Tuesday, January 28, 2014

Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) effects from 12-21% of Australian women of reproductive age.[i] It is diagnosed by having 2 out of 3 of the following symptoms: irregular or absent ovulation, signs of excessive testosterone such as facial hair or acne, and polycystic ovaries.  The consequences of PCOS are reduced fertility, weight gain, irregular menstruation, insulin resistance (a pre-type II diabetic state in which cells do not respond to insulin leading to excess glucose in the blood) and increased risk of cardiovascular disease (CVD) and endometrial cancer.[ii]  There are other health problems that can seem similar so it is important to have appropriate testing done.  It is estimated that 70% of women with PCOS in Australia are undiagnosed. [iii] PCOS can have major health implications so if you have similar symptoms it is important to see your healthcare provider. Women with PCOS should have measurements taken for abdominal obesity, triglycerides, HDL, blood pressure, and glucose tolerance.

If you have been diagnosed with PCOS the biggest improvement can be seen with a 5-10% reduction in weight. This reduces insulin resistance as well as improving fertility and excess testosterone symptoms.  According to Australian guidelines, pharmaceutical fertility treatments should not be given to anyone with a BMI over 35 until weight is reduced because it is too big a health risk to mother and baby.[iv]  The best way to achieve weight loss is through diet modifications and exercise.  For advice on exercise please see my previous article.  A minimum of 150 minutes a week is needed to see results.  Even for women with PCOS who are not overweight exercise improves symptoms.

There are some supplements that can be helpful in improving symptoms.  Cinnamon can be taken as a supplement to help reduce fasting glucose and insulin resistance.  Berberine is a compound found in several plants and can be found in supplement form.  It has been shown to reduce insulin resistance, aid in weight loss, and improve lipid levels. Chromium and Magnesium can be helpful in reducing insulin resistance but will not help with the other symptoms of PCOS.  Inositol can also improve lipid levels, reduce CVD risk and improve fertility.

If you have PCOS and are planning on falling pregnant, it is important to improve the condition before conceiving.  Daughters of women with PCOS often have metabolic problems from infancy.[v]

If you have any questions about PCOS please see your local naturopath.



References

Some information for this article was taken from the following online presentation:
Villella S. Oligo and Amenorrhoea (unpublished lecture notes]. Health Masters Live, online; lecture given – 2013 Nov 14.



[i] Jean Hailes Foundation for Women’s Health. Evidence based guideline for the assessment and management of polycystic ovarian syndrome. Clayton South: Jean Hailes Foundation for Women’s Health; 2011. 130 p.

[ii] Barclay L. New Guidelines for Polycystic Ovary Syndrome (internet). Medscape Medical News; 2004 Jan 28. Available from: www.medscape.org/viewarticle/467811

[iii] Jean Hailes Foundation for Women’s Health. Evidence based guideline for the assessment and management of polycystic ovarian syndrome. Clayton South: Jean Hailes Foundation for Women’s Health; 2011. 130 p.

[iv] Jean Hailes Foundation for Women’s Health. Evidence based guideline for the assessment and management of polycystic ovarian syndrome. Clayton South: Jean Hailes Foundation for Women’s Health; 2011. 130 p.

[v] Barclay L. New Guidelines for Polycystic Ovary Syndrome (internet). Medscape Medical News; 2004 Jan 28. Available from: www.medscape.org/viewarticle/467811