What is Polycystic Ovarian Syndrome?
PCOS, or polycystic ovarian syndrome, is a hormone-related condition that can affect your cycle and fertility. If untreated, PCOS can eventually develop and increase the risk of type 2 diabetes. It is diagnosed by having two out of the following three listed below. As a syndrome, it is a collection of symptoms that are person-dependent. Because of this, PCOS can present very differently from person to person. It is important to understand the root causes driving your polycystic ovarian syndrome.
Polycystic Ovarian Syndrome is diagnosed when you have 2 out of the 3 (or possibly all) of the following:
1. Elevated androgens (testosterone / DHEA)
Testosterone (ovarian) can be elevated due to insulin resistance. This is because increased blood insulin signals the ovaries to produce more testosterone
DHEA (adrenal) can be elevated due to stress / inflammation. DHEA is an enzyme combines with testosterone, and at elevated levels leads to acne and hair loss.
2. Polycystic ovaries on ultrasound
Small cysts due to the follicle trying to produce an egg
DIFFERENT from an ovarian cyst
3. Anovulatory cycles / irregular periods
Irregular periods due to lack of or delayed ovulation
Stress, high testosterone levels can affect ovulation
Questions to ask to the answer to help understand root causes to the question ‘what is polycystic ovarian syndrome?’:
Do I have elevated androgens? If so, which ones?
Check testosterone and DHEA
Knowing if you have elevated androgens is important because elevated androgen levels can induce symptoms like hirsutism (unwanted facial hair growth), acne, low libido, and hair loss. These elevated levels contribute to PCOS and can result in insulin resistance which if untreated can develop into type 2 diabetes.
Source: University of Rochester Medical Center, 31466345, 25008465
Do I have polycystic ovaries on an ultrasound completed by my doctor?
Diagnostic criteria: A polycystic ovary is one that contains 25 or more follicles using new ultrasound technology measuring 2 to 9 mm in diameter or an ovary that has a volume of greater than 10 mL on ultrasonography.
The polycystic ovaries mean the follicle is trying to produce an egg, but having a difficult time and may result in anovulatory cycles
These are different than ovarian cysts that can cause pain. Pain is not a symptom of PCOS. It is possible to experience period pain if you have PCOS but it would have a different root cause.
Source: 26807298
FREE PCOS 5-DAY MEAL PLAN:
Am I ovulating? Is my period irregular?
Diagnostic criteria: A period is considered irregular if your cycle is less than 21 days or more than 35 days, missing 3 or more periods in a row, or if your flow is much lighter or heavier than usual. Having a regular period is dependent on ovulation and also hormones. It is vital to have a normal period because if your don’t this is your body sending you a signal that there is something imbalanced with your hormones.
It is common to experience long cycle when you have PCOS
Source: NIH
Do I have insulin resistance?
70% of those with PCOS have insulin resistance.
This is one of the main answers to what is polycystic ovarian syndrome because of how common it is.
It is important to note if you have it because this could be driving higher testosterone levels.
Source: 22192137
Am I favoring the 5-alpha pathway for androgen metabolism?
Androgens will utilize either the 5-beta or 5-alpha pathway.
The 5 alpha pathway is an enzyme that helps to convert testosterone into DHT can cause acne, hair loss, and hirsutism. This pathways usage can be answer to what is polycystic ovarian syndrome for you.
Using the 5-alpha pathway means that you can be up to 3x more symptomatic than if you are favoring the 5-beta pathway. This is why even if your testosterone or DHEA are not significantly elevated, but you are favoring this way of metabolism then you can experience symptoms like acne, hair loss, and hirsutism.
Source: 7636302
How is my gut health?
Inflammation in the gut can impact hormone levels.
Patients with PCOS have been found to contain a fewer diversity of gut bacteria and this is inversely related with androgen levels.
Source: 32109968
Do I have signs of inflammation?
Signs of inflammation include chronic digestive issues, autoimmune conditions, skin issues, fatigue, headaches, joint pain, food sensitivities. You can also test a marker of systemic inflammation called hs-CRP.
Source: 29467962
How are my other hormones?
Hormones are such a key feature for what is polycystic ovarian syndrome.
Hormones are all connected and an imbalance in one means there is usually a compensation somewhere else. Checking estrogen, progesterone, and cortisol levels can be helpful in addition to FSH, LH, SHBG, and prolactin to get a picture of your overall hormone levels.
PCOS is a hormonal condition, so it is important to not only check your androgens, but also your other sex and adrenal hormones to better understand your hormone health.
How are my adrenal glands?
Stress can affect our delicate hormone balance.
If DHEA (androgen) is elevated this can be a sign of stress and inflammation. DHEA is your adrenal androgen and if it is elevated could be one of the diagnostic criteria for PCOS
Additionally, check cortisol levels at 4 points throughout the day. First thing in the morning, before lunch, before dinner, and then right when you go to bed.
Understanding these 4 points can give a clue into how you manage the stress and also how it varies throughout the day.
Source: 29681710
TAKE AWAY MESSAGE:
There is specific diagnostic criteria for PCOS and additional information to look into to understand the root causes driving your PCOS. If you’re looking to understand the root causes of your hormones, check out my hormone testing packages HERE.
