PCOS: The Basics

This "silent disorder" is one of the most common hormonal problems in women. It is associated with infertility and can create an emotional burden for those who suffer from it. In addition to its numerous related symptoms and physical problems, this disorder, called polycystic ovary syndrome (PCOS), affects 1 in 7 women.

This syndrome is not only associated with infertility, affecting about 72% of those affected. It is also a risk factor for type 2 diabetes, and many other disorders and diseases.

Day by day, people are becoming aware of the troubles caused by this syndrome: mood disorders, endometrial cancer, hepatic steatosis, sleep apnea, hyperglycemia, hypercholesterolemia, hypertension, etc.

The good news is that there are many natural remedies to treat the various symptoms of PCOS, starting with naturally balancing the hormonal system. But sometimes it's difficult to determine where to start.

First and foremost, it is important to understand the syndrome and its nuances because while the diagnosis can be lengthy, misdiagnosis is also common. It is essential to distinguish between PCO and PCOS, which are two different things. Here, we will only discuss PCOS.

What is polycystic ovary syndrome?

PCOS is one of the most common hormonal imbalances in women today. It is often characterized by insulin resistance (in 70% of cases). The endocrine system is very complex; although PCOS has been recognized and diagnosed for over 75 years, it remains the main form of endocrine disruption in women of childbearing age. There is still much to learn about how this hormonal imbalance occurs in different women and the most effective way to treat it.

This syndrome develops for different reasons, and symptoms can also vary from one woman to another, although it is generally accepted that insulin resistance plays an intrinsic role in the syndrome.

There is no "cure" for polycystic ovary syndrome, although hormonal causes are believed to be largely reversible, and many women find effective ways to reduce their symptoms without resorting to medication.

"I was diagnosed in 2016, and since then, I have been managing my PCOS naturally. My cycles have become regular, I have managed to conceive, my hair no longer falls out, and my acne has disappeared. However, we cannot cure PCOS, so during more complicated periods, when I eat sweeter and stress much more, acne makes a big comeback, and my cycles become a bit longer."

It is true that PCOS symptoms are very unstable and depend heavily on a person's environment and lifestyle, but insulin resistance is very common. In the absence of treatment, this resistance can increase metabolic risk, hypertension, dyslipidemia (high cholesterol and/or triglyceride levels), and diabetes.

Signs and symptoms of PCOS

Several symptoms of PCOS are common in women suffering from hormonal problems, so it is important to have a correct diagnosis.

During normal ovulation: A sac forms on the surface of an ovary around a maturing egg. Generally, the sac disappears when the egg is released. If the egg is not released, it becomes a functional cyst.

In the context of PCOS, the ovaries have a large number of small follicles on the surface that have not matured and therefore have not reached the ovulation stage. And so they end up stuck. The presence of 20 follicles or more per ovary often allows one of the diagnostic criteria to be established. It should be noted that ovarian dystrophy or ovaries with multi-follicular shapes are not mandatory. And these follicles should not be confused with cysts.

The common symptoms of polycystic ovary syndrome are as follows:

• Partial or total infertility (linked and affected by many other symptoms, such as insulin resistance, menstrual cycle disruption, weight problems, high male hormone levels, and low libido).
• Oligomenorrhea (irregular periods) or amenorrhea (absence of periods).
• Weight gain and/or difficulty losing weight
• Acne
• Insulin resistance
• High levels of male hormones, especially testosterone
• Hirsutism (excessive hair growth in masculine areas)
• Androgenic alopecia or thinning hair
• Fatigue
• Mood swings
• Low libido

Causes and risk factors

Although the exact cause of PCOS is not clear, there are some fundamental studies on how it develops. It is probably not a single answer but rather hypotheses to follow the development of factors and diagnose this syndrome.

The main risk factors are as follows:

• Change in the action of luteinizing hormone (LH)
• Insulin resistance
• Genetic predisposition to hyperandrogenism (which can be diagnosed by high subclinical androgen levels).
• Family history of PCOS
• Smoking
• Excessive alcohol consumption
• Sedentary lifestyle
• Epilepsy and/or use of valproic acid to treat epilepsy
• Type 1, type 2, and gestational diabetes (it is not known if diabetes causes PCOS, or vice versa)
• High birth weight (especially when the child is born to an obese mother)
• Premature puberty
• Metabolic syndrome

WEIGHT AND PCOS? A connection?

Obesity is generally a risk factor for PCOS. However, clinicians seem to agree, based on recent research, that while weight loss is an important way to naturally treat polycystic ovary syndrome, weight itself is probably not the direct cause. However, it can contribute to the rapid onset of symptoms. In my opinion, weight is more the consequence of difficult-to-manage PCOS than the cause.

A high percentage of patients with PCOS are prone to weight gain. Conversely, many women with normal weight have hormonal disturbances leading to polycystic ovary syndrome. So do not think that if your weight is normal, you cannot suffer from PCOS.

Patients with PCOS are diverse and varied and have no particular characteristics, making the treatment of this syndrome even more complicated. However, two elements can also explain PCOS: cortisol and insulin. In this article, we will only focus on insulin.

What does insulin do?

Insulin is a peptide hormone made in the pancreas: an organ that contains clusters of cells called Langerhans islets and beta cells in the islets that make insulin and release it into the blood.

Insulin maintains normal blood sugar levels by facilitating the absorption of glucose by cells, regulating the metabolism of carbohydrates, fats, and proteins, and promoting cell division and growth.

It plays a major role in regulating how the body uses digested food to produce energy. With the help of insulin, glucose is absorbed by the cells of your body and used as a source of energy.

When blood sugar rises after a meal, the pancreas releases insulin into the blood. Insulin and glucose then travel in the blood to the cells of the body.

Symptoms of insulin resistance

Insulin resistance can have silent symptoms for several years that are associated with other factors, stress, changes in a person's life. So people can suffer from this health problem for several years without knowing it. Especially since generally fasting blood sugar levels in blood tests are completely normal. To find out if you suffer from insulin resistance or not, you can go to a laboratory to do a HOMA test (reimbursed with a prescription or billed between 25 and 30 euros by your laboratory without presenting a prescription).

When you are insulin resistant, your body lacks the ability to respond to the insulin it produces for use. When the beta cells of the pancreas cannot meet the demand for insulin, an excess of glucose accumulates in the bloodstream, leading to serious health issues such as prediabetes and type 2 diabetes. In other words, individuals with insulin resistance require higher levels of insulin to help glucose enter cells normally.