Do not be too quick to accept a diagnosis.
Ultrasound is NOT enough to diagnose PCOS. 25% of perfectly normal women display polycystic ovaries at one time or other (2). A subsequent ultrasound will show it to be normal again. True PCOS involves hormone irregularities that must be picked up with blood test.
Many cases of PCOS are temporary. More specifically, many cases of so-called PCOS that we see in our clinic can more accurately be described as post-Pill syndrome. Your doctor will not tell you this, but it is a medically recognised fact that it can take up to 2 years for normal ovulation to resume after stopping the Pill. (7)(8)(9)
Blood tests necessary to diagnose PCOS are:
Our Naturopaths can order these blood tests for you.
Polycystic ovaries are NOT ovarian cysts
The cysts that you see on ultrasound are not abnormal growths. A normal ovary produces fluid-filled follicles that contain the eggs. These follicles are essentially 'cysts'. Normal cysts (that the ovary is supposed to have) form and are reabsorbed every month, in every woman. Follicles of different number and different size will be visible in every normal ovary. They will look different on every ultrasound.
It is only when the ovarian follicles do not form properly, that the concept of abnormal cysts has some meaning. Follicles can be too large (the type of 'ovarian cyst' that can cause pain or rupture), or too small (as seen is polycystic ovaries). Polycystic ovaries or 'multiple cyst ovaries' means that the ovaries - at the time of viewing - have too many small, underdeveloped follicles. This occurs because ovulation has not occurred properly in that month. (It could be completely different in a month or two). Failure to ovulate properly can be due to a number of causes, but in true PCOS, it is due to a problem with testosterone, and often, a problem with insulin.
Let me repeat. The polycystic appearance may mean nothing - may be normal. Or the ovaries may look that way because something is preventing ovulation from progressing normally. That "something" is either insulin (in classic, Type 1 PCOS), or something else (Type 2 PCOS). (see below)
Reminder: The ovaries themselves are not the cause of weight gain. In Type 1 PCOS, insulin resistance is the cause of the weight gain. Insulin resistance is also the cause of the polycystic appearance of the ovaries, the lack of proper ovulation and the lack of periods.
Does The Pill cause PCOS?
The Pill is not a solution for PCOS. It does absolutely nothing to improve the underlying insulin resistance, and can actually worsen it (9). In 2003, the Journal of Clinical Endocrinology & Metabolism published an article called 'A Modern Medical Quandary: Polycystic Ovary Syndrome, Insulin Resistance, and Oral Contraceptive Pills'.(10) The Pill has been standard treatment for PCOS, and yet, perversely, it appears to worsen the metabolic problem that is at the root of the condition. The authors say:
'...what has been lacking is a critical examination of whether oral contraceptives might...exert adverse metabolic effects with long-term consequences..'.
The Pill may have made further contributions to the epidemic of PCOS. The Pill is known to cause permanent hormone changes, even once it is stopped.(6,7) In particular, the Pill causes chronically elevated LH, which is a major feature of many cases of PCOS. It can take up to 2 years to get ovulation going after stopping the Pill. (Some women are lucky to have periods start up quickly, but that is not the case for everyone.)
The monthly bleed induced by the Pill is a chemically-induced event. It is not a period. It is no indication of what your own hormones are doing. In fact, while on the Pill, your own hormones are completely surpressed. The Pill is chemical castration.
Read Lara's article Problem with the Pill for more information.
Interesting Facts about PCOS.
PCOS linked with thyroid disease
A recent German study has found that PCOS sufferers have an increased risk for autoimmune thyroid disease. (3)
The researchers believe that the progesterone deficiency associated with PCOS makes women more susceptible to the autoimmune condition. It may also be that women with thyroid conditions are more like to develop PCOS. Healthy thyroid function is necessary for healthy ovulation.
Autoimmune thyroid disease, also called Hashimoto's, is common. Read more about it here.
PCOS may improve with age
According to Swedish researcher Miriam Hudecova:
"As [PCOS patients] get older, their chance of getting pregnant may actually be higher,"
Her research shows that by the age of 35, women with PCOS have had as many successful pregnancies as women without PCOS, even without the assistance of fertility treatment. (4)
The number of follicles in the ovaries gradually reduce as women age. Normally, this is a bad thing, but it appears to be a good thing for PCOS sufferers. Other studies have shown something similar in that the periods of PCOS patients become more regular over time.
Plastic chemical BPA linked to PCOS
Two new studies have been released this week linking the plastic chemical Bisphenol A to a increased risk for Polycystic Ovarian Syndrome. (5)(6)
The chemical referred to has BPA, was originally developed as an oestrogen drug, but is now widely used in the manufacture of plastics. It is found in much food packaging, baby bottles and baby toys. It has also been linked with obesity, diabetes, cancer and heart disease.
Trans-fat linked with PCOS
Trans-fat is a damaged vegetable oil that is used in processed food, commercial salad dressing and margarines. Researchers from the Harvard School of Public Health found that only 4 grams of trans-fat per day is enough to interfere with ovulation. This much trans-fat is found in one doughnut or one meat pie. Trans-fat has also been shown to cause abdominal obesity linked with PCOS, even when total calories are low.(10). Naturally occurring fat, even saturated fat from animals, does not appear to be a problem for PCOS.