The Skinny OnPolycsytic Ovarian Disease: What your doctor may have forgotten to mention about lifestyle management
Dr James Meschino DC, MS, ROHP
Polycystic ovary syndrome (PCOS) is a common female hormonal disorder affecting approximately 5%-10% of women of reproductive age (12–45 years old). Polycystic ovaries develop when the ovaries produce excessive amounts of testosterone. This is due to either the release of excessive luteinizing hormone (LH) by the anterior pituitary gland or from high levels of insulin in the blood. Being overweight can indirectly produce over secretion of LH and result in high insulin levels. Thus, being overweight, and/or not physically fit are common findings in women with PCOS. While the causes are not completed understood, insulin resistance, diabetes, and obesity are all strongly correlated with PCOS.
The cysts discovered in the ovaries upon ultrasound examination are actually immature egg follicles, not cysts. As such, “polyfollicular ovary syndrome” would have been a more accurate name. Rather than one egg follicle maturing and ovulating during a normal menstrual cycle, in PCOS a number of egg follicles start to develop, but their development becomes arrested along the way (forming permanent cysts) due to hormonal imbalances of high testosterone, dihydrotestosterone, estrogen (made in the fat cells along with testosterone), insulin and LH, as well as low amounts of FSH (follicle stimulating hormone). As such, many ovarian cysts accumulate and women often miss menstrual cycles due to interrupted ovulation.
The principal findings in PCOS are obesity, irregular menstrual cycles or amenorrhea, acne, and related effects of masculinizing hormones, such as excessive hair growth. The symptoms and severity of the syndrome vary greatly among women. Ovarian pain and cyst rupture can occur spontaneously, in severe cases.
Treatment Options
Medical treatment has been aimed at controlling insulin levels through the use of diabetic drugs, as well trying to balance female hormones with birth control pills, and attempting to lower testosterone with androgen blocking agents. None of these methods have proven to provide consistent amelioration of PCOS and many of these drugs are associated with undesirable side effects.
On the other hand there a number of lifestyle practices that can naturally bring these hormones into balance, and help manage PCOS. I believe these non-toxic measures should be applied as the first line of management in these cases. These include:
- Lose excess body fat (preferrably via the Meschino Clinical Weight Loss Program Method, and is also explained in my book – The Meschino Optimal Living Program).
Enlarged fat cells produce excess testosteone and estrogen. The excess estrogen blocks the release of FSH, producing the LH:FSH imbalance that is a common finding in PCOS (this is what often inhibits normal maturation of egg follicles in the ovaries). Too much body fat also increases insulin levels.
- Endurance exercise – endurance exercise shrinks fat cells and lowers insulin levels, helping to better balance female hormones, testosterone and insulin – the main culprits in PCOS
- Take a natural supplement that tones down the effects of estrogen and blocks the over secretion of LH. The supplement should include black cohosh, soy extract and gamma-oryzanol.
- Take a supplement that blocks the conversion of testosterone into dihydrotestosterone, and also blocks the synthesis of estrogen and testosterone in fat cells. These ingredients are those usually found in prostate support products for men (e.g. saw palmetto, pygeumafricanum, soy isoflavones, beta-sitosterol, singing nettle)
- Consume soy products and cruciferous vegetables at least 3-5 times per week. Also ingest 2 tablespoons of ground flaxseed powder daily. These nutrients block the production of estrogen and testosterone in fat cells and help to detoxify more dangerous estrogens.
- Take a supplement containing milk thistle and the indole-3-carbinol to enhance liver detoxification of excess estrogen
- Take a supplement containing borage seed, flaxseed and fish oil to reduce inflammatory and hyperproliferative (too rapid cell division) activity from occurring (3 capsules per day)