PCOS (polycystic ovary syndrome) afflicts millions of women. It has been called a form of prediabetes, because the conditions have much in common. What can we learn from the story of polycystic ovary syndrome?
What is PCOS?
Polycystic ovary syndrome is a disease of hormones. Depending on how PCOS is defined, somewhere from 5% to 20% of American and European women have it. It is the most common reproductive hormone disorder of women of childbearing age and the number one cause of female infertility.
PCOS is usually diagnosed when a woman has:
• Very irregular or absent periods.
• Elevated male sex hormones, which can lead to male pattern hair growth on face and body, along with acne and hair loss on the head.
• Ovaries with large numbers of “cysts,” which are actually groups of follicles that are supposed to produce eggs. In PCOS, the eggs aren’t released and the follicles keep growing and clump into cysts.
Other symptoms include skin discolorations, painful periods, depression, mood swings, lack of sex drive, and fatness around the waist. It’s a really unpleasant condition, affecting appearance, fertility, mood, and general health. It’s also linked to diabetes and heart disease.
PCOS and diabetes very similar
Like Type 2 diabetes, polycystic ovary syndrome often starts with insulin resistance. In studies, 50% to 90% of women with PCOS are insulin resistant. According to the American Diabetes Association, insulin resistance leads the body to produce high levels of insulin, just as in early stage Type 2 diabetes.
In some women, insulin stimulates the production of male hormones such as testosterone. The male hormones cause facial hair, baldness, and acne and may suppress the female hormones that produce eggs in the ovaries. Other hormones seem disturbed also. As a result, women with polycystic ovary syndrome often can’t get pregnant.
Researchers in Australia found that women who had PCOS were three to five times more likely to develop Type 2 diabetes than women who didn’t have PCOS. According to other research from the Medical College of Virginia, up to 27% of premenopausal women with Type 2 diabetes also have PCOS.
Polycystic ovary syndrome has also been implicated in Type 1 diabetes. About 25% of women with Type 1 have PCOS, according to one study.
Causes of PCOS
What causes PCOS? How do women with this condition become insulin resistant in the first place? Many seem to have it in early childhood or even at birth.
In Type 2 diabetes, as in obesity, experts like to blame patients for eating too much and not exercising. You can’t say that about PCOS. Since a disease of one-year-olds can’t be blamed on overeating or laziness, what causes this insulin resistance and other hormonal damage?
The three documented causes are the same as for diabetes: genetics, exposure to environmental chemicals, and eating refined carbohydrates.
A study from Alabama found that a sister of a woman with polycystic ovary syndrome has about a 32% chance of having it. Her mother has about a 20% chance, compared to less than 10% chance for the average woman in the study. So there is a genetic factor.
Genes just give you a tendency, though. Something has to set it off, and studies show several chemicals that may be involved. According to the site Natural Health Solutions for PCOS, organic pollutants like PCBs and triclosan, plastics like bisphenol A, and heavy metals may disrupt hormones. This can happen to a baby in the womb and stay with her for life.
The same chemicals are strongly associated with diabetes and fatness. They are sometimes referred to as EHDs (environmental hormone disruptors) or EDCs (endocrine disrupting chemicals) and there are a lot of them.
Diabetes, PCOS, and obesity are best thought of as environmental conditions. It may be that fatness develops as a way to store chemicals like bisphenol A out of the bloodstream.
Diet is also important. Refined carbohydrates like sugars and white flours seem to promote both PCOS and diabetes.
Treatment of PCOS
Two drugs are often prescribed for polycystic ovary syndrome. Metformin reduces insulin resistance, and birth control pills moderate the male hormones and establish a menstrual cycle.
Along with drugs, both diabetes and PCOS are managed with exercise and diet. PCOS symptoms have been found to improve with a loss of 5% of body weight. As with diabetes, we don’t know whether it’s the weight loss or the behaviors that cause weight loss that help.
Many herbs are also tried. Most herbalists seem to recommend chaste tree berry, licorice, and dong quai for the hormonal symptoms, although the American Botanical Council website lists dozens of other possibilities. Bitter melon, cinnamon, gymnema, and fenugreek will help with the insulin resistance. Note these herbs are also used for diabetes.
Self-management of PCOS
The website My PCOS Info and the book Natural Solutions to PCOS by nutritionist Marilyn Glenville, PhD, agree on some ways to manage and improve life with PCOS:
• Cut out all refined carbohydrates.
• Eat more fiber.
• Exercise regularly.
• Eat small frequent meals — Glenville says every three hours.
• Reduce or eliminate processed foods, trans fats, alcohol, dairy products, and caffeine.
• Avoid environmental chemicals, especially pesticides and plastics.
• Both sources list supplements and herbs to try — some they agree on are vitamin D, inositol, and chromium, and they both list many more.
Notice how similar this is to diabetes advice, but there’s a lot more to living with PCOS. For more self-help information, check out My PCOS Info or Natural Health Solutions for PCOS.
Living with the possibility of diabetes complications doesn’t mean that fear, stress, and worry are inevitable, says Scott Coulter. Bookmark DiabetesSelfManagement.com and tune in tomorrow to read more.
