polycystic ovarian syndrome
What is it?
Also known as the Stein-Leventhal syndrome, it is a condition associated with multiple cysts in the ovaries. The job of the ovaries is to produce hormones, ripen and release the egg ready for fertilisation, and prepare the womb lining ready for pregnancy. One egg matures first and is released into the fallopian tubes (ovulation), while the remaining follicles degenerate. This process is controlled by several hormones, FSH (Follicle stimulating hormone) LH (luteinising hormone) made by the pituitary in the brain, it signals the release of progesterone, testosterone and oestrogen. When there is an imbalance in these hormones, and the levels of LH, testosterone and oestrogen are high, insulin also becomes high causing insulin resistance. In PCOS, ovaries are much larger than normal and have clusters of underdeveloped follicles. PCOS are not troublesome. The problem is when the cysts cause an hormonal imbalance: PCOS can’t be diagnosed with just a scan. A blood test is needed to check hormone levels.
One in 5 woman who have a gynaecological investigation have polycystic ovaries. Fortunately, only a few of these women develop the syndrome. The problem starts, however, when the cysts cause a hormonal imbalance, leading to a series of other symptoms.
This condition is now recognised as the most common pre-menopausal cause of failure of ovulation leading to infertility.
Causes
The exact cause is unknown, though the condition tends to run in families. The ovaries don’t appear to produce the correct proportions of hormones. Insulin resistance appears to be an important factor, especially in women who are overweight. Problems with the thyroid and adrenal glands may make some women more susceptible to PCOS.
Symptoms
Women with PCOS may have one or several of the following:
- Menstrual irregularities
- Impaired fertility
- Higher miscarriage rates (because of high levels of LH)
- Increased hair growth and acne
- Obesity (about half of women with PCOS are overweight, weight loss induces the changes in ovarian function. Cycles are more regular, ovarian volume decreases as well as number of micro-follicles per ovary. Overweight women have lower levels of SHBG, needed to help bind and remove excess hormones).
- Abnormal insulin action (40 per cent of women with PCOS from insulin resistance will develop diabetes).
- Heart disease
- Breast milk secretion
- Higher risk of developing endometrial (uterine) abnormalities
Women with PCOS are more likely to have problems balancing blood sugar, which can lead to insulin-resistance. Insulin resistance happens when insulin levels are chronically high but the insulin can’t take glucose into the cells. This, in turn, leads to high levels of blood glucose. Excess insulin leads to increased appetite. The more circulating insulin, the more the ovaries produce testosterone and so the cycle continues. Insulin causes the liver to make less SHBG, needed to help bind and remove excess testosterone.
Nutritional protocol
The idea is to correct the hormonal imbalances associated with PCOS.
Follow the hormone balancing diet (to control androgens), plus:
- Lose weight
- Increase SHBG: phytoestrogens
- Increase liver function to excrete hormones efficiently: diet, dandelion root, milk thistle.
Diet
- Eat plenty of fruit and vegetables, to increase fibre and help with the elimination of excess hormones.
- Eat complex carbohydrates, whole grains like brown rice, oats and wholemeal bread, for blood sugar balance.
- Eat protein with every meal to help balance blood sugar.
- Buy organic foods, as these can disrupt hormones.
- Eat phytoestrogens, including beans such as lentils, chickpeas and miso, flax seeds soya products, to help reduce oestrogen levels.
- Eat oily foods, including salmon, herring, mackerel, tuna, nuts, seeds (flax) and oils, to increase omega 3 essential fats, as these fats play an import and roll in helping to control insulin resistance and the subsequent hormone disruption that may follow.
- Drink enough fluids, as they help with toxin and hormone elimination.
- Cut down on red meats, beef, pork, lamb, dairy products and fried foods. Too much of the wrong fats can slow down liver function and cause heart problems and woman with PCOS are more susceptible to heart disease.
- Avoid additives, preservatives and chemicals, such as artificial sweeteners.
- Reduce your intake of caffeine from tea, coffee, soft drinks as it disrupts hormone levels
- Avoid alcohol as it has an oestrogen like affect on the body.
