Updated: Jul 6
Acronyms can be confusing. What is the world is PCOS?
If you have it, you know. If you are experiencing symptoms and have not yet been diagnosed, you may have your suspicions.
You may have a friend who struggles with haunting infertility, frustrating acne, or mysterious weight gain.
The symptoms of Polycystic Ovarian Syndrome, more commonly known as the verbally less tongue-twisting PCOS, can creep up slowly and leave you (or your friend) tired, chubby, zit-ridden, and confused.
Polycystic Ovarian Syndrome "is one of the most common endocrine disorders of reproductive-age women, with a prevalence of 4-12%. Up to 10% of women are diagnosed with PCOS during gynecologic visits." (source).
This means that if you are sitting in a row with nine of your girlfriends at church one week, odds are that at least one of you has PCOS.
And that's just diagnosed.
Unfortunately, very smart people disagree over how to actually diagnose this disease. Right now, the consensus is that a woman must suffer from these three issues:
irregular periods due to non-ovulation or weird ovulation
high androgen levels (usually testosterone)
12-25 cysts on any given ovary (or either given ovary, I suppose).
However, there are some other criteria that usually support a diagnosis of PCOS. If you have wonky or elevated blood sugar levels, or if you have had repeated infertility, or if you have Type II diabetes along with the three issues listed above, your diagnosis will be more certain.
I can't diagnose, but I can teach you and give you information to take to your doctor. And I can teach you how to care for yourself when you realize that modern medicine has precious little to offer you by way of treatment.
What in the world would cause a body to start doing weird things like making excess man hormone or growing things like cysts where they ought not be?
We really should be asking ourselves these questions, right?
Since you are reading an autoimmune series, are you thinking what I am thinking?
You quick one, you!
Check this out:
"Low level[s] of progesterone in PCOS causes overstimulation of immune system that produces more estrogen which leads to various autoantibodies. Different autoantibodies have been documented in PCOS, for example, anti-nuclear (ANA), anti-thyroid, anti-spermatic, anti-SM, anti-histone, anti-carbonic anhydrase, anti-ovarian, and anti-islet cell antibodies. There is an association between PCOS and autoimmune diseases such as ANA and anti-TPO that have been documented in systemic lupus erythemiasis and Hashimoto thyroiditis." (source).
Let's break this down:
Low progesterone means estrogen dominance, which means that things like lupus and Hashimoto's can occur.
And it's more likely that PCOS will follow suit.
I know I am a nerd, but does anyone else find this fascinating?
So if PCOS can be classified as essentially an autoimmune disorder, we can walk through our autoimmune disorder principles to manage it.
But we will get to that.
Let's look at the way PCOS works in the body.
In PCOS, the ovaries don't work right. Healthy ovaries are necessary for a healthy period and a healthy pregnancy.
Before that happens, luteinizing hormone (LH) will increase in the bloodstream. Luteinizing hormone tells our ovaries to make more estrogen, tells our ovaries to ovulate, and tells the corpus luteum to produce progesterone.
That is how it works in a healthy woman.
Theca cells in the ovary respond to LH stimulation by secretion of testosterone, which is converted into estrogen.
So if you have more testosterone, you will have more estrogen. That is a problem because progesterone gets lower and lower as a ratio.
When too much LH is present, the ratio of luteinizing hormone to Follicle Stimulating Hormone (FSH) will be off.
If Follicle Stimulating Hormone is low, ovulation will not happen. Essentially, this is because too much estrogen and testosterone are present, and not enough progesterone.
That means that your period is controlled by your brain.
So when your brain is too stressed out and overwhelmed to function properly, or it has too much glucose being shunted upward, or it is inflamed or decaying, your LH and FSH levels will be off.
And then your estrogen, progesterone, and testosterone levels will be off.
And you won't ovulate, leading to more estrogen and less progesterone. The cycle repeats every month, when your ovaries are trying to ripen and release an egg but lacking the right hormonal signals to complete this miraculous and tenuous task.
The Lord knows. If we are too stressed or unhealthy to care properly for a child, He will slow down our menstrual cycle until balance is restored and we can safely menstruate and carry a healthy baby.
Though this is excruciating for those who are struggling through infertility, it is the care of the Lord for your own dear body and for that of your future children. Take heart, sweet ones. He is kind even through the struggle. My own heart weeps with yours.
If you are overweight and have PCOS, the two issues can mutually exacerbate each other. It is also estimated that 40% of women with PCOS have depression. I theorize that this has to do with lower levels of progesterone and higher levels of estrogen, though I could find no clinical studies that can prove this to you. However, this study shows that high estrogen shows a correlation with both PCOS and Hashimoto's.
