Healing PCOS

Insulin in large quantities can be toxic to cells, so when there is too much insulin in the body over time, cells become insulin resistant in order to protect themselves. Alternatively, the hypothalamus may become insulin resistant and continue to send signals to the pancreas to create more insulin unnecessarily. When insulin resistance occurs, the insulin does not pick up or cannot deliver the glucose to the cells that need it. Glucose levels in the blood remain high, and diabetes and other serious health disorders may result.

Hyperinsulinemia results when more insulin is present in the bloodstream than is considered normal, usually as a result of insulin resistance. Although it is associated with diabetes, someone with hyperinsulinemia does not necessarily have diabetes.

Insulin resistance and hyperinsulinemia create a self-perpetuating and destructive cycle called the insulin resistance cycle. Insulin resistance creates chronically high levels of insulin, and those chronically high levels bombard cells, forcing them to protect themselves, thus perpetuating insulin resistance. Eventually, your pancreas can no longer keep up with the insulin demand. This means there is less insulin in the body to store and regulate glucose levels, and the result is diabetes.

In addition, high levels of insulin and insulin resistance sometimes pave the way for hyperandrogenism, excessive levels of male hormones. This may be the cause of missed periods and infertility in some women with PCOS. The relationship between hyperandrogenism and hyperinsulinemia in women with PCOS is unclear. Researchers disagree about whether hyperinsulinemia (#litres_trial_promo) causes hyperandrogenism, hyperandrogenism causes hyperinsulinemia, or a third cause is responsible for both. One way or the other, we have a destructive cycle: insulin resistance leads to hyperandrogenism, which increases insulin levels.

A top priority of the Healing PCOS 21-Day Plan (#litres_trial_promo) is to get your insulin under control.

HORMONE IMBALANCES

When my hair started falling out during high school, my mom took me to a dermatologist who did a scalp biopsy. When it came back negative, the hair loss as well as other symptoms such as fatigue, acne,and sporadic periods were written off as a result of stress. Things got worse as I grew older. I began gaining weight, growing facial hair, experiencing anxiety and depression, and still fighting the symptoms I had since puberty. The birth control pill that was supposed to be my “quick fix” manipulated my hormones, leaving me feeling moody and dull. I wish that I had had a better understanding then of how my hormones work and how hormone imbalances caused by diet and lifestyle choices could be the source of my symptoms.

Hormones are responsible for keeping your major bodily functions running smoothly, so when hormone levels become imbalanced, you’ll feel the effects in many ways. Hirsutism, acne, hair loss, higher stress levels, mood disorders, depression, anxiety, and infertility can all result.

The most common hormones that become imbalanced and the ones that you will learn to manage with the Healing PCOS 21-Day Plan (#litres_trial_promo) are androgens, cortisol, progesterone, estrogen, and thyroid hormones.

Androgens: Androgens are male hormones, such as testosterone, dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), and DHEA sulfate (DHEA-S). In males, these steroid hormones are responsible for sexual development and muscle mass. In women, they play a much subtler, though no less important role. Among other things, they help us maintain muscle mass, regulate our weight, and keep our libidos humming. They are produced in the ovaries, adrenal glands, and fat cells. The problem isn’t that women with PCOS have androgens; it is that we typically have an excess. This androgen excess, or hyperandrogenism (#litres_trial_promo), affects about 25 percent of women with PCOS and is often the root cause of common symptoms such as hirsutism, acne, hair loss, and infertility.

Androgen excess may be caused by:

Ovarian dysfunction, which causes the ovaries to produce excess testosterone.

Insulin resistance, which signals the ovaries to produce excess testosterone.

Stress, which taxes the adrenal glands and stimulates the production of androgen hormones. For this reason, women with PCOS should practice stress relief from an early age.

Early adrenal activation, which initiates early puberty and correlates with increased lifelong androgen formation. Girls who experience early puberty (#litres_trial_promo) may have an increased risk of developing PCOS.

Obesity.

Genetics.

Taking artificial hormones in birth control.

Individual hypersensitivity to a normal amount (#litres_trial_promo) of androgen.

