Everything You Need to Know About Polycystic Ovarian Syndrome (PCOS)
Polycystic Ovarian Syndrome (PCOS) is a multifaceted endocrine and metabolic disorder affecting approximately one in ten individuals assigned female at birth (AFAB) during their reproductive years. PCOS is a condition that involves a constellation of symptoms, and while our understanding of it is continually evolving, there remains much we have yet to uncover. In this comprehensive guide, we'll explore the intricacies of PCOS, its pathophysiology, signs and symptoms, long-term health risks, diagnostic criteria, medical interventions, and the role of naturopathy in its management.
WHAT IS PCOS?
With our current knowledge, we understand that PCOS is a complex condition, often characterized by a combination of factors, including ovarian dysfunction, hyperandrogenism (an excess of male/AMAB hormones), insulin resistance, polycystic ovaries, chronic inflammation, HPA-axis dysfunction, and microbiome dysbiosis. These components interact in a way that contributes to the hallmark symptoms of PCOS, making it a challenging condition to understand and manage.
WHAT ARE THE SIGNS & SYMPTOMS OF PCOS?
Because PCOS is a multifactorial syndrome, its presentation can be highly variable. Common symptoms include:
Irregular or absent menstrual cycles (less than eight menstrual cycles per year or cycles exceeding 35 days)
Hirsutism (excessive hair growth - usually on the face)
Acne
Scalp hair loss
Infertility
Weight management difficulties
Mood disturbances, including depression and anxiety
Eating disorders
WHAT ARE THE LONG-TERM HEALTH RISKS OF PCOS?
Individuals with PCOS face an elevated risk of insulin resistance and metabolic syndrome, increasing their likelihood of developing:
Type 2 diabetes mellitus (T2DM)
Cardiovascular disease (CVD)
Gestational Diabetes Mellitus during pregnancy
Chronic Kidney Disease
This is why early management is so important, and where Naturopaths can guide lasting change to mitigate these risk factors.
HOW IS PCOS DIAGNOSED?
Diagnosing PCOS can be a complex process, but the Rotterdam criteria, an internationally recognised evidence-based guideline, offers valuable guidance. To receive a PCOS diagnosis, an individual must exhibit at least two out of the following three criteria:
Hyperandrogenism
Chronic anovulation
Polycystic ovaries
PCOS can be further divided into four distinct phenotypes, each with its unique characteristics.
HOW IS PCOS TREATED MEDICALLY?
Traditionally, PCOS has been managed with medical interventions, including metformin, an insulin sensitizer with associated gastrointestinal side effects. Oral contraceptive pills (OCP) are often used to manage PCOS symptoms, and a relatively new approach involves the use of Ozempic for individuals with insulin resistance seeking to improve fertility.
HOW CAN NATUROPATHY HELP WITH PCOS?
At this time, there is no cure for PCOS, and treatment is focused on managing symptoms through reducing inflammation, balancing hormones, supporting healthy weight management, improving insulin sensitivity, enhancing fertility and pregnancy outcomes, and reducing co-morbidities and long-term health risks. Although there is no cure, Naturopathy is well placed to support those with PCOS, as our arsenal of diet and lifestyle interventions, herbal medicine and nutritional supplements are emerging in the research for their ability to modulate and normalise many of these factors. Our approach in Naturopathy is versatile, and can work in harmony with prescribed medications (and may even improve the efficacy of medications) or as a standalone strategy, always tailored to the unique preferences and requirements of each client.
In conclusion PCOS remains a prevalent reproductive disorder in AFAB individuals, and while we continue to make strides in understanding its complexities, much remains to be discovered. PCOS is a metabolic-neuroendocrine disorder characterized by hormonal imbalances, insulin resistance, and other interconnected factors. Herbal, nutritional, dietary, and lifestyle interventions offer promising avenues for managing PCOS and improving the quality of life for those affected by this condition.
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