More than a picture: investigating PCOS from all angles

12 March 2020

Polycystic ovarian syndrome (PCOS) is a hormonal condition that affects 12-21% of women of reproductive age. It’s estimated to cost up to $400 million per year in Australia. 

Characteristic symptoms of PCOS

Females naturally produce small amounts of androgens (male type hormones such as testosterone) from the ovaries and adrenal glands. In small amounts androgens play specific roles in the body. 

However, in PCOS, excessive production of androgens in the bloodstream leads to development of hallmark PCOS symptoms, including:

  • Abnormal and excessive hair growth (e.g. facial hair, thicker hair under the arms and on the legs)

  • Male pattern baldness (i.e. hair loss on the scalp)

  • Acne (as androgens increase serum in the skin)

  • Depression and anxiety symptoms

  • Decreased ovulation leading to infertility

  • Irregular periods or loss of periods all together (amenorrhea) 

Decreased ovulation can lead to cysts on the ovaries, which can be seen on an ultrasound - hence the name PCOS. However, cysts on the ovaries is merely a symptom of PCOS, which is caused by high androgens driven by insulin resistance.

Ultrasound alone is not sufficient for diagnosis

Just because a female has cysts on her ovaries, does NOT mean she has PCOS. Cysts can occur on the ovaries for other reasons aside from increased androgen levels. Far too often, women who report missed periods or irregular periods are sent for an ultrasound to check for PCOS. The ultrasound shows cysts on their ovaries, and they’re diagnosed with PCOS. However, they don’t have any of the other characteristic PCOS symptoms (listed above) including acne, abnormal hair growth, male pattern baldness etc. This is why an ultrasound alone should not be used to diagnose PCOS. Cysts are merely a symptom of underlying hormone disruption. 

Hormone disruption can occur for several reasons including:

  • Stress

  • Inflammation resulting from poor diet and lifestyle habits

  • Inflammation resulting from chronic diseases in the body

  • Poor digestive/gut health 

  • Thyroid issues

  • Post oral contraceptive pill use

Many women are wrongfully diagnosed with PCOS and prescribed the oral contraceptive pill. The synthetic hormones in the pill suppress ovulation and natural hormone production by the ovaries. This can exacerbate a hormone system where ovulation is already out of whack.  The pill does not address the underlying causes of the hormone disruption, it merely suppresses symptoms.  

Holistic approach to PCOS

Treatment of PCOS needs to address the underlying cause/s of hormonal disruption. This includes diet and lifestyle changes, and evidence based herbal and nutritional supplementation. If a female is experiencing irregular periods but doesn’t have PCOS, an investigation into the underlying cause of menstrual cycle irregularities is warranted. Just like PCOS, diet and lifestyle changes, as well as supplementation, can help bring hormones back into a natural balance.

Note: Some females with PCOS or irregular periods, when their periods do come, they can be heavy, painful, clotted and suffer a lot of premenstrual symptoms. These are all signs of hormone disruption (i.e. estrogen and progesterone). This can also be addressed via diet and lifestyle change, as well as supplementation.

This article was written by Alon Blumgart, Melbourne Naturopath at Vital Chi Wellness who specialises in female hormone disruption (including PCOS, endometriosis, fibroids, PMS, post-pill hormonal disruption, menopause and infertility). To book a FREE 15-minute appointment with Alon, contact our friendly team on 9894 0014.