In the past few articles, we’ve discussed PCOS or polycystic ovarian syndrome quite at length.
So by now you know that PCOS is an endocrine disorder and is fairly common among women of childbearing age. But even when we know the statistics and symptoms, many people remain confused about how to tackle it.
The problem lies in the fact that there’s little to no consensus in the medical world on a singular definition of the disease. Moreover, researchers are still working on trying to find the exact causes and adequate treatment methods for PCOS.
In this vein, I think it’s important to draw a distinction between traditional and functional medicine. You see, traditional medical approaches to endocrine problems are more or less based on managing the symptoms. Functional medicine, on the other hand, tries to take a holistic approach to the case. And this is important because without knowing a person’s unique health condition, it’s nearly impossible to get down to the root cause.
And this is what makes the functional medicine approach to PCOS different. Today, I’ll be speaking to you about finding solutions to PCOS through the functional medicine lens but for that, we’ll need to recap a few things differently.
How do functional medicine practitioners view PCOS?
PCOS, at its core, is a metabolic disorder that’s coupled with various types of hormonal imbalances. In fact, it’s the most common hormonal imbalance disorder within the United States, with up to 6 million women being affected by it.
But even as we talk about the number of women affected by PCOS, we need to keep in mind that there are no set diagnostic criteria. So really, the 6 million figure above is a mere estimation given the recurring symptoms in our patients.
Problems like IBS, fibromyalgia and even premenstrual syndromes have a very specific etiology. We know the causes and have a better understanding of the underlying systems that need to be addressed. But with PCOS, we’re just grouping the commonly reported symptoms in hopes of being able to find a valid treatment.
Thankfully, with functional medicine, we’ve made great strides in being able to narrow down some key health factors that can be held responsible for the hormonal imbalance.
What bodily systems can be causing PCOS?
The human body is a complex mechanism that has several interrelated and co-dependent networks of organs. When you point the finger at one sub-system you realize there are multiple adjoining sub-systems that are contributing to a certain activity. Likewise, when I talk about the following hormonal imbalances, I want you to remember that these are not distinct categories; rather they are intertwined mechanisms that work together to manifest PCOS as we know it.
The most basic type of hormone disruption we notice with PCOS is the excessive amounts of adrenal androgens in women.
Androgens can be considered as male hormones, such as DHEA or testosterone, although there’s no monopoly on them. Women always have a small number of androgens in their bodies that sustain their reproductive health, emotional well-being and cognitive function. And these are just some basic functions; androgens are responsible for over 200 different activities in the female body.
Now, women share some common androgen functions with males. For example, androgens regulate libido, promote the growth of body hair and lean muscles in both sexes. Hold on to this thought because we’ll come back to it in a bit.
The primary purpose of androgens in the female body is to convert these hormones into estrogen hormones. Estrogen is essential for women because it gives them their female reproductive characteristics. This includes the regulation of the menstrual cycle and maintains the health of the endometrium.
Women who have PCOS tend to have excess levels of male androgens in their body. What does this mean?
- There are more testosterone hormones than there should be. Increased levels of testosterone are linked with inflammation and overactive sebaceous glands.
- Increased levels of Luteinizing hormones that can over-stimulate ovulation functions, risking ovarian dysfunction.
- More prolactin hormones than the required amount. Prolactin triggers the production of breast milk in women during pregnancy.
- Low levels of sex hormone binding globulin. SHBG is responsible for countering the effects of testosterone on the female body but with the reduced number, PCOS women are unable to regulate the number of male hormones.
All these androgens are being produced within the adrenal glands and each hormonal imbalance is linked with a particular kind of symptom, which we’ll discuss below. Meanwhile, for more information on androgen excess, you can read my previous article.
The next major risk factor for PCOS is insulin resistance. Insulin is a hormone released by the pancreas to regulate the body’s blood sugar level. It does this by breaking down the glucose molecules present in the red blood cells, converting them into energy for the brain and other metabolic processes. However, about 80 percent of women with PCOS are unable to convert glucose into energy because their body is resistant to the insulin hormone.
The lack of energy leads to fatigue and the body tries to overcome this by producing more insulin. Now increased levels of insulin can trigger the onset of Type2 diabetes and are often considered its primary symptom. But increased insulin is also correlated with excess male androgens like testosterone in PCOS women. So you’re starting to see how the two problems are connected here?
There is a third component that we often disregard when it comes to diagnosing PCOS, and that’s family history. Studies indicate that women who have blood relations with PCOS have a 50 percent greater risk of developing the disorder at some point in their life. Women can also inherit PCOS if their male relatives have female family members who have PCOS.
What is the impact of these imbalances on the body?
As previously mentioned, each type of hormonal dysfunction is correlated with a particular type of symptom. Here, I’ll explain the common signs of PCOS and how they’re related to the aforementioned risk factors.
