Polycystic ovarian syndrome (PCOS) is one of the most common endocrine abnormalities in woman of the reproductive age. It affects 5% to 10% of women making it a leading cause of infertility in woman of child bearing age.

Understanding The Syndrome

What is PCOS?
PCOS involves and over production of ovarian androgens (male hormones) leading to a diverse range of symptoms including hirsutism (male pattern/excessive hair growth), acne, oligo-ovulation (irregular) or anovulation (lack of ovulation) and infertility.

Increased insulin levels, blood sugar irregularities, difficulty losing weight, obesity, hormonal imbalances, irregular cycles and of course multiple ovarian follicles arranged in a pearl necklace shape around the ovaries are also some key features to be found in women with PCOS.

How do I know if I have PCOS?
PCOS is a strange syndrome-not all women have the same presentation of symptoms. It's important to note that although the symptoms above can be a guide to some women's experiences-others diagnosed with PCOS are very slim, have no hair growth, pimples or even cysts on their ovaries!

The official medical diagnosis states that in order to confirm whether a woman indeed has PCOS at least two of the following features must be present: polycystic ovaries; oligo-ovulation or anovulation; clinical and/or biochemical evidence of androgen excess.

Interestingly this means that not every woman with cysts (more accurately: multiple follicles, not actually cysts) in her ovaries has necessarily developed PCOS and some woman don't even have them to begin with. However clinically, often the observation follows that when a woman has a few of the other symptom criteria present, particularly as far as signs of androgen excess are concerned-in many cases she is very likely to eventually develop cysts in her ovaries and the full blown syndrome. Prevention is possible through specific holistic health management and is an essential part of treatment.

What causes PCOS?
There is little consensus in the literature about the causes of PCOS4, however it is suggested the condition runs in families (although a specific genetic link remains to be established) and environmental triggers are proposed to play a role in the development of PCOS.

The contraceptive pill, sugar and high carbohydrate intake, weight gain and certain nutritional deficiencies are amongst some of the relevant environmental triggers associated with PCOS.

How can I get a diagnosis?
The best way to attain a diagnosis is to see your health care professional and requests some blood tests, a pelvic ultrasound and a revision of your presenting symptoms.

A blood sample collected before 10am after an overnight fast, preferably performed on day 2 of you cycle if you are menstruating semi-regularly would be ideal. If your menstruation is longer than 45 days or has a very lengthened and irregular pattern you can perform the test on any day of the cycle. Just remember to fast.

The following is a comprehensive blood work-up list to diagnose PCOS and possible related irregularities:

Follicle Stimulating Hormone (FSH)
Luteinizing Hormone (LH)
Thyroid Stimulating Hormone (TSH)
Dehydroepiandrosterone DHEA
Testostrone
Prolactin
Sex Hormone Binding Globulin (SHBG)
17-hydroxyprogesterone
Oestrogen
Fasting Glucose
Fasting Insulin
Blood Lipids (including triglycerides and HDL/LDL cholesterol)
Homocysteine

What is expected to be found?
The likely findings (individuals can vary significantly) in women with PCOS include an increased LH:FSH ratio of at least 3:1 (key diagnostic finding in many women); usually elevated total and free testosterone; SHBG is generally low1. In some woman oestrogen levels will be lowered, insulin and glucose levels can be increased. Also for some woman homocysteine can be increased as can cholesterol levels and triglycerides. In addition, TSH is usually higher than 1mmol/L and on basal temperature charts readings in the first half of the cycle are consistently below 36.2oC and in the second half of the cycle they often dip below 36.5oC.

It's important to note some women may not present with all of the above findings on a blood test however may still be diagnosed with PCOS if they have multiple follicles in the ovaries, ovulatory and/or menstrual irregularities, hirsutism and/or acne.

Long term health effects
Woman with PCOS are more prone to developing insulin resistance, diabetes, cardiovascular disease and metabolic syndrome later in life if not properly manage. In addition, due to excessive thickening of the endometrium (as a result of lack of periods) research suggests a small increase in the risk of uterine cancer, however having at least 2-3 periods per year adequately protects most women1.

Is there a cure?
The short answer is that symptoms experienced due to PCOS are manageable but not exactly ‘curable'. A natural, holistic treatment approach yields very effective results as far as helping woman regulate cycles, lose weight, balance insulin and blood sugar levels, decrease male pattern hair growth, treat acne and boost one's natural fertility in order to increase a couple's chances of creating the healthiest possible baby.

For some woman with milder cases of PCOS, symptoms can seem to disappear completely after a period of treatment, however for best results in the long term the most effective PCOS treatments involve permanent lifestyle changes that support optimum general health.

Natural fertility specialist and leading naturopath Gabriela Rosa (BHSc, ND, Post Grad NFM, DBM, Dip Nut, MATMS, MNHAA) is the author of three books, including 'Eat Your Way To Parenthood: The Diet Secrets Of Highly Fertile Couples Revealed'. For more information or a FREE subscription to the Natural Fertility Booster please visit www.NaturalFertilityBreakthrough.com