Root Cause: PCOS
Polycystic ovarian syndrome is a condition with three defining characteristics:
Polycystic ovaries
Elevated Androgens (male hormone)
Irregular periods
It is a common condition, affecting 1 out of 10 women, and yet it isn’t often well understood in the conventional medical community as it can years to get an appropriate diagnosis.
PCOS is a syndrome, not a disease, which means that it is a collection of symptoms, not one individual biochemical process and organ dysfunction (e.g. heart disease is a dysfunction of the heart). In actualiity, PCOS symptoms are on a spectrum, often a metabolic spectrum and a hormonal spectrum, because of this, there are different “types” of PCOS.
In actuality, PCOS really boils down to one hormone: luteinizing hormone (LH), and its errors in signalling.
Luteinizing Hormone
The role of LH is to stimulate the ovaries to produce testosterone, and, during the ovulatory window, “surge” to trigger ovulation. With PCOS, there are issues with the triggers for signalling LH, as well as the production of LH.
LH is produced by the anterior pituitary (in the brain), in response to the hypothalamus signals through GNRH (gonadotropin releasing hormone), which is released in waves (called “pulses”). The cross talk communication between the hypothalamus is rudimentary, when GNRH is pulsing is fast, the pituitary signals the ovaries to prepare for ovulation; after ovulation, GNRH pulses slow to encourage a luteal phase.
In PCOS patients, LH is produced at higher amounts, and often in dyssynchronous GNRH pulsing. The question is why. Here are some of the reasons:
Insulin Resistance
This is classic PCOS, and is by far the most common. While insulin resistance can develop in almost every cell in the body, the pituitary and ovaries will continue to respond to excess insulin. Insulin stimulates the release of more LH from the pituitary, which then tells the ovaries to produce more testosterone. Instead of an estrogen rise that should occur in the follicular phase, testosterone is produced. A follicle starts to develop but doesn’t mature and forms the stereotypical cyst.
Because studies show that LH secretion is directly associated with insulin resistance, the best way to approach an insulin-resistant type PCOS is through a insulin-sensitizing diet and weight loss if you are overweight. This means avoiding foods that raise glucose and insulin such as refined carbs, trans fats sugars, dairy, sweets, and sweetened beverages. If you have been told that you have an abnormal glucose, you probably have elevated insulin. I recommend testing your fasting insulin and glucose to get a better gage of your insulin resistance via a HOMA-IR score (homeostatic model of insulin resistance).
HPA Dysfunction
Other reasons for issues with pituitary/ovarian communication (through LH) includes the birth control pill, inflammation, and environmental toxicants (such as BPA).