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Polycystic Ovarian Syndrome (PCOS)

What is Polycystic Ovarian Syndrome or PCOS?

Polycystic Ovarian Syndrome (commonly mispelled as poly cystic, polysystic, polycycstic or polycyctic) or PCOS, which is now thought to be a genetic (inherited) condition, consists