- Avoid sugar, both on its own and hidden forms in foods, it affects hormone levels, and contributes to Insulin resistance which appears to be a possible cause of PCOS in some women so it is vital that you do all you can to balance you blood sugar levels.
- Avoid smoking.
Supplements
- Chromium: helps the formation of Glucose Tolerance Factor, released by the liver and needed to make insulin efficient in controlling blood sugar. Chromium helps reduce cravings and hunger. It also helps to control fat and cholesterol in the blood.
- B Complex (B2, B3, B5, B6): useful for controlling weight. B2 helps to turn fat, sugar and protein into energy; B3 is a component of the GTF; B5 helps to control fat metabolism; B6 helps maintain hormone balance and, with B2 and B3, is necessary for normal thyroid hormone production. B vits are essential to detox old hormones.
- Zinc: for appetite control, and for the correct action of many hormones like insulin and is involved in the production of thyroid hormone.
- Magnesium: There is a strong link between Mg deficiency and insulin resistance.
- Co-Q10: involved in energy production and carbohydrate metabolism. Useful also to control blood sugar levels.
- 5-HTP If your PCOS is causing you stress and upset. It helps to improve mood. Taken before bed (do not take alongside St Johns Wort or antidepressant medication).
Herbs:
- Agnus Castus: to balance hormones.
- Black Cohosh: helps suppress LH levels which are usually high in PCOS.
- Milk Thistle to help livers ability to break down and remove excess hormones.
- False Unicorn root: helps to balance hormones and encourage healthy development of follicles.
- White Peony: encourages the healthy development of the follicles and hormone balance (especially the male hormones).
- Saw Palmetto: helps reduce levels of testosterone.
How to balance your blood sugar
To help maintain a steady blood sugar level during the day, aim to eat complex carbohydrates as part of your main meals, and make sure that you eat little and often during the day. Sometimes just an oat cake can be enough between meals to keep eating urges at bay.
If you find the symptoms associated with low blood sugar, such as racing heart or sweats, are worst first thing in the morning, or if you wake during the night with your heart pounding and you are unable to get back to sleep, then it is very likely that your blood sugar level has dropped overnight and adrenaline has kicked into play. Eating a small, starchy snack, like half a slice of rye bread, one hour before going to bed, will help to alleviate these symptoms.
Remember to make sure your complex carbohydrates are unrefined. In general, this means choosing brown instead of white. For example, eat whole wheat bread, brown rice and wholemeal flour as opposed to their white versions, which have been refined and stripped of essential vitamins, minerals, trace elements and valuable fibre.
- Eat unrefined complex carbohydrates including sweet potatoes, brown rice, millet, oats, quinoa.
- Always eat breakfast. Porridge or oatmeal is a good choice.
- Eat small, frequent meals no more than three hours apart.
- Reduce, preferably avoid, stimulants including tea, coffee, chocolate, smoking and canned drinks that contain caffeine.
- Don’t eat refined carbohydrates. Avoid ‘white’ in general. Remember that white flour is in many things, such as cakes, biscuits, pastries and white bread.
- Don’t eat sugar or the foods it is found in, including chocolate, sweets, biscuits, pastries and soft drinks.
Lifestyle
Food wrapped in plastic and cling film can have a negative effect on hormone balance, and this is made worse by heating.
Use a water filter, there is a lot of oestrogen in our water system from the vast amount of woman using the contraceptive pill and urinating into the water cycle.
Stress has a massive affect on our hormone balance. It is important to keep your blood sugars balanced as mentioned earlier and as stress can play havoc with this, it is very important to do what ever you can to reduce the stress in your life. The best way to do this is prioritise so that you aren’t taking on too much. The next best thing is actually to find ways to relax e.g. breathing exercises, visualisation, yoga, tai chi.
Exercise is good for us, but it is particularly important if you have PCOS. In conjunction with a healthy diet, exercise helps to control weight. It is important to find some sort of exercise that you enjoy doing – otherwise the motivation wont be there! Try to exercise at least 3 times a week, ideally 5 times a week for 30 minutes. It should be something that raises your heart rate and makes you puff! Brisk walking, swimming or aerobic classes are some ideas.
