Polycystic Ovarian Syndrome (PCOS) and type-II Diabetes

Thursday, March 20th, 2008

PCOS (Polycystic Ovarian Syndrome) is a hormone imbalance that occurs in women, and can often be mistaken for something else. Women who have it have high testosterone and high circulating insulin levels. Without diagnosis, women with PCOS risk infertility, persistent weight gain and, if left untreated for a long period of time, Type-II diabetes.

It’s estimated that over 50% of women with untreated PCOS contract Type-II diabetes before their fortieth birthday. Women with PCOS have a five- to seven-times higher incidence of heart attacks than women of childbearing age without the ailment. PCOS therefore poses an important danger to women, and should be diagnosed and treated as early as possible.

What causes PCOS? Simply put, PCOS represents multiple cysts on the ovaries. Cysts originate in follicles which should be producing oocytes (eggs) for reproduction. Because of a higher level of male hormones, these follicles do not fully mature, and instead remain as cysts in the ovaries. Since the follicles don’t mature, the ovaries put out less progesterone and are less likely to have their periods. With less estrogen and progesterone, a woman’s testosterone secretions increased and PCOS results.

These cysts are sources for testosterone, which counteract a woman’s natural estrogen level and lead to other problems. These problems can include excess facial hair, obesity and a diminished number of periods. Although all women secrete some level of male hormones, PCOS-afflicted women’s levels are much higher, which stimulates other symptoms. Other symptoms can include:

  1. Acne
  2. High cholesterol
  3. High blood pressure
  4. Thinning hair or male-pattern baldness
  5. In more severe cases, patches of brown spots at the elbows, breasts, knees and other points on the body (note: these are also symptoms of Type-II diabetes

In reviewing the symptoms, it is clear that many women with PCOS are at a heightened risk for heart and other circulatory diseases. Of all the symptoms, high and persistent insulin levels may be the most harmful to a woman’s health. This symptom causes blood vessels to constrict, and may lead to insulin-dependent diabetes in some cases if left untreated.

How does one treat PCOS? There is no one perfect therapy. Each woman’s case must be treated in a different way. Those women who suffer from severe symptoms should be given steroids to reduce acute problems. Over the longer term, many women are given one or more of the following:

  1. Birth control drugs, in order to regularize their periods and counteract the increased production of male hormones
  2. Anti-diabetes medicines, including glucophage and Avastin, to reduce the effects of higher levels of insulin being circulated in the bloodstream.
  3. Fertility medications, both to stimulate normal female hormone production and, in the case of infertility, to stimulate a pregnancy. The two drugs most often prescribed are Clomid and mettformin if the Clomid is not enough.
  4. In the case of reduced pituitary output, gonadotropins are also administered.
  5. Anti-androgens, such as Minoxidil (topical) are administered in order to counteract the male hormones’ influence on hair loss. Their secondary effect is to reduce the overall effect of male hormones on the female body.

If these drugs are not enough, a woman with PCOS can undergo surgery to reduce the number of cysts in the ovaries. By “cyst drilling,” the surgeon can reduce the amount of male hormones and insulin secreted by the ovaries and improve the relative output of estrogen and progesterone. Although any surgery is potentially dangerous (particularly with obese patients), this is a relatively non-invasive procedure which can be performed using laparoscopic tools.

It is estimated that five to ten percent of women have PCOS. Women who have a family history, or are obese, are more likely to contract PCOS.

John Lonergan is a staff writer for It’s Entirely Natural, a resource for helping you achieve a naturally healthy body, mind, and spirit. You may contact our writers through the web site. Follow this link for more information on Insulin Resistance & PCOS.

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PCOS and Its Treatment

Wednesday, March 19th, 2008

PCOS, or Polycystic Ovarian Syndrome, is estimated to affect over 10% of women around the world. It is essentially a hormone imbalance which causes women to undergo a series of symptoms. These include:

  1. Hair growth in a masculine pattern on the face and elsewhere on the body.
    Infertility
  2. Irregular, reduced or a total lack of menstruation. When menstruation does occur, it can be much more heavier than in a ‘normal’ period
  3. Insulin resistance, which can result in diabetes
  4. Weight gain—many women with PCOS become obese, which exacerbates other symptoms (such as insulin resistance). It can be much more difficult for women with PCOS to lose weight, as compared to women without the syndrome.

The root causes of PCOS are unknown, although several theories abound. A clear sign of PCOS is the production of many follicles on the ovary, none or few of which result in the production of a mature ovum which can be fertilized (hence the problems with infertility in many women with PCOS).

A theory which is gaining currency is that the underlying cause is the failure of the pituitary to secrete enough FSH, or Follicle Stimulating Hormone. This hormone starts the entire cascade of other hormones which leads to a proper fertility cycle. Without enough FSH, the follicles of the ovary are unable to mature effectively, which may lead to the proliferation of immature follicles on the ovarian surface.

