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7) PCOS – What is it?

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Article Originally Submitted 2004

PCOS stands for “Polycystic Ovary Syndrome”

It is also known as: “Polycystic ovaries”; “Sclerocystic Ovarian Disease”; “Polycystic Ovarian Disease” or “PCOD” and “Stein-Leventhal Syndrome”. The latter is the original name for the condition when Michael Leo Leventhal and Irving Freiler Stein when they discovered that women having erratic Periods and infertility often had “bilateral poly(many)cystic ovaries.”

PCOS affects between 5 to 10% of all women, is a hormonal disorder, primarily driven by the insulin/oestrogen dynamic, and is one of the leading causes of female infertility.

Are you PCOS? As a very broad indicator, If you are an “Apple-shape” woman, and you have a really, really hard time shifting the fat, even when you are strict as strict with your low-carbing, then the answer is probably yes.

Although the medical profession settled on “PCOS” as a name, it is a misnomer, because it only refers to one of many symptoms associated with this disorder. You don’t actually have to have PCO (Polycystic Ovaries) to have PCOS, although the overwhelming majority of Women that have PCOS do have PCO

Other Symptoms:

Most people only have a few (thankfully), and not all of which can be apparent (the last seven need GP/Hospital tests to become apparent)

  • Menstrual periods are abnormal, irregular, or scanty (oligomenorrhea)
  • Absent menses (amenorrhea), usually (but not always) after having one or more normal menstrual periods during puberty (secondary amenorrhea)
  • Obesity
  • Infertility
  • Decreased breast size
  • “Teenage” Acne
  • Increased hair growth (hirsutism),
  • Distribution of body hair in a male pattern ie a moustache/sideburns, and/or a “tummy line” (virilization)
  • Alopecia (male-pattern hair loss)
  • Acanthosis Nigricans (brown skin patches, often found on the nape of the neck)
  • Skin tags
  • Exhaustion and/or lack of mental alertness
  • Decreased sex drive
  • Infertility
  • Ovarian cysts
  • High cholesterol levels
  • High blood pressure
  • Excess “male” hormones, such as androgens, DHEAS, or testosterone
  • Enlarged clitoris(rare)
  • Enlarged ovaries
  • Enlarged uterus

Please note that you can also have PCO and not have developed the Syndrome. Becoming obese (Which is all too easy in a woman whose Insulin mechanism is already slighted by having PCO) does seem to be a major “turn on” factor in developing PCOS, and then the syndrome worsens with the more weight gained.

As I mentioned above, PCOS is primarily driven by Insulin/Oestrogen. Hopefully I don’t have to explain to all you educated low-carbers about how Insulin works? If you do need this lesson, I suggest that you go back and read your chosen plan’s section on this subject.

So, knowing about how insulin works in the body, the question regarding PCOS has to be: “Well, what effect does Oestrogen have on Insulin then?”

Well, in a normal ovulatory cycle, oestrogen is produced up to the point of ovulation. When the follicle bursts, releases the ova and becomes a “Corpus Luteum” (lit. “Yellow Body”), it releases Luteinizing Hormone (LH), which lets the body know that ovulation has occurred, and LH ramps down oestrogen production, and boosts progesterone levels.

However, in a woman with PCO, the follicle doesn’t burst, and so LH is not released. And although some progesterone is produced, to make the woman menstruate, Oestrogen remains dominant (hence scanty or irregular periods). This oestrogen domination drives the pancreas to release more insulin than normal, which is in turn why PCO women become easily obese.

It is a vicious upwards spiral. The more obese you become, the less likely your follicles are to burst, and so more oestrogen there is in your system, driving your pancreas to produce insulin.

The syndrome is one that you have a propensity to develop from Birth (There is strong evidence to suggest it is genetic, but the establishment are denying a link right now) and there is no “cure”.

According to Medline, Treatment options are thus:

“Medications used to treat the symptoms of Stein-Leventhal syndrome include oral contraceptives, spironolactone, flutamide, and clomiphene citrate.

Treatment with clomiphene induces the pituitary gland to produce more FSH, which in turn stimulates maturity and release of the ova. Occasionally, more potent ovulation induction agents (fertility drugs, human menopausal gonadotropins) are needed for pregnancy.

A “wedge resection” of the ovaries has been used in the past to remove cysts.

Finally, weight reduction, which may be very difficult, is also very important. Maintaining general good health and eliminating the complications of obesity are helpful.”

So, as you can see, the best help that standard conventional Medicine gives is to tell is to lose weight and pump us full of synthetic hormones to suppress our symptoms. (Which, by the way, make losing the weight even more difficult!) Or, in the cases of infertility, tell the patient to lose weight before she starts treatment, and once she has starved off 25lbs or so, either pump her full of other drugs to induce ovulation, or take away a section of her ovary, to make the rest of it work!

Not that helpful, or natural really!

However, in the more holistic medical world, it is becoming acknowledged that the best “cure” for PCOS is to control insulin, which will therefore make the body lose that insulin driven Visceral fat.(and hey, like we know that that is the answer to most of the “diseases of civilisation”!)

Losing your abdominal fat stores will make the other symptoms lessen/disappear, will help to kick start the body into ovulating itself again, without any other drugs in most cases.

Of course, with standard dietary wisdom, from that standard doctor, starting that fat-loss process is extremely difficult, as the Hormones in a PCOS lady are so unbalanced as to throw buckets of spanners in the works with the S.A.D!

As we know, control of insulin is extremely important in normalising every other hormone level in the body, in the search for overall heath, so, as you can gather, an LC approach is the perfect one, as it is the best way to control your insulin levels. Some PCOS women find that all they need to do is start to LC in a dedicated manner, cutting out the junk food, and eating real foods, not going overboard on the LC junk foods, and keeping their carbs down to under 60g or so, and that is enough.

However, even with the added LC metabolic edge, some PCOS women find it very difficult to shift the lbs!

This is where medical science can help. There is some promising development using the Diabetic medicine Metformin (Glucophage) to help out with overcoming insulin resistance. Be warned however, it is not a miracle for everyone, some women react wonderfully to it, have no side effects and it really helps to regulate their insulin, and the weight drops of effortlessly, others feel really sick, and like they have been hit by a truck, and it does nothing for them at all.

There is also a huge spectrum of “in-between” people that feel either a little, or a great deal of nausea when taking Metformin, but it helps them out a great deal with both weight loss and reduction of other symptoms.

So, if you are a lady that is finding it hard really to lose on an LC diet, you have a decidedly apple-shape to your body, and if you have been trying for a baby, are failing right now, go to an Endocrinologist and get your ovaries Ultrasound scanned, and some blood drawn. PCOS might well be the reason why you are having such a time of it.

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