Poly Cystic Ovarian Syndrome PART I : Signs and Symptoms + Diagnosis

Poly Cystic Ovarian Syndrome Part 1: Common Symptoms and Diagnosis

Poly Cystic Ovarian Syndrome (PCOS) is a female hormone condition that affects 6-10% of the population. Symptoms can begin with the onset of the menstrual cycle, however more obvious symptoms and subsequent diagnosis usually occur in a women’s 20s -30s. It is common we see this condition go undiagnosed for years in females until they begin trying to conceive. This condition disrupts the hormone metabolism of both male and female reproductive hormones in women. It can lead to anovulation (lack of ovulation), poor egg quality and metabolic concerns (diabetes, obesity, high blood cholesterol and lipid regulation). As naturopathic doctors, we work with women to help regulate hormones to promote regular ovulatory cycles. We also help promote egg quality and minimize the formation of new cysts in the ovaries.

As mentioned previously the signs and symptoms of this condition can sometimes go undiagnosed in women for years. Symptoms and clinical presentations of PCOS vary in women, which may contribute to lack of early diagnosis. The conventional criteria for diagnosing the condition do not reliably include varying presentations of this condition leading to increased risk of missed diagnosis.

Signs and Symptoms of PCOS:

Irregular cycles due to anovulation (lack of ovulation) or oligoovulation (irregular ovulation): this will present differently in every woman however diagnosis is clear if a woman has less than 9 cycles a year, 80% of the time.

o   Irregular bleeding or spotting can often times indicate anovulatory cycles.

Hyperandrogenism (increased levels of male sex hormones): often presents with one or more of the following:

o   Hirsutism. Male patterned hair growth, chin, sides of the jaw (sideburns), chest, neck, and back.

o   Androgen Patterned Hair loss. Often times the excess of male reproductive hormone it can lead to hair loss. It will often present as thinning of the hair along the crown of the head or lead to thinning or receding of the hairline.

o   Acne. Moderate to severe acne in a similar pattern to male patterned hair growth. Often times will be deep, painful and cystic in nature.

Metabolic Disturbances: the hormonal impact of the androgens (male sex hormones) can lead to:

o   Insulin resistance and subsequent glucose intolerance, inevitably leading to the development of type 2 diabetes. Insulin resistance can lead to an increase in pigment or darkening of the skin known as acanthosis nigricans.

o   It commonly presents on the skin at the nape of the neck, armpits, and crease of the thighs.

o   Dysregulation of cholesterol and triglycerides.

o   Obesity- generally focused around the abdominal area.

o   Sleep Apnea.

Diagnosis of PCOS requires 2 of 3 of the following clinical and laboratory signs known as the Rotterdam Criteria:

-       Oligo or anovulation

-       Clinical or laboratory signs of hyperandrogenism (see above). Blood tests can be done to evaluate levels of androgens and are often used as a means to confirm hyperandrogenism. Although the blood tests can be quite variable, clinical signs as mentioned above are often enough for confirmation of hyperandrogenism.

-       Polycystic Ovaries (by ultrasound)- only 50% of women will present with this.

Poly Cystic Ovarian Syndrome can be treated with natural therapies. As naturopathic doctors, we work with women to help regulate hormones to promote regular ovulatory cycles. We also help promote egg quality and minimize the formation of new cysts in the ovaries. Herbal medicine, dietary counseling and clinical nutritional supplementation can have a profound effect on hormonal regulation.

If you experience any of the above-listed signs or symptoms we encourage you to book a consultation with one of our naturopathic doctors. Early diagnosis and treatment of PCOS can help preserve fertility and prevent metabolic conditions (obesity and diabetes).

In health,

EASTND team

References:

The American Association of Clinical Endocrinology, Disease State Clinical Review: http://journals.aace.com/doi/pdf/10.4158/EP15748.DSC?code=aace-site

Kelekci KH, et al. (2010). Ovarian morphology and prevalence of polycystic ovary syndrome in reproductive aged women with or without mild acne. 

Poly Cystic Ovarian Syndrome and Metabolic Syndrome: https://www.ncbi.nlm.nih.gov/pubmed/26265416