Even young women can suffer from PCOS. If that is the case, they may be at risk for not only Hashimoto's thyroiditis, but also higher body mass index, larger waist circumference, and higher blood pressure.
Is PCOS your fault?
There are a myriad of lifestyle factors that contribute to autoimmune disease, and as an autoimmune sufferer myself, I am loathe to say but confident in saying that many of our symptoms can be attributed to lifestyle issues.
However, the fact remains that there are genetic predispositions to our autoimmune issues.
In fact, buried in this study is the information that your mom's estrogen levels when you were in her tummy could have contribute to your PCOS.
Thanks a lot, mom.
An immature thymus gland and low vitamin D levels can also contribute to your PCOS.
This is a great reason to ask your doctor to test your Vitamin D levels.
And your TPO antibodies.
And your ANA antibodies.
If he won't, I will. Get ahold of me and we will get this ball rolling.
The Sugar Connection
Metabolic dysregulation is another hallmark of PCOS. This can lead to nonalcoholic fatty liver disease.
If your liver is not doing its job, you will have issues converting your thyroid hormone to the usable form appropriately. Just something to think about.
PCOS girls tend to have higher waist to hip ratios, higher blood pressure, more insulin resistance, and higher triglycerides than non-PCOS women.
Being insulin resistant is a big problem. It impacts most of us women. Insulin resistance has been rising for years and just continues to rise.
Insulin is our fat storage hormone.
It is supposed to shuttle normal levels of blood glucose into the liver and muscles. But when we have too much sugar in our blood, too often and for too long, insulin backs up in the body.
The sugar is still there, but insulin cannot do its job as well anymore. So we get immune to its effects of using blood sugar properly.
And now, the body stores excess sugar in our fat cells.
That's a lot of preamble. You want the guide, right? Here we go!
PCOS is a metabolic disease. So is obesity. And insulin resistance. I know one darling lean PCOS-er, but many more women will struggle with the weight issue here. And I feel you. It stinks, darn it.
(Do you notice I am not swearing? It was brought to my attention via my husband via my pastor- hey, Chad!- that it's perhaps not becoming of a Christian lady. My apologies- you'll see nothing but clean language from now on. Unless we are talking about poop. Then I might say poop.)
So if PCOS is a metabolic disease, it would make sense to work on the metabolism, yes?
What slows metabolism?
How to speed up the metabolism?
That, dear, is the million dollar question.
1. Stop eating so often
Don't restrict calories. That is a no brainer. But every time you eat, especially carbohydrates, your pancreas will release insulin.
So if you eat six times a day, you release insulin 6 times a day. And if you restrict calories at the same time, you will lose weight, bien sur.
But then, when your metabolic rate and your calories equalize, you will start gaining weight on your restricted number of calories.
If you normally burn 2000 calories a day just by being alive
and you eat 2000 calories
your metabolic rate will be normal.
you cut to 1500 calories a day
and your basal metabolic rate drops to burning 1500 calories a day
because your Creator wants you to survive
when you inevitably increase calories by 50,
you start gaining weight
because your body is only burning 1500 calories a day
instead of 2000.
One day, I may write that dark children's tale.
It's a sad story. And I am begging you- don't let your daughters fall into this trap. Not vegan. Not low calorie. Not low fat. Not flat belly diet.
So do the following:
3 meals a day
20 grams protein
30 grams fat
20 grams carbs
The more protein and the more fat, the less insulin response. And that, dears, is exactly what we want.
Reducing carbohydrates and meal frequency will reduce insulin. This will help manage your PCOS. And it is the first step.
You must reduce caffeine, alcohol, and grains. That wins me no popularity contests. But if you want to manage symptoms, reduce the things that are making you sick.
You know I am not a fan of a one-size-fits-all approach. However, there are some supplements that can decidedly help PCOS.
The first, is, clearly progesterone. I like a progesterone that is only available by practitioner recommendation. Please get ahold of me for this.
Progesterone will oppose- well, unopposed- progesterone. You will want to work with doses that complement your estrogen levels. Hormones are powerful, so please work with a practitioner.
The second is Ovasitol. Inositol has a beautiful effect at normalizing estrogen-progesterone-testosterone balance and helps regulate ovulation.
Use as directed for at least three months to see a regulation of ovulation.
That is the end, dears. Let me know if you have any questions. And stick to the guide to start managing you PCOS today.
To your metabolic health,