Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS): Understanding the Basics

Polycystic Ovary Syndrome, commonly referred to as PCOS, is a prevalent and multifaceted endocrine disorder affecting women of reproductive age worldwide. Characterized by a variety of symptoms such as irregular periods, excessive body hair, weight gain, and infertility, PCOS is more than just an ovarian condition; it represents a complex metabolic, hormonal, and insulin-related anomaly. The diagnosis of PCOS often involves various tests, including pelvic ultrasounds and blood work, aimed at detecting ovarian cysts and hormonal imbalances. Traditional treatments for PCOS typically involve lifestyle changes and medications like birth control pills and diabetes drugs, focusing largely on symptom management

A Metabolically Directed Approach to PCOS

Diving deeper into the treatment of PCOS, a metabolically directed approach offers a unique and comprehensive perspective. This approach, grounded in understanding the root metabolic causes of PCOS, shifts focus from merely treating symptoms to addressing the underlying factors contributing to the syndrome. Key elements include managing insulin resistance, inflammation, and hormonal imbalances through diet and lifestyle modifications. By embracing this holistic strategy, individuals can achieve a more effective and sustainable management of PCOS, potentially reducing long-term health risks associated with the condition such as type 2 diabetes and heart disease.

Symptoms of PCOS

Irregular periods, missed periods, very light periodS
Excess body hair
Weight gain
Male-pattern baldness
Oily skin and acne
Infertility
Ovaries that are enlarged
Cystic ovaries

Diganostic Tests

Pelvic ultrasound – to determine presence of ovarian cysts
Blood work – checking for elevated testosterone levels, estrogen levels, blood sugar levels, HgA1c, Insulin levels

Conventional Treatment for PCOS

“healthy diet”
Birth control pills – to treat symptoms of painful cycles, and acne
Diabetes medication – to lower insulin levels
Spironolactone – to block high testosterone levels
Other drugs to treat other symptoms

Office on Women's Health (.gov)

“There is no cure for PCOS, but you can manage the symptoms of PCOS. You and your doctor will work on a treatment plan based on your symptoms, your plans for having children, and your risk of long-term health problems such as diabetes and heart disease” Feb 22, 2021

The Mayo Clinic

The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may lower the risk of long-term complications such as type 2 diabetes and heart disease”

Root Causes of PCOS

A high carbohydrate, high sugar, low cholesterol, low saturated fat diet and chronic snacking (Edibolic Stress) This unhealthy diet increases your insulin secretion while simultaneously increasing insulin resistance Chronic inflammation secondary to chronic stressors including environmental illness (CIRS, mold) also increases insulin resistance High insulin and inflammation stimulate aromatase activity transforming testosterone and androstenedione into estrogen Therefore, most women with PCOS have high estrogen and high

Hippocrates 2,500 Years Ago

“All Disease begins in the Gut”
Every time you eat or drink, you are either enhancing your health or promoting disease

Root Causes of PCOS

Aromatase Transforms Androgens into Estrogens and Visa Versa

Aromatase activity is increased by excess insulin levels
Aromatase activity is increased by chronic inflammation
Therefore, a metabolically directed approach to treatment of PCOS includes a relatively low carbohydrate diet and treatment for chronic inflammation

Elevated Aromatase Activity Increases Production of Estrogens

There are Several Forms of Estrogen

The most potent Estradiol (2 alcohols)
The least potent Estriol (3 alcohols)
Intermediate potency Estrone (1 alcohol and 1 ketone)
These estrogens are then metabolized by various enzymes to produce estrogenic intermediates
The 4 hydroxy and the 16 hydroxy estrogens cause proliferation of estrogen sensitive tissues and are causative in PCOS

Some forms of Estrogen are more Potent than Others Diindolylmethane (DIM) can lower the Potency of Estrogen

Diindolylmethane (DIM)

Diindolylmethane (DIM) is a natural compound that is found in cruciferous vegetables like broccoli, cabbage, cauliflower, and brussel sprouts. DIM has been found to have a wide range of potential health benefits.

Catechol O Methyl Transferase

COMT
An important enzyme that transfers methyl groups from one substance to another
Important for the metabolizing of hormones and neurotransmittors
Needed for the proper detoxification of estrogens
Adequate methyl groups need to be available for this transfer
Therefore, inadequate availablility of methyl groups

Specific Estrogens (Catechols) can be Metabolized by Catechol O Methyl Transferase (COMT) to Safer Metabolites

Glucuronidation

An important process in your liver
Processes carbohydrates, therefore a high carbohydrate, high sugar diet can raise your estrogen
Helps detoxify both estrogen and testosterone
Dysbiosis (imbalanced bowel flora) increases glucuronidase levels which impede glucuronidationleadingtoelevatedestrogen

Estrogens can be Detoxifed by your Liver Through a Process Known as Glucuronidation

Glucuronidation

What is the function of glucuronidation?
The human body uses glucuronidation to make a large variety of substances more water-soluble, and, in this way, allow for their subsequent elimination from the body through urine or feces (via bile from the liver). Hormones are glucuronidated to allow for easier transport around the body.
Glucuronidation-Wikipedia

Progesterone Balances Estrogen

Many women have simultaneously high estrogen and low progesterone
This is known as Estrogen Dominance
Estrogen Dominance is contributing factor to developing PCOS

Estrogen Dominance Contributes to PCOS

Paracelsus

“All things are poison, and nothing is without poison; the dosage alone makes it so a thing is not a poison”
“The dose makes the poison”

Metabolic Imbalances Contributing to PCOS

Excess Alkalinity – contributes to insulin resistance
Parasympathetic imbalance contributes to excess insulin secretion
Ketogenic imbalance contributes to excess alkalinity and insulin resistance
Glucogenic imbalance depletes glucuronidation leading to increased estrogen

Thyroid Involvement in PCOS

Elevated Insulin and elevated estrogen, commonly seen in PCOS will contribute to Reverse T3 Syndrome
Reverse T3 syndrome leads to a functional hypothyroidism consequently exacerbating the weight gain, insulin resistance and fatigue seen in PCOS

Diet Myths

Myth -“Eating multiple small meals will boost your metabolism”
Fact – every time you eat, your pancreas secretes insulin
Myth – Saturated fat causes heart disease and obesity
Fact – Consuming saturated fats increases your metabolism and reduces inflammation

PCOS Overview

PCOS Treatment Summary

Fix your diet – relatively low carbohydrate, high saturated fat diet, no snacking
Identify and reduce stressors of chronic inflammation
Address metabolic imbalances
Address thyroid issues
Some people may benefit from DIM, Calcium-D-Glucurate, B – Vitamins (Activator, Trimethylglycine), Synbiotics (Immunosynbiotic, Immune Power), Iodine, Progesterone Replacement

To learn more about MD Wellness contact us today by giving us a call at (732) 268-7663, emailing us at [email protected] or by requesting an appointment online.

1670 ROUTE 34 N. 3R FLOOR SUITE 3C WALL • NJ 07727

+1 732 268-7663

1670 ROUTE 34 N. 3R FLOOR SUITE 3C WALL • NJ 07727

+1 732 268-7663

Polycystic Ovary Syndrome (PCOS)