I’m so often asked about Polycystic Ovary Syndrome; what is PCOS, what does it really mean, what might cause it, could this thing be a PCOS sign or symptoms or is it due to something else, could I have it, what is PCOS fact and what it fiction? So I wanted to share the first chapter of my bestselling book Conquer Your PCOS Naturally to help address these questions, and help you get a grasp on what’s going on in and to your body…
Introduction to Poly Cystic Ovary Syndrome (PCOS)
Firstly, I want you to know most of what you have been told about PCOS is probably wrong.
Secondly, I want you to understand the true meaning of ‘health’. The World Health Organisation (WHO) definition states:
“Health is not only the absence of infirmity and disease but also a state of physical, mental and social well-being.” I must also add spiritual well-being. Symptoms may, or may not be a sign of disease. Lack of symptoms may, or may not be a sign of health. For example, if you have gastroenteritis and develop a fever, vomiting and diarrhoea, this is a completely healthy response by your body to kill and remove the invading bug. On the other hand, the first sign of heart dis-ease may be a fatal heart attack.
Addressing only one area of your life will not lead to the long term glorious health you deserve in all areas of your life. Your body is an intricate web of complex interactions, based on simple truths and balance, and always innately intelligent responses.
Throughout this book, you will see I refer to ‘disease’ as ‘disease’ ? not a horrible affliction, but a lack of ease in your body, mind and soul. Your focus should be on what it takes to be optimally well. This is how you conquer your PCOS.
This book is not about which drugs work best. Looking at the cold hard facts, a lack of a pharmaceutical agent or agents is not the reason you are experiencing suboptimal health. The BEST medicine for PCOS, and the dis-eases you are more likely to experience as a result of it ? heart dis-ease, cancer and diabetes ? is positive lifestyle change. The research shows lifestyle improvements are superior to drug therapy, and far safer. These improvements focus on what it takes for a human being to be optimally well: movement, nutrition, thought and environment.
The history of PCOS
The first descriptions of PCOS date back to 1721. However, PCOS was first formally described in the mid-1930s by two Chicago doctors ? Irving Stein and Michael Leventhal. The findings from their research were published in the American Journal of Obstetrics and Gynaecology. These doctors reported on women who were suffering from infertility, hirsutism (the excessive growth of thick dark hair in women), lacking a regular menstrual cycle, and with enlarged ovaries.
Stein and Leventhal developed a surgical intervention called a “wedge removal”. This technique was successful in restoring ovulation. However, it did nothing to address the many other symptoms, or the underlying drivers, of PCOS.
As we have moved forward in time, treatments have revolved around the birth control pill, drugs to decrease ‘male hormones’ and, more recently, those that improve insulin sensitivity. However, these both bring about side effects and do not address the underlying drivers of dis-ease. It’s a little like covering up your car’s oil light, there to warn you there’s a problem. Initially, it works ? no more annoying light. But then, one day in the future, you wonder why your car no longer runs as it should. And what else has this low oil level done to your car’s engine?
Increased emergence of PCOS
PCOS is present in approximately 10% of Caucasian women and up to 15 – 20% of African-American and Hispanic women. PCOS has been on the rise in recent years. This is attributable to our lifestyles. Excessive intakes of unhealthy food and drink, the introduction of artificial hormones to our food and environment, loss of appropriate nutrition, the constant state of stress we live under, suboptimal gut function, increasing medications, lack of movement and increasing rates of overweight and obesity, are taking their toll on our physical, psychological and spiritual health.
There are two main diagnostic criteria used for the diagnosis of PCOS; the Rotterdam Criteria and the NIH/NICHD. The Rotterdam criteria define PCOS as being present with at least two of the following: infrequent menstruation, excessive ‘male’ hormones (hyperandrogenism) and/or Poly Cystic ovaries on ultrasound. The NIH criteria define PCOS as the presence of hyperandrogenism and infrequent ovulation (oligo-ovulation).
Both of these definitions are after the exclusion of other disorders that could be responsible for the symptomatic picture.
Pathophysiology of the ovary
Poly (meaning multiple) Cystic Ovary Syndrome (PCOS) got its name from the multiple ‘cysts’ in the ovaries. However, these ‘cysts’ are in actual fact immature follicles. Researchers (Hughesdon, Webber, Maciel) showed there is an increased number of growing follicles in a Poly Cystic Ovary (PCO). These egg follicles begin to develop, but may stop growing, known as ‘follicular arrest’. If a dominant follicle does not enlarge and the egg does not mature, an egg is not released. This is known as anovulation, and affects hormonal balance. The numerous follicles also cause enlarged ovarian size.
What does a Poly Cystic Ovary look like?
