Women with PCOS don’t usually have the exact same symptoms
but nearly all of them have one thing in common: insulin resistance.
Still insulin resistance is just one player in the complex mix of hormonal imbalances
that lead to PCOS. And the ways these imbalances show up can vary widely. That’s
one of the big reasons why it’s often so challenging to trace the range of symptoms
back to their root cause: PCOS.
Every woman with PCOS has travelled a separate path to her diagnosis, but all can
benefit from knowing more about what’s going on in their bodies. Understanding how
PCOS develops can help you figure out how to make specific changes to your diet
and lifestyle that will reduce your PCOS symptoms.
PCOS causes and solutions
Women with PCOS typically deal with the following three-factor hormonal scenario:
1. High amounts of androgens (including testosterone)
2. Insulin resistance (impaired sugar tolerance)
3. Both of the above interacting in a positive feedback loop with one amplifying
Genetics, environment and lifestyle are some of the major factors that can influence
these different hormonal scenarios.
This is a simplified diagram of the chain of events often leading to PCOS. The good
news is that limiting your carbs and taking other lifestyle measures can make a
PCOS sufferers typically have:
Increased insulin. The majority of women with PCOS
need to first address an overproduction of insulin (hyperinsulinemia), which, overtime,
leads to insulin resistance, but also stimulates the production of androgens. Androgens
are sex hormones, like testosterone, that are usually considered “male” hormones.
It’s thought that circulating insulin may be one of the factors that confuse the
ovaries, because when it’s reduced, the ovaries often function better. There is
a much smaller group of women with PCOS who are not insulin resistant though research
suggests that that they still produce excess androgens. It’s still not clear why
Increased androgens. Excess androgens in women with
PCOS disrupt overall hormonal balance and produce some of the syndrome’s characteristic
signs. It’s normal for all women to have some androgens, but excessive amounts can
lead to weird hair growth, or hair loss in “male” patterns (facial hair and/or male
Increased estrogen. Excess androgens can also be
converted into estrogen. This extra estrogen suppresses the normal surge in follicle-stimulating
hormones (FSH) that triggers ovulation. When this happens, ovulation generally doesn’t
occur, which elevates luteinizing hormone (LH) and leads to low progesterone. Without
enough progesterone, the body can’t fully support normal ovulation or pregnancy.
Irregular/absent periods and cyst formation. Many
women with PCOS have irregular periods or stop menstruating altogether. If ovaries
produce an abundance of egg follicles each month, but do not release an egg, a series
of small cysts forms that often look like a string of pearls. This is where the
name “polycystic” ovarian syndrome comes from: “poly” = many.
Signs and symptoms of PCOS and insulin resistance
As with most “syndromes,” PCOS shows up differently in each woman. Every woman with
PCOS has a symptom picture that will change during the course of her lifetime, too.
Some women experience very few symptoms, while others have many. High androgens
may cause acne, male-pattern hair growth or hair loss, or other visible changes.
The wide range of PCOS signs and symptoms includes:
- Irregular or absent periods
- Infrequent (or total lack of) ovulation
- Unwanted hair growth
- Hair loss
- Darkened skin patches
- Mid-body weight gain
But of all the health concerns caused by PCOS and insulin resistance, irregular
periods and unwanted weight gain are the ones women most often want help with.
Here’s how those two problems can play out in women with PCOS:
Irregular or absent periods. With PCOS, you may go for
months without a period. Or you may have difficult periods, bleeding heavily for
days — or weeks. Heavy bleeding occurs when the body naturally sheds the uterine
lining but the lining has gotten extra thick. Also, during periods — even regular
periods — the ovary may or may not have released an egg. This unpredictability can
be very disturbing, especially if a woman is trying to become pregnant. PCOS is
one of the major causes of infertility in women, affecting between 4% and 18% of
women of childbearing age.
Unwanted weight gain. Extra fat cells fuel production
of extra estrogen, which further disrupts ovulation. This extra fat usually accumulates
around the waist — where it can be more difficult to lose, even with diet restriction
and exercise. This stubborn extra weight is more likely to have adverse long-term
effects on your health, including cardiovascular disease.
It’s fairly common for less obvious clues to PCOS to be missed. For example, polycystic
ovaries (PCO) can occur even with normal periods and normal androgen levels, or
they may come and go. And some women with PCOS do not have cysts at all.
Hormonal imbalance is variable and dynamic and so its signs and symptoms are, too.
This is why diagnostic criteria for PCOS are open to interpretation, and why appropriate
diagnosis and treatment are often delayed.
Fortunately, there are a lot of
natural ways to take care your body if you have PCOS — like
taking steps to support better hormonal health, changing your diet,
and adjusting a few lifestyle factors. If you suspect you might have PCOS, the sooner
you recognize your symptoms for what they are, the better.
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