I’ve had a number of clients come to the clinic lately who are struggling with Polycystic Ovarian Syndrome (PCOS).
The common thread woven into their experience has been confusion, frustration and disappointment at the lack of medical care available.
Aside from being offered the pill to regulate their cycles (it doesn't) or drugs that force ovulation, there isn't a lot medically available to support folks with PCOS or to help them heal the underlying causes.
PCOS is a notoriously puzzling condition - so let's shed some light on what PCOS is, how getting the right diagnosis can be a game changer and how holistic support can help.
First things first.
What is PCOS?
PCOS is complex condition that can be best thought of as a “group of symptoms” that effect ovulation and involve a high level of androgens.
Having PCOS doesn't mean you can't have kids, or that you can't use Fertility Awareness for natural contraception.
When is it PCOS and when is it not?
PCOS is tricky to diagnose correctly, now I’m a herbalist and not a doctor so diagnosing is not in my wheel house - but here’s a few things you oughta know.
As PCOS is more deeply studied and understood, the diagnostic criteria is being revised.
At present, according to the Androgen Excess Society in order to get a PCOS diagnosis you have to meet all three of the following:
1. Ovarian dysfunction or polycystic ovaries
(Looks like: the inability to ovulate / irregular cycles or polycystic ovaries on ultrasound.)
2. High androgens on blood tests and / or hyperandrogenism aka: Hirsutism.
(Sometimes termed “male-pattern” hair growth.)
3. Exclusion of other conditions that would cause elevated androgens.
This brings us to the PCOS myth bust: you can’t diagnose PCOS by ultrasound alone!
It’s normal for between six-twelve ovarian follicles to develop under the influence of estrogen and follicle stimulating hormone (FSH) each cycle.
During a healthy cycle, one dominant follicle will eventually mature, suppressing the growth of the others and go on to ovulation.
This means that benign ovarian cysts or follicles are a normal part of ovarian function and an ultrasound can observe multiple cysts on perfectly healthy ovaries.
Therefore an ultrasound, alone, is not an effective diagnostic tool for PCOS diagnosis.
In cases of PCOS, the inability to ovulate means the dominant follicle never develops, instead all the follicles continue to develop until multiple cysts are present.
Which means you can have poly-cystic ovaries and not have PCOS.
Digging deep by Annie Spratt.
“PCOS is essentially a problem with ovulation, which results in an overproduction of androgens such as testosterone. “ - Lara Briden, N.D.
OK, how does PCOS show up in my body?
If you have PCOS you will have late, delayed or erratic periods.
You'll possibly experience some form of hirsutism and / or struggle with acne, hair loss, weight gain and difficulty conceiving.
You might also notice shifts in your libido and mood.
Many, but not all people with PCOS will also have insulin resistance, or diabetes may run in their family.
A side note on Hirsutism:
Hirsutism does not mean a few dark chin or upper lip hairs it is a condition where dark or coarse hair appears on the face, chest and back and is driven by androgen excess.
The two key criteria for PCOS are: inability to ovulate regularly and androgen excess.