Polycystic ovary syndrome, or PCOS, is believed to be a hormone disorder affecting up to 20% of women at some point in their lives, especially those of reproductive age; theories abound, ‘cures’ are often unsatisfactory and the answer, anyway, may well lie in you.
What is PCOS? Most usually, small cysts of fluid form in the ovaries. This results in women having irregular periods: None, infrequent or prolonged and heavy.
For some women, excess male (androgen) hormones may be felt to be the issue; in others, excess weight and fat levels are blamed. (PCOS symptoms are usually more severe if you are obese.) In others, poor diet and poor sugar control is blamed.
But PCOS is not simply an annoying problem linked to acne or facial hair. It is serious – a potential cause of infertility and heart problems.
Diagnosis of PCOS – Usually, the doctor will diagnose PCOS if you experience two or more of the PCOS signs above.
Cause of PCOS – The exact cause of PCOS has not been determined. Factors believed to play a role are:
- Heredity – other family members have it – e.g. mother, sisters.
- Inflammation – women with PCOS often have low-grade inflammation in their bodies; this can cause heart issues and blood pressure problems.
- Insulin resistance – higher blood sugar levels; may be an issue in 70% of cases.
- Adrenal link – may follow extremely stressful times – exams, divorce, loss.
- Androgen (testosterone) production – linked to the adrenals, or insulin production, inflammation and/or weight-gain. Acne is a common feature, as is body and face hair.
- Post-contraceptive pill – temporary and reversible.
Treatments for PCOS
To date, these have really been ‘symptom management’ treatments not cures:
If insulin is felt to be the issue, women may be given metformin (2). At one point the use of Metformin was thought to be some sort of breakthrough, but randomised and meta-analyses have put the drug in a much more confined role.
If a woman was post-pill she might be given HRT. A sledgehammer to treat something that was anyway reversible?
If a woman had acne she might be given an antibiotic for two years. This causes severe microbiome damage and can lead to many further and longer-term issues.
If a woman had body or facial hair, a laser has replaced creams.
The Cure for PCOS –
So, there is currently no “cure” for PCOS, just symptom management.
In 2021 research, led by Dr. Paolo Giacobini at the French National Institute of Health and Medical Research and published in the journal Nature Medicine, researchers felt something in the environment of the womb might be causing PCOS.
The conclusion was that PCOS may be an epigenetic issue (1) – gene blockage (rather than some inherited and permanent mutation) – originating from poor diet, infection, gut microbiome issues, stress, environmental toxins etc..
There is increasing evidence that factors like happiness, sex, stress and environmental toxins anyway alter the microbiome. In turn, gut microbiota are known to affect weight and hormone levels – sex hormones, adrenal stress hormones, insulin and so on. It’s a two way street – hormones can affect the make up of the microbiome, and the microbiome can affect hormone levels.
It’s more than a theory. PCOS has now been associated with decreased microbiota diversity and changes in the membership and levels particularly of two species of gut bacteria – Bacteroidetes and Firmicutes. And so infection and diet may play a big role. After all, you are what your gut bacteria eat! (3).
Gut microbiome make-up is known to be linked to insulin and diabetes and to heart problems, two factors that are linked to PCOS. And two recent studies have reported a lowered level of gut bacteria diversity in women with PCOS when compared with healthy women. Lowered diversity was also linked to increased androgen and body hair growth (4).
What is PCOS? It’s a chronic metabolic illness.
The fact is that all the different symptoms currently being treated in PCOS are really the result of weaknesses in the gut bacteria in the microbiome, commonly called dysbiosis (5). This is hardly unusual. We know that other chronic illnesses from Dementia to Diabetes are linked to dysbiosis.
Even vaginal microbiome changes have been linked to PCOS symptoms; but at the moment, no one knows whether the vaginal changes are causes or effects? (6).
It is very likely that further studies will show what pathogens are present in excess in the microbiome, and which good (commensal) bacteria are at reduced levels.
The use of probiotics and probiotic foods alongside high soluble fibre diets (the favourite foods of the good bacteria – oats, pulses, vegetables, nuts and seeds), and extra virgin olive oil, fish oils, avocados and fruits like berries, alongside a diet unfavourable to pathogens, (cutting glucose, high fructose corn syrup, alcohol, lactose in dairy) and taking yeast killers such as Oregano oil pills and Artemisinin for pathogenic bacteria – just might be a good place to start.
Remember the old saying: if you eat junk you end up with a junk body. Poor diet and infection might just be the real cause and, if so, for the first time, PCOS would be treatable.
- Metformin – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475283/
- Sex, microbes and PCOS – –https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6309599/
- J Clin Endocrinol Metab 2018; Apr – https://pubmed.ncbi.nlm.nih.gov/29370410/
- Alterations in the Intestinal Microbiome associated with PCOS – Biomedicine & Pharmacotherapy – Vol 133; Jan 2021; Lan Wang et al – https://www.sciencedirect.com/science/article/pii/S0753332220311501
- Vaginal microbiome changes; 2021 – https://pubmed.ncbi.nlm.nih.gov/33171400/#affiliation-1