Inflammation is widely recognized as the root of many of the major diseases that plague the Western world. Cardiovascular disease, metabolic syndrome, hypertension, some cancers, diabetes, and PCOS all share the common root of inflammation.
Chronic inflammation may be caused by obesity, food sensitivities and allergies, and stress. It may also result from environmental and lifestyle factors such as pollution, poor diet, smoking, lack of exercise, and poor dental health. Getting to the root of these problems through a proper inflammation-reducing diet and lifestyle is critical for women with PCOS.
Why Do I Have PCOS?
Although the exact cause of PCOS is unknown, it is generally agreed that genetics, hyperinsulinemia (high levels of insulin) and insulin resistance, and/or a defect in a hormone-producing organ play a role. I have already discussed the chicken-and-egg debate about insulin and PCOS, whether chronically high levels of insulin cause excess androgens or vice versa. With regard to genetics, studies show that a woman with PCOS has a 40 percent likelihood of having a sister with the syndrome and a 35 percent chance of having a mother with the disorder. It is possible that a mother’s obesity, insulin resistance, or exposure to food high in advanced glycation end products (AGEs) or industrial toxins such as bisphenol A (BPA) may be the root cause. If PCOS is genetic, the genes involved in its expression may be triggered by environmental stimuli such as poor diet or rapid weight gain.
Some women with PCOS first experience symptoms when they stop taking the birth control pill. Typically, there was a predisposition before taking the pill, but only when they stopped taking it did symptoms emerge as a result of the disruption in communication between the pituitary gland and ovaries. In this case, symptoms should clear as soon as communication is reestablished.
How Can I Get Diagnosed?
Getting a firm diagnosis can be a long journey. There are several things to remember when seeking a diagnosis:
Be honest with your doctors. Tell them all of your symptoms. Try not to be embarrassed, and don’t write symptoms off to genetics, saying something like, “My aunts all have thinning hair; it must be genetic.” Your aunts may all have PCOS!
PCOS has a name problem. Approximately 20 percent of women who do not have PCOS have cysts on their ovaries. Similarly, about 30 percent of women who do have PCOS have no cysts.
Doctors are not always well-educated about PCOS and may try to treat each symptom separately instead of looking for the root cause. Press to get to the heart of your symptoms.
Be assertive when asking for lab tests. The more information you and your doctor can collect, the quicker you will get to the root of your symptoms and develop an effective plan. For a complete list of suggested labs, visit PCOSDiva.com/labs.
There is no definitive test to determine whether you have PCOS, but the most widely accepted diagnostic criteria are the Rotterdam Criteria. These were developed by the European Society for Human Reproduction and the American Society for Reproductive Medicine and include the original National Institutes of Health and EAE-PCOS Society diagnostic criteria. To be diagnosed with PCOS, a woman must present two of these three criteria:
1 Oligoovulation (irregular ovulation) or anovulation (absent ovulation)
2 Hyperandrogenism (elevated levels of androgenic hormones such as testosterone, clinical and/or biochemical)
3 Polycystic ovaries (enlarged ovaries containing at least twelve follicles each, shown on an ultrasound)
Even with these criteria in place, diagnosis can be tricky. Medications like birth control pills alter androgen levels and make testing inaccurate. Keep in mind that women may have irregular or even regular cycles and not ovulate or only ovulate occasionally. Having a period does not mean that you are ovulating. In addition, the presentation of symptoms may vary. There is no one-size-fits-all characterization of PCOS. You may be overweight and have irregular periods and acne, and the next woman may be lean with polycystic ovaries, absent periods, and hirsutism.
It is possible that you do not meet the Rotterdam Criteria at all, but still suffer from the symptoms. PCOS is often used as an umbrella term to include women with similar symptoms stemming from hyperandrogenism. You may also have a thyroid condition, and, again, I encourage all women with PCOS symptoms to have a complete set of thyroid labs to rule out thyroid dysfunction. You may have post-pill PCOS, a temporary condition with many of the same symptoms as PCOS caused by coming off of the birth control pill. If this is the case, once you rebalance your hormones, your symptoms should clear up for good.
As you can see, no single treatment will work for all women. The Healing PCOS 21-Day Plan is designed so that you can examine your symptoms, find the root cause, and discover what works for you.
Why Medications May Not Help: The “Band-Aid Effect”
I hear from women every day whose PCOS journeys had a very similar beginning. In their teens, they had irregular periods, acne, and/or painful PMS. Their doctor “fixed” these symptoms by prescribing the pill. Now the journeys divide. Some women tolerated the pill, but when they got off it, their symptoms returned with a vengeance and they struggled to conceive. Others could not tolerate the pill (nausea, headaches, weight gain, loss of libido) and have struggled with their symptoms and a series of drugs meant to help ever since.
There is a reason that these drugs cannot provide real, sustainable healing. At best, they are nothing more than Band-Aids, covering symptoms but not treating the root cause. At worst, they complicate your health picture with destructive side effects.
The Birth Control Pill
The pill is hands-down the go-to prescription from doctors. It has been touted as a miracle drug for everything from regulating periods to clearing up acne. In many cases, it seems to work for a while, but eventually you stop taking it and your symptoms return. Unfortunately, the pill has some serious downsides that most women are never told about.
Blood clots. Research indicates that women on the birth control pill increase their risk of blood clots by a factor of 1.6. For those taking pills with higher levels of estrogen, that risk is twice as high. This risk throws fuel on the fire for women with PCOS who are already at higher risk for heart attacks and stroke.
Increased insulin resistance. Studies show that with certain types of birth control pills, women suffered “unfavorable changes of insulin sensitivity.” This was certainly my experience. Researchers believe that this may have to do with the ratio of estrogen and progestin used in the various pills. Due to this concern about estrogen and insulin resistance, many doctors do not prescribe the pill for women at risk for or who already have diabetes. Whatever the reason, women with PCOS should not be taking any medications that worsen insulin resistance.
Lower libido. The pill, by definition, alters your hormones. Unfortunately, for some women, it dampens libido (you see the irony). This happens for a couple of reasons. First, the steady stream of synthetic hormones from the pill evens out the body’s natural cycle of high (around ovulation) and low libido. Second, it suppresses testosterone levels. That’s great for taking care of androgen-induced symptoms (acne, facial hair), but is lousy for your sex drive.
Nutrient deficiency.