PCOS: Symptoms, solutions, and impact on Fertility
Polycystic ovarian syndrome (PCOS) is a constellation of symptoms and traits. It is not a “specific disease”, but rather a set of symptoms commonly seen together. As a result, there is some real variation in how it presents. According to the Rotterdam criteria, diagnosis is based on having at least two out of these three main indications.
Androgen excess: Androgens, or male sex hormones, affect various tissues in different ways. As a result, the clinical picture is also quite variable. Some of the more common symptoms include reproductive dysfunction and symptoms of virilization such as hirsutism (excess coarse hair growth on face/chest), oily skin, and acne. This trait can be indicated by either blood work, symptoms, or both.
Ovulatory dysfunction: Most women experience this as irregular periods, very long cycles, or total absence of a period (amenorrhea). Many of my patients share that as teenagers, they didn’t mind having their period every three to six months. It’s only when they begin trying to conceive that it becomes a real problem.
Polycystic ovaries or high AMH: If imaging confirms an excess of small cysts OR blood work shows high Anti Mullerian Hormone (AMH) levels, then PCOS may be confirmed. AMH is a commonly used measurement of ovarian reserve, as it is secreted by the follicles: if it’s low, there are less follicles (low ovarian reserve), and if it’s high, there is an excess of follicles (PCOS), even if we can’t see them on the ultrasound.
How does this affect your fertility? Firstly, many women with PCOS are only ovulating a handful of times per year. Also, you have a lot of follicles, but those eggs are unfortunately lower quality due to the inflammatory nature of the syndrome.
Factors for improving fertility and other health outcomes
Low-inflammatory diet: This includes not only what you eat but when. Regulating your eating times is also part of the solution.
Special attention to sleep quality and quantity: Stimulate melatonin production by getting light in your eyes early in the morning, and staying out of the light a couple of hours before bedtime.
Exercise every chance you get. By exercise I mean movement throughout the day. Also, building muscle and doing HIIT is an excellent way to combat insulin resistance.
Supplements to support reduced inflammation and to improve insulin response. This is a great opportunity to check in with your natural health practitioner for some specific recommendations.
Acupuncture to reduce inflammation, balance hormones, improve egg quality, and regulate your menstrual cycle. There is some pretty exciting research regarding acupuncture and PCOS coming out of Sweden in the past 15 years. In this study, electro acupuncture was administered to 84 women with PCOS. At the end of 16 weeks, not only was ovulation significantly more frequent, but also serum levels of androgens and other markers were lower. Stener-Victorin has recently finished another similar study looking at more frequent acupuncture and its effect on ovulation, which has shown even better outcomes.
For an assessment and treatment plan tailored specifically for you, reach out by email, and set up a 15 minute discovery call. I’m always available for a chat.