Irregular menstrual cycle
Irregular periods are the fundamental sign of PCOS and even when doctors don’t agree on all the symptoms, this is one sign they don’t debate on. Some women have delayed or early periods and the condition is medically known as oligomenorrhea. The other case is where women skip their periods completely for some time. This is known as amenorrhea. Both these conditions are tied with high levels of testosterone in the body that disrupt the menstrual cycle and trigger the production of ovarian cysts. This brings us to the second symptom.
Some people prefer calling this sub-fertility too because it’s not impossible to have children with PCOS; rather it just becomes incredibly difficult to conceive than the average woman. Due to the overproduction of male androgens and the disruption of the ovarian cycle, PCOS women tend to have trouble with proper ovulation. This is also linked with irregularities in the menstrual cycle.
Excess hair growth
The overproduction of testosterone in the body causes PCOS women to develop hair growth that is uncharacteristic of females. PCOS women tend to grow thick hair on their face, backs, chest and abdomens. The condition is known as hirsutism.
Hair loss from the scalp
PCOS women can experience hirsutism but also feel like the hair on their head has significantly thinned out. In rare situations, women can exhibit male balding patterns like receding hairlines.
Acne is often mistaken as a purely dermatological issue but with functional medicine, we never take things on face value. There’s always a reason why certain symptoms show on your body. With acne, high levels of testosterone overstimulate the skin’s sebaceous glands. These glands are responsible for maintaining your skin’s moisture balance but the hormonal imbalance leads them to clog the pores. Combine that with bacteria and you’ve got a serious case of inflammation on your skin.
One way to spot PCOS acne is to see if it’s localized. This type of inflammation will mostly occur on the lower half of your face like the chin or jawline. I’ve written on PCOS acne in quite some detail. You can read my previous article here.
This symptom is closely linked with insulin resistance. As explained, the lack of insulin absorption means your body is unable to breakdown glucose for energy. Without the energy, you’re likely to feel tired and sleepy even when you’ve had a good night’s rest. This condition is also backed by medical research. You should be on the lookout for conditions like insomnia or sleep apnea.
Weight gain or trouble losing weight
Also linked with insulin resistance is being overweight or even obesity. Since the glucose doesn’t get distributed in the body, it gets stored as fat. This is dangerous because the extra fat in the body causes more insulin production and that just leaves you locked in a cycle of trying to lose weight but putting more of it on.
As we have seen, androgen excess and insulin resistance can trigger a whole score of symptoms that are intertwined. You might not experience all of these signs at the same time but I suggest you get in touch with me for a quick consultation before making presumptions.
How does functional medicine treat PCOS?
There is no one way of treating PCOS with functional medicine. I may have been able to point out a singular form of treatment with conventional medicine but here what we’re doing is trying to heal the patient, not dwell on the disease itself. Hence, it’s important for me to customize my treatment plan for each PCOS patient. That’s why I urge all potential clients to please complete this health survey before reaching out so that my team and I have a better understanding of your overall health condition.
The main line of action is to identify your type of PCOS. Are you prone to hormonal imbalance? Then what kind of hormones are you producing in excess? For example, if your body is producing too much testosterone then we know it’s disrupting the development of ovular follicles and causing your irregular menstrual cycles. Therefore, in this case our aim will be to bring down the testosterone levels. But where are these excess hormones coming from?
Studies show that those women with high levels of testosterone are also likely to be producing excess DHEA hormones. These hormones are mostly produced by the adrenal glands so it gives us an indication of what regions of the body need more attention.
You can take the Female Hormone Panel Test to help identify any irregularities in your ovarian cycle, potential risks for infertility and the effect of birth control pills.
I’d like to point this out that birth control pills are not effective in treating PCOS. You see, oral contraceptives can only help regulate the flow of blood during the menstrual cycle, but they don’t fix the cycle itself. In traditional medicine, pills are often administered to mask the symptoms of PCOS but they don’t really get down to the root cause.
To treat PCOS naturally, I recommend maintaining a healthy diet in line with functional nutrition guidelines. Essentially, what you eat will trigger the insulin production in your body and the nature of food can either reduce or worsen inflammation. For example, you’ll have to cut down on sugar, skip the fad diets, eliminate gluten and dairy to keep your insulin levels from spiking. You can read more about maintaining a PCOS-friendly diet here.
My recommendation would be that you consume more slow-digesting, complex carbs for that energy boost. Get your healthy fats from fish and eggs and try to eat more whole foods. I’ll be able to devise an in-depth, concrete plan of action for you once you’ve been tested for PCOS.
We can then work on the Functional Nutrition Consultation program that works specifically for you!
For any more queries and information regarding PCOS, you can contact me through this link.