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Polycystic Ovarian Syndrome (PCOS)

pcos

What is polycystic ovarian syndrome?
Also known as polycystic ovary disease, polycystic ovarian syndrome (PCOS) is a condition in which small, benign (non-cancerous) cysts develop in one or both of a woman's ovaries. The condition is characterized by irregular menstrual periods, infertility, and other hormonal difficulties.

What are the symptoms?
PCOS usually causes more than one symptom. These may include:

  • Irregular or absent menstrual periods
  • Development of some male sex characteristics, most commonly excess hair on the face and body, deepened voice, and male-pattern baldness
  • Acne
  • Weight gain or obesity
  • Infertility (PCOS is the most common cause of female infertility)
  • Insulin resistance
  • Decreased breast size

Women with PCOS are also at higher risk for the following conditions:

What are the causes?
Excess production of luteinizing hormone by the pituitary gland is often the initial cause, prompting a woman's ovaries to produce higher-than-normal levels of the male sex hormone androgen and lower-than-normal levels of follicle-stimulating hormone. This prevents the ovaries from releasing an egg, which instead remains in the ovary and develops into a cyst.

Who is likely to develop polycystic ovarian syndrome?
PCOS affects between 5 and 10 percent of females. Symptoms often begin at puberty, but women are most likely to be diagnosed with PCOS in their twenties or thirties. Those who have a  mother or sister with PCOS have a higher risk of developing the condition.

How is polycystic ovarian syndrome diagnosed?
Physicians typically recognize PCOS by its symptoms alone, and can sometimes feel enlarged ovaries or large ovarian cysts during a pelvic examination. Other tests can be used to confirm a diagnosis of PCOS, including:

  • Abdominal or vaginal ultrasound, which use sound waves to create images of the pelvic organs on a screen.
  • Blood tests, to check hormone levels.

What is the conventional treatment?
Conventional treatment of PCOS is aimed at addressing symptoms, especially those that contribute to increased risks of cardiovascular disease, such as hypertension, diabetes, and obesity. Treatments include:

  • Medications to regulate a woman's menstrual cycle, such as oral contraceptives (birth control pills) and progesterone.
  • Medications that block excessive androgen, such as the drug spironolactone (Aldactone).
  • Fertility drugs (if pregnancy is desired) that trigger ovulation, such as Clomid.
  • The drug Metformin (glucophage), which treats insulin resistance and shows promise for treating PCOS in particular.

For some women with PCOS who have difficulty getting pregnant, a type of surgery called laparoscopic ovarian drilling may be recommended to stimulate ovulation. This procedure involves using a laser fiber or electrosurgical needle to puncture the ovary up to 10 times, resulting in lowered production of male hormones and a corresponding increase in fertility.

Women are also encouraged to achieve and attain a healthy weight by following a healthy diet and getting regular exercise.

What therapies does Dr. Weil recommend for polycystic ovarian syndrome?
In addition to maintaining a healthy weight through diet and exercise, Dr. Weil recommends the following approaches to PCOS:

Dietary changes:

  • Follow an anti-inflammatory diet
  • Avoid conventionally raised beef and dairy products, which may contain residues of estrogenic hormones used as growth promoters
  • Increase intake of whole soy foods, which contain isoflavones, substances that may help regulate hormone imbalances

Exercise: Tieraona Low Dog, M.D., director of education for the Arizona Center for Integrative Medicine, says that PCOS is principally a metabolic problem and that many treatment approaches are similar to those for insulin resistance. For example, she says that exercise is "an absolute must - no exceptions!" This means exercising for at least 30 minutes every day.

Traditional Chinese medicine: Consider working with a practitioner of TCM, who may recommend peony and licorice, two herbs that have been studied for PCOS. He or she may also recommend acupuncture.

Supplements: Dr. Low Dog notes that a small study published in the July, 2007, issue of Fertility and Sterility showed that one-quarter to one-half teaspoon of cinnamon powder reduced insulin resistance in women with PCOS.

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