The typical ovarian cyst in a woman with PCOS is typically enlarged 5 to 7 times greater than a normally-maturing ovarian cyst. Its larger-than-normal size and the number of immature cysts result in an excess of hormone production. The cysts generally produce androgens (male hormones, like testosterone) and insulin, both of which cause some additional symptoms seen in this syndrome.

Among PCOS’ most serious effects is on the production of insulin and subsequent insulin resistance. Insulin is primarily produced by the pancreas, but also by the follicles on the ovary. Since the follicles are much more numerous, and produce much more insulin, they contribute to an overproduction of insulin in the body.

All cells in the body rely on insulin to take in the right amount of glucose. The liver relies on insulin levels to tell it when to produce more glucose, while the cells (muscles, brain, all cells) rely on insulin to tell them how much glucose to use. In a smoothly-functioning insulin-glucose system, the pancreas secretes insulin in response to the body’s needs—after eating, during exercise, or during rest periods, for example. As you can imagine, the amount of insulin produced over a day can vary a good deal. The system is normally self-regulating. That is, the liver produces more glucose, the cells use more glucose, and insulin production goes down.

In a woman with PCOS, the ovaries become the main insulin producers of the body, overpowering the pancreas and the normal insulin-glucose cycle. Rather than responding to the body’s true needs for insulin, the ovaries continue to secrete larger-than-normal amounts of the hormone, continually assaulting the liver and other cells of the body. Over time, the liver becomes a chronic overproducer of glucose, while the cells become increasingly resistant to the insulin signals. The result is insulin resistance—and a resultant case of diabetes.

John Lonergan is a staff writer for It’s Entirely Natural, a resource for helping you achieve a naturally healthy body, mind, and spirit. You may contact our writers through the web site. Follow this link for more information on PCOS & Insulin Resistance.

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PCOS Affects 10% of Women Worldwide

Tuesday, March 18th, 2008

What is PCOS? It seems to be in the news and on TV programs these days, but it is difficult to understand what it is, and what causes it. PCOS stands for “Polycystic Ovarian Syndrome,” which is, at basis, a condition in which women produce many follicles on their ovaries each month, but generally do not produce a mature egg.

These follicles emit hormones, and wreak havoc on a woman’s hormonal system. Since the follicles emit testosterone, they can cause a woman to grow facial hair. They also secrete insulin, which results in long-term insulin resistance, and can eventually result in full-blown Type II diabetes, which must be treated for the rest of a woman’s life.

PCOS often is the cause for infertility. Many of us know that fertility requires a careful balance of female hormones in order to produce an egg on a regular basis. Since the woman suffering from PCOS has a deficit in estrogen and progesterone—the two primary female hormones associated with fertility and female qualities—she is often unable to produce an egg for fertilization.

What causes PCOS? It’s been called a “syndrome” because the cause is unknown. Although we know that the follicles are overactive and unproductive, we don’t know what causes this activity to take place.

We know that, in a normally-functioning reproductive system, a woman’s ovaries contain all the eggs she will have for her lifetime. These eggs are expressed from puberty to menopause, typically one per month. The mechanism of expression is the follicle, which both grows at the surface of the ovary and issues signaling hormones to let the rest of the body know when an egg is coming.

In a malfunctioning system, more than one follicle develops at a time. The excess of hormones may trigger a ‘defensive’ mechanism in the follicles which prevents their full expression, and thus inhibits overall production of an egg ready for fertilization.

The symptoms of PCOS can be confusing, as they are so diverse. The first indication is a weight gain, despite exercise and proper diet control. Insulin resistance occurs because of a spike in insulin production over a long period of time; the cells of the body receive an oversupply of insulin for so long that they develop an overall resistance, which results in insulin losing its effect to control serum glucose levels and results in a diabetes which needs to be controlled through diet, and sometimes through insulin injections.

Other symptoms can include acne (as a part of the hormonal storm), hair growth, and extremely irregular periods. A woman with PCOS can go for several months with no period, then suddenly have extremely heavy bleeding for a longer-than-usual period of time.

Depression is a common symptom, which may be related to hormone-caused mood swings, or to other underlying causes of the disease. Of course, women who suffer these other symptoms, including infertility, would have reason to feel depressed.

Until recently, few physicians were trained to recognize PCOS. There are now a good deal more articles in the scientific literature on how both to recognize and treat the syndrome.

John Lonergan is a staff writer for It’s Entirely Natural, a resource for helping you achieve a naturally healthy body, mind, and spirit. You may contact our writers through the web site. Follow this link for more information on  PCOS & Insulin Resistance.

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