A defect in the hypothalamus, a part of the brain responsible for regulating the production of many hormones, including androgens.

Cortisol: Women with PCOS often make too much cortisol, the “stress hormone” produced in the adrenal glands. In fact, research indicates that many women (#litres_trial_promo) with PCOS may naturally have higher cortisol levels. Being overweight also increases cortisol production.

Raised levels of cortisol change the way your body manages other critical hormones, putting you at risk for insulin resistance, anxiety, depression, and thyroid dysfunction. In addition, the overproduction of cortisol can overwork the adrenals to the point of adrenal fatigue. For this reason, stress—emotional or physical—takes more of a toll on women with PCOS than on those without it.

Progesterone: Progesterone is a hormone, produced mainly in the ovaries, that plays an important role in the menstrual cycle and maintaining and nourishing the body during pregnancy. After ovulation each month, progesterone helps thicken the uterine lining in preparation for a fertilized egg. This is called the luteal phase of the menstrual cycle. Women with PCOS almost always have low progesterone and thus a luteal-phase defect. This makes it nearly impossible to maintain a pregnancy even if ovulation and implantation do occur and is often the cause of miscarriage and unsuccessful assisted reproduction. Some doctors recommend supplemental progesterone (#litres_trial_promo) for women with PCOS in order to support early pregnancy if they have suffered multiple miscarriages.

Signs of Low Progesterone (#litres_trial_promo)

Anxiety

Waking at night

Fibrocystic breasts

PMS

Bone loss

Low libido

Infertility or irregular periods

If you have a progesterone deficiency and your doctor suggests hormone replacement, you may be prescribed a bioidentical progesterone. Bioidentical, or natural, progesterone is a combination of elements derived from natural plant sources that identically matches the progesterone we naturally make in our bodies. Prometrium is a micronized (reduced to tiny particles and mixed with peanut oil) natural progesterone in the form of a pill. It is approved by the Food and Drug Administration (FDA) as a natural hormone-replacement therapy medication. Because natural progesterone is molecularly identical to the hormone produced by the body, it causes few side effects.

Alternatively, your doctor may suggest a synthetic progestin such as Provera, since it was the standard before good natural alternatives were developed. Provera is also a constructed compound, but its chemical structure is not identical to natural progesterone. As a result, it can cause changes in vaginal bleeding (#litres_trial_promo), blood sugar issues, blood clots, and depression. Unfortunately, many women are told that synthetic progestin is the same as natural progesterone. Be a PCOS Diva at the doctor’s office and discuss the differences between these two hormone-replacement options to find one that is best for you.

Estrogen: Estrogen, the primary female sex hormone, is produced in the ovaries, adrenal glands, and fat tissues. Many women with PCOS experience estrogen dominance, that is, too much estrogen and not enough progesterone to balance its effects. Symptoms such as heavy or painful periods, infertility/miscarriage, and hypothyroidism (an underactive thyroid gland) may result.

Signs of Estrogen Dominance

PMS

Headaches and/or migraines

Fluid retention

Heavy or painful periods

Endometriosis

Moodiness, anxiety, or depression

Hypothyroidism

Infertility or miscarriage

Breast pain or tenderness

Thyroid hormones: Many women with PCOS have a dysfunctional thyroid. It may be overactive (hyperthyroidism) or, more commonly, underactive (hypothyroidism). Hashimoto’s disease, an autoimmune disease and the most common cause of hypothyroidism, is prevalent in women with PCOS.

If the thyroid is not functioning properly (#litres_trial_promo), the balance of thyroid hormones and every other hormone in the body will be disrupted, causing abnormal sexual development, menstrual irregularities, and possibly infertility. I encourage all women with PCOS symptoms to have a complete set of thyroid labs to rule out thyroid dysfunction.

“Think of PCOS as being in an extended state (#litres_trial_promo) of puberty, where androgens, luteinizing hormone (LH), and insulin resistance dominate and follicle-stimulating hormone (FSH), estrogen, and progesterone haven’t established their rhythm.”

—DR. FIONA MCCULLOCH

Signs of Thyroid Dysfunction (#litres_trial_promo)

Signs of Hypothyroidism (Underactive Thyroid)