treat symptoms. The problem with hormone replacement therapy and birth control pills is that they often contain estrogen without the necessary progesterone to maintain a proper hormone balance. This leads to estrogen dominance, another form of hormone imbalance. Trading one imbalance for another isn’t the answer.
The hormones used in synthetic HRT and birth control also tend to be toxic, synthetic hormones that are not easily metabolized by the liver. This can lead to DNA damage and an increased risk for breast and endometrial cancer.12 Bioidentical hormone therapy is a more natural option for those who depend on HRT. It uses hormones extracted from plants that act just like the hormones we produce in our bodies. I also recommend balancing your hormones naturally through diet and lifestyle changes.
The Myers Way® is my proven lifestyle approach that addresses the root cause of your condition and puts you on the path towards achieving optimal health. It starts with a 30-day elimination diet to reset your digestive system by eliminating inflammatory foods such as gluten, dairy and refined sugar, along with toxic foods such as alcohol and caffeine. After 30 days, you begin to reintroduce foods to discover which foods are problems for you so you can maximize your diet while building a foundation for lifelong health.
Here are a few more ways you can balance your hormones naturally:
Exercise can increase the production of estrogen in women. If you are experiencing symptoms caused by low levels of estrogen you can find relief by engaging in daily activity, particularly high-intensity exercises such as running, spin classes, or even jumping rope.13 Find an activity you enjoy doing and will keep doing. I like to move my body by swimming or doing yoga on my Yogi Bare mat.
Toxins are poison substances that are dangerous to our bodies. Toxins can hide our water, processed foods, and even the air we breathe. Toxins are also prevalent in your personal care products. They may contain phthalates, parabens, and other hormone-disrupting chemicals. These toxins get absorbed into your skin, where they can enter your bloodstream and wreak havoc on your hormone production.14 I recommend that you read ingredient labels carefully to avoid the “dirty dozen” toxic ingredients and get rid of any toxic products you may have in your cabinets and replace them.
Get Enough Sleep
Many studies have found a high number of sleep disorders in women with PCOS.15 Poor sleep in women with PCOS is associated with depression, increased insulin resistance, obesity, cardiovascular diseases, and diabetes.16 Getting restful, quality sleep can lower your risk of diabetes and heart disease, two common long-term effects of PCOS. Sleep also supports healthy hormone production.17
You can maximize quality sleep by eating foods rich in tryptophan, magnesium and melatonin; eliminating alcohol, caffeine, over-the-counter medicines, fatty foods and chocolate; and getting on a regular sleep schedule and creating a bedtime routine. Rest and Restore Max™ is my number one tool to support a healthy sleep pattern. This physician-formulated supplement combines essential amino acids and minerals designed to support falling asleep fast and promotes deep and restful sleep.
Supplement to Balance Hormones
In conjunction with making lifestyle changes, supplements can be particularly helpful in naturally achieving an optimal hormone balance. A few of my go-to supplements to support hormone balance are:
- EstroProtect supports an optimal estrogen balance and mitigates estrogen dominance as well as your body’s natural elimination of excess steroid hormones and toxins.
- Adrenal Support is a cutting edge blend of adaptogenic herbs that supports optimal stress response, adrenal health and stress hormone production.
- The Myers Way® Multivitamin provides key nutrients that support optimal thyroid hormone production and overall general wellness.
As I’ve mentioned, PCOS is often overlooked by conventional medicine, so it’s important to advocate for your own health. Now that you have the tools and information to understand PCOS don’t wait to advocate for your reproductive health. If you’re experiencing the symptoms of PCOS, work with your functional medicine doctor to test your hormones and get them into balance. By incorporating these natural solutions into your everyday life, you CAN find relief from the troublesome symptoms of PCOS and achieve optimal health.
- Geographical Prevalence of Polycystic Ovary Syndrome as Determined by Region and Race/Ethnicity. Wendy M Wolf, Rachel A Wattick, Olivia N Kinkade, Melissa D Olfert. PubMed. 2018.
- The Role of Polycystic Ovary Syndrome in Reproductive and Metabolic Health: Overview and Approaches for Treatment. Carrie C. Dennett1 and Judy Simon. Diabetes Spectrum. 2015.
- Polycystic ovary syndrome (PCOS). May Clinic Staff. May Clinic. 2020.
- Ovarian overproduction of androgens. . Medline Puls. 2020.
- Inflammation in Polycystic Ovary Syndrome: Underpinning of insulin resistance and ovarian dysfunction. Frank González, M.D.. U.S. National Library of Medicine. 2013.
- Genetics of Polycystic Ovary Syndrome. U.S. National Library of Medicine. 2009.
- Genetics of Polycystic Ovary Syndrome. Richard S. Legro, MD. The Global Library of Women's Medicine. 2021.
- Polycystic Ovary Syndrome (PCOS). U.S. Department of Health & Human Services. 2020.
- Polycystic Ovary Syndrome (PCOS). The American College of Obstetricians and Gynoocolgists. 2020.
- Polycystic Ovary Syndrome (PCOS). May Clinic. 2021.
- How do health care providers diagnose PCOS?. U.S. Department of Health & Human Services. 2021.
- Previous oral contraceptive use and breast cancer risk according to hormone replacement therapy use among postmenopausal women. Vanessa Dumeaux, Agnès Fournier, Eiliv Lund, and Françoise Clavel-Chapelon. . 2007.
- How exercise helps balance hormones. Piedmont Healthcare. 2020.
- What Are the Side Effects of Parabens?. Kay Peck, RD, MPH. Healthfully. 2019.
- What Are the Side Effects of Parabens?. Ahmed A El-Sharkawy, Ghada S Abdelmotaleb, Mohammed K Aly, Ahmed M Kabel. Pub Med. 2014.
- Effect of metformin on sleep disorders in adolescent girls with polycystic ovarian syndrome. A N Vgontzas 1, E O Bixler, G P Chrousos. Pub Med. 2003.
- Role of Sleep and Sleep Loss in Hormonal Release and Metabolism. Rachel Leproult and Eve Van Cauter. U.S. National Library of Medicine. 2011.
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