What is PCOS?

 Poly Cystic Ovarian Syndrome (PCOS) is the most common female endocrine disorder affecting at least 1 in 10 women of the reproductive age. PCOS affects the fertility of women causing irregular periods by halting ovulation and have numerous contributing factors. Some of the common issues associated with PCOS include;

• Irregular menstrual cycle
• Obesity
• Insulin resistance
• Environmental toxins 
• Weight gain
• Acne
• Hirsutism – excess hair growth
• Fatigue
• Thyroid dysfunction
• Zinc deficiency 
• Vitamin D deficiency 
• Undereating 

PCOS is a broad term for the syndrome includes which has 4 different types based on the origin which helps diagnose and treat the condition.  

Types of PCOS 

1. Insulin Resistance PCOS

Insulin resistance is the most common PCOS type drive contributing 70-80% of cases.  This type of PCOS is concurrent with hormonal dysregulation as excess insulin can cause high androgens. Contributing causes include a high sugar diet, stress, alcohol, smoking, use of oral contraceptive pill, sleep deprivation, gut dysbiosis and magnesium deficiency.

Hormonal imbalance of insulin can cause weight gain (particularly around the central stomach area), heart disease and eventually type 2 diabetes, if left uncontrolled. 

Common symptoms of insulin resistance include;

• Weight gain
• Craving sugar
• Frequent urination
• Thirstiness 
• Fatigue 

2. Post-Pill PCOS

This PCOS type develops in women after coming off the oral contraceptive pill, the risk increases with the duration of OCP usage. The OCP can cause symptoms that qualify for PCOS that become apparent after ceasing use and can happen for numerous reasons;

• Worsen insulin resistance, leading to the development of insulin resistance PCOS
• Suppressing ovulation 
• Coming off a low androgen OCP can cause a surge in production of androgens leading to excess in the blood. 

3. Inflammatory PCOS

Inflammation can cause disruption in hormone receptors, supress ovulation and stimulates adrenals to make more androgens, leading to an excess. Inflammation can be driven by environmental toxins (endocrine disruptors), insulin resistance, smoking, inflammatory foods and digestive issues. 

Signs and symptoms of inflammation;

• Unexplained fatigue
• Headaches
• Joint Pain
• Skin conditions such as eczema and psoriasis 

4. Adrenal PCOS

Adrenal PCOS is not driven by insulin resistance or impaired ovulation and instead driven by the stress response. Caused by excessive stress, adrenally depleted PCOS paitents suffer from fatigue, insomnia and commonly mood issues. 

This type of PCOS is only diagnosed if;

• Do not have insulin resistance
• No affect after coming off the pill
• Met all the criteria for PCOS
• No signs of inflammation
• Have normal ovarian androgens (testosterone and androstenedione) but do have elevated adrenal androgens (DHEAS)

How do I know if I’ve got PCOS?

Unfortunately, because PCOS is a syndrome there is no single diagnostic criteria that is sufficient for clinical diagnostic and therefore relies on the Rotterdam Criteria, where clients must have at least 2 of the 3 following presentations;

• Irregular or no ovulation
• Hyperandrogenism 
  • high androgens in either blood test or clinical signs (i.e acne, excess male hair patter growth, hair loss)
• Polycystic ovaries on an ultrasound examination 

It is important for women to know that PCOS cannot be diagnosed by an ultrasound itself as cysts on the ovaries are common and can develop from not ovulating that month due to factors such as;

• OCP usage
• Stress
• Under-eating
• Travelling 
• Being out of a normal routine

Signs and symptoms associated with PCOS

• Irregular periods or cycles that are consistently longer than 35 days 
• Not ovulating
• Multiple follicles on your ovaries
• Acne; around the jawline, chin and chest and upper back 
• Unwanted hair growth (hair growing on your chin, upper lip and chest and around nipples)
• Hair loss or thinning on your head
• Insulin resistance or imbalanced blood sugar levels 
• Anxiety, depression, mood swings, fatigue, low libido, cravings
• Weight gain and/or difficulty losing weight 
• Blood tests with high LH to FSH ratio
• Blood tests with high androgens such as testosterone or DHEAS
• Infertility

Book in for an initial consultation today at Pure Health to help investigate and treat your PCOS 

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