PCOS affects 6-12% of women. Symptoms may include unwanted facial hair growth, weight gain, and irregular menstrual cycles. Part of my Naturopath practice in Kamloops, BC, and Merritt, BC, is helping diagnose and treat PCOS.
Diagnosis of PCOS requires two out of these three criteria:
enlarged ovaries containing an increased number of follicles as seen on an ultrasound
irregular or absent menstrual cycles
high androgens (i.e. testosterone)
There are other conditions that can look like PCOS. It is important to work with a licensed healthcare practitioner who will do a health history and choose appropriate testing to arrive at a diagnosis.
What are the main features of PCOS?
high testosterone, which may cause acne and unwanted hair growth
irregular ovulation, causing decreased fertility
issues with blood sugar regulation. This may result in weight gain, increased acne, mood changes, and increases a person's risk of developing type II diabetes
high OR low estrogen
More likely to have chronic, low-grade inflammation
Testing
If your doctor suspects PCOS, they may begin by referring you for a transvaginal ultrasound. They may also recommend lab work, which will likely include testing hormones and metabolic markers.
Hormone testing may include estrogen, progesterone, free and total testosterone, DHEA-S, prolactin, and FSH and LH. When it comes to testing hormones, timing is important. Most of the hormones listed are best tested on Day 3 of the menstrual cycle, while progesterone is best tested 7 days before an expected period. My testing approach is comprehensive and specific for each person, with clear instructions on when to go to the lab.
Metabolic testing may include testing HbA1C and/or fasting insulin and glucose. Women with PCOS are more likely to have insulin resistance and are at greater risk of developing Type II diabetes. Naturopathic medicine is uniquely situated to address insulin resistance early on with a multifaceted approach with a focus on prevention, patient education, and emphasis on diet and lifestyle changes.
There are many complexities with PCOS. The presentation of symptoms, lab values, and treatments can look different for each patient. As research unfolds and we gain more information about PCOS, I aim to integrate this into my assessment and treatment while covering the foundations. For example, individuals with PCOS are more likely to be deficient in melatonin, B12 and Vitamin D. The complexity of PCOS and furthermore, the complexity of each individual gives all the more reason to take a thorough health history, assess comprehensively, and individualize treatment. Additionally, I always aim to put my patient's goals at the forefront, whether that be fertility, weight loss, increased energy, balanced mood, or any other primary concern.
Treatment
Naturopathic Treatment approaches include restoring hormone balance, supporting regular ovulation, increasing insulin sensitivity and reducing inflammation. Specific diet and lifestyle changes are effective towards all of these goals and are backed by research. There are several nutraceutical supplements and herbs that improve insulin sensitivity, improve fertility, lower androgens, and decrease inflammation -- all very relevant outcomes for individuals with PCOS.
If you reside in BC, suspect you may have PCOS and are looking for a comprehensive, patient-centred approach, consider booking an initial visit!
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