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Polycystic Ovary Syndrome
Medical & Scientific Research Polycystic ovary syndrome (PCOS) is a common heterogeneous Endocrine Disorder characterized by irregular menses, hyperandrogenism, and polycystic ovaries. The prevalence of PCOS varies depending on which criteria are used to make the diagnosis, but is as high as 15%–20% when the European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine criteria are used. Clinical manifestations include oligomenorrhea or amenorrhea, hirsutism, and frequent infertility. Risk factors for PCOS in adults include type 1 diabetes, type 2 diabetes, and gestational diabetes. Insulin resistance affects 50%–70% of women with PCOS leading to a number of comorbidities including metabolic syndrome, hypertension, dyslipidemia, glucose intolerance, and diabetes. Studies show that women with PCOS are more likely to have increased coronary artery calcium scores and increased carotid intima-media thickness. Mental health disorders including depression, anxiety, bipolar disorder and binge eating disorder also occur more frequently in women with PCOS. Weight loss improves menstrual irregularities, symptoms of androgen excess, and infertility. Management of clinical manifestations of PCOS includes oral contraceptives for menstrual irregularities and hirsutism. Spironolactone and finasteride are used to treat symptoms of androgen excess. Treatment options for infertility include clomiphene, laparoscopic ovarian drilling, gonadotropins, and assisted reproductive technology. Recent data suggest that letrozole and metformin may play an important role in ovulation induction. Proper diagnosis and management of PCOS is essential to address patient concerns but also to prevent future metabolic, endocrine, psychiatric, and cardiovascular complications. (Simons & Pate 2013) Patient Information Polycystic Ovary Syndrome (PCOS) is a physical condition that affects the ovaries. People who have been diagnosed with PCOS via an ultrasound of the ovaries “may” have ovaries that have many small “cysts” on the ovary or (both ovaries) and “may” also have abnormal elevated levels of androgen hormones, such as testosterone as well as abnormal level of DHEA. The diagnosis of PCOS is typically established by the evidence of cysts and /or abnormally high levels of testosterone in biologically female individuals that have two X chromosomes (XX) coupled with the patient reporting abnormal ovulation and menstrual cycles. PCOS Signs & Symptoms The Syndrome of PCOS can be complex because this syndrome can include other physical symptoms that may contribute to PCOS diagnosis, and physical signs and symptoms such as;
Potential Causes That May Contribute to PCOS
Typical Patient PCOS Labs Advanced Female Hormone Panel Adrenal Stress Panel Fasting Insulin Test Hemoglobin A1C Fasting Blood Sugar Nutritional Recommendations for PCOS Based on nutritional scientific literature reviews for PCOS, the following findings appear to improve outcome strategies for patients diagnosed with PCOS. PCOS Diet A Mediterranean Diet demonstrated an improvement in PCOS in the literature based on ultrasound of the ovaries. Hydration and exercise also showed a positive impact on PCOS. Weight loss in PCOS patients may be more effective when diet and exercise is improved on a daily basis. Fruits and vegetables low in glycemic index such as artichokes, asparagus, bean sprouts, brussels sprouts, broccoli, cabbage, cauliflower, celery, cucumber, eggplant, mushrooms, onions, peppers, salad greens, spinach, tomato, turnips, zucchini, melons, berries like strawberries, raspberries, blackberries and blueberries, citrus fruits like oranges, tangerines, grapefruit and lemons, peaches, plums, apricots, cherries, and pears. Low-fat dairy (small quantities). Fish rich in omega 3 fatty acids, lean red meat and poultry (e.g., chicken, turkey) in small quantities, fatty acids (olive oil-olives, vegetable oils, fish oils), (almonds, pumpkin seeds, sunflower seeds, sesame seeds, poppy seeds), legumes, whole grain products and alcohol in moderate amount (150 mL of red wine per day). Grains such as whole wheat, brown rice and barley with their fiber-rich outer shell, (bran), and inner germ provides vitamins, minerals and good fats. Choosing whole grain side dishes, cereals, breads and more may also lower the risk for heart disease, type 2 diabetes, cancer and improve digestion. The Mediterranean Diet (style) of eating has been reported in the literature to also improve cholesterol as well as blood sugar levels. Improving your cholesterol and elevated blood sugar levels contributes to improvement of the polycystic ovarian syndrome. This particular diet also has been shown to improve the damaging outcomes of chronic inflammation, coupled with an immune response that often gets “triggered” when high levels of refined food is consumed. A high sedentary lifestyle has been shown to also lead to chronic or ongoing inflammation which can lead to diabetes, heart disease, and also contribute to PCOS. The Mediterranean Diet has been shown to help arteries stay flexible and resist plaque build ups. Nutritional Professional-grade supplements that are highly recommended for patients diagnosed with PCOS are available at Dr. Carly's online nutritional store called Fullscript. Click here to purchase. All supplements directions are per bottle label. Glysen (k-1) Adaptocrine (K-2) Omega Co-3 (K-7) Methyl SP (K-14) Advanced Functional Testing may be required to manage PCOS. Two advanced tests that can help providers & patients develop home based strategies include Adrenal Testing and Female Hormone Testing. The Adrenal Stress Index can: • Help identify possible causes of excessive fatigue • Identify underlying reasons for chronic infections including sinusitis and other recurrent respiratory infections • Screen for concerns with blood sugar and insulin resistance • Help determine if a gluten-free diet may be best for you • Identify possible reasons why you may have difficulty falling asleep or staying asleep The Female Hormone Panel Is easy to collect saliva test samples. The hormone panel evaluates various hormones that play a role in female reproductive function. These hormones fluctuate throughout the menstrual cycle; therefore, testing on only one day of the month may not give a complete portrayal of the dynamic balance of your hormones. The Female Hormone Panel tests 11 separate samples taken throughout the entire monthly cycle in order to gain a more comprehensive understanding of what may be contributing to symptoms. Your hormone levels are measured from your saliva, which can be collected easily and painlessly at your convenience. The Eleven saliva samples are used to assess: • Estradiol - Produced by the ovaries, this is the most active form of estrogen prior to menopause. Proper levels are necessary for healthy menstrual cycles and fertility. • Progesterone - As the word indicates, progesterone is “pro-gestational”. This hormone prepares the endometrium (internal uterine lining) for implantation of the fertilized ovum. Abnormal levels can play a significant role in infertility and recurrent miscarriage. • DHEA - A hormone produced by the adrenal glands, DHEA is a precursor to estradiol and testosterone. Too much or too little DHEA can lead to abnormal levels of both estradiol and testosterone. • Testosterone - Often considered a male hormone, testosterone plays an important role in maintaining muscle mass, bone density, metabolism, energy, and libido. Elevated levels are associated with symptoms such as acne and facial hair growth, and may indicate PCOS. The Female Hormone Panels screen for: • Hormone imbalances that may contribute to PMS and migraines • Factors contributing to infertility such as luteal phase deficit, anovulation, and polycystic ovarian syndrome (PCOS) • Inadvertent or excessive hormone exposures that may cause irregular menses • Underlying hormone abnormalities associated with painful or heavy menses • Early indicators of perimenopause |
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