The definition of a Poly Cystic Ovary is one in which there is “either 12 or more follicles measuring 2-9mm in diameter and/ or increased ovarian volume (>10cm3)” 1. The follicles appear in a typical peripheral pattern, also known as the ‘string of pearls’ appearance. This is most commonly determined by ultrasound ? abdominal, and/or trans-vaginal. It’s very important to have your scans performed by an experienced ultrasonographer. It is more accurate to have both abdominal and trans-vaginal scans performed. The trans-vaginal scan may not be performed if you are a virgin, or you refuse.
What is the difference between Poly Cystic Ovaries and Poly Cystic Ovary Syndrome?
The appearance of Poly Cystic Ovaries, and Poly Cystic Ovary Syndrome, are two separate entities. A woman with the appearance of Poly Cystic Ovaries (PCO) may or may not have PCOS. Approximately 19-33% of the general female population2 may show PCO appearance on an ultrasound.
There is some thought that PCO may develop into PCOS given the ‘right’ conditions (i.e. weight gain, or an increase in insulin levels), however, until further research is conducted, these two entities should be considered distinct from one another. However, the lifestyle changes and advice in this book are not only what is best for a women with PCOS to be well, but also for a human being to be well. Regardless of whether you have PCO or PCOS, following the advice in this book will improve your health.
PCOS can present in a myriad of ways. The picture of an average woman with PCOS is of an overweight woman with irregular, potentially painful, periods, infertility, excessive facial and body hair and acne. However, there is much variation.
Symptoms may include:
- Delay of normal menstruation (primary amenorrhea)
- Fewer than normal periods (oligomenorrhea)
- Absent periods, after having previously experienced periods (secondary amenorrhea)
- Menstrual cycles without ovulation (anovulatory cycles)
- Painful periods with abnormal flow
- Excessive body and/or facial hair
- Male pattern balding (alopecia)
- Poly Cystic Ovaries on ultrasound
- Overweight or obesity
- Difficulty losing weight
- Elevated insulin levels
- Skin discolouration (acanthosis nigricans)
- Skin tags
- High blood pressure
- Abnormal blood lipid levels
- Mood swings
- Hot flushes
- Sleep apnoea
- Heart dis-ease
It’s not just your ovaries
The name PCOS is somewhat misleading. It may lead you to believe this is an ovarian condition, but this is simply not the case. Your ovaries play an important role. However, PCOS is a ‘whole body’ endocrine condition, a systemic syndrome that affects the entire body.
Two of the main drivers of PCOS:
Insulin Resistance and Inflammation
One of the issues now known to lead to and aggravate PCOS is Insulin Resistance. Your body produces insulin to allow your cells to ‘take in’ glucose. When a person’s body cannot respond properly to the insulin, it produces excessive amounts ? known as hyperinsulinemia. As hyperinsulinemia continues, Insulin Resistance results. The excess insulin causes the ovaries to swell and develop cysts, and stimulates secretion of excess amounts of androgen. These ‘male hormones’ affect regular ovulation, the menstrual cycle and cause the masculine characteristics associated with PCOS.
Implementing positive lifestyle changes will help you conquer Insulin Resistance. In this book, I will take you through the steps involved.
Inflammation is an underlying cause of dis-ease that is rarely discussed, let alone appropriately addressed. This is no different in women with PCOS, regardless of age. Women with PCOS have been found to have elevated markers for inflammation.
Even before you begin to develop the tell-tale signs of PCOS, you may be suffering from chronic low grade inflammation affecting every part of your body.
“Why not adjust causes instead of treating effects?”
DD Palmer – Founder of modern day Chiropractic
The reality of the situation is this… you can take a variety of drugs to ‘treat’ each symptom, and then more to deal with the side effects. But, your body is not sick because of a lack of a drug. There is no miracle drug to cure PCOS. The only real way to conquer your PCOS is lifestyle change. One truth remains constant for all human beings ? what you eat, how you move, what you think and your environment, have dramatic effects on your body, mind and soul.
I congratulate you on taking the first incredibly important step ? picking up this book. You must read this book from cover to cover, and then again. There is much to learn. There may be times when you think it’s too complicated. If this happens, remember why you need to change. Remember also, everything comes down to a few simple points.
As a sufferer of PCOS, it is necessary to re-evaluate each aspect of your life. You need to create an environment conducive to a healthy life. The good news is the best lifestyle for a woman with PCOS is simply the same as the best lifestyle for any human being.
You need to remove deficiency and toxicity and attain purity and sufficiency. By making healthy changes, you can conquer your PCOS, achieve a brand new state of optimal health, and create a happy, healthy, long life for yourself and your family.
Where to start?
If you are struggling to overcome your PCOS, are tired of being fobbed off and unable to find the answers to your deepest questions, you have picked up the right book at the right time. I will take you through ? step by step ? the information you need to know, including the steps you need to take, to conquer your PCOS.
This book has been written to educate, but especially to empower.
I wish you all the very best of health, for now and into the future, for you, your family and the community we call our world.
From PCOS to perfect health, with love,
Dr Rebecca Harwin
The PCOS Expert
Author, Nutritionist, Chiropractor