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Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome (PCOS) is a common, multi-organ endocrine disorder. It was originally described as cystic ovaries combined with the presence of excess hair growth, and menstrual irregularities. Women with PCOS do not necessarily have to have cystic ovaries. While the exact underlying cause is unknown, it is known that PCOS can involve the ovaries, pancreas, thyroid, adrenals and the pituitary may be involved.

The most common symptoms are male pattern hair growth, particularly facial hair, menstrual irregularities, and infertility. Menstrual irregularities can include variable cycle lengths or no cycles at all, and heavy bleeding. Infertility is usually due to the absence of ovulation. PCOS affects between 4-10% of women of reproductive age. Fifty percent of women with PCOS are found to be obese, a situation which will increase the magnitude of insulin resistance.

A thorough history will be taken, including menstrual history and onset of symptoms, and family history. Initial laboratory testing includes free and total testosterone levels, Insulin, DHEA-S, LH, FSH, Prolactin, and thyroid tests if indicated. An ultrasound may be used to evaluate cysts on the ovaries.

There are many ways to treat this syndrome, most of which are dependent on the patient. The gold standard for treatment of PCOS is weight loss (if needed), diet and exercise. You can decrease circulating testosterone, resume menses and improve insulin resistance with a weight loss of as little as 5% of starting weight. Even without the need to lose weight, increasing fiber, fruits and vegetables, adding flaxseeds/chia seeds and fish oils may be indicated in your plan. Exercise plans will be introduced or modified, as this can aid in weight loss, decrease insulin sensitivity and increase general well being. Cycles can become regular once the insulin resistance is addressed. Specific hormone balancing herbs will also help to regulate the cycle and decrease facial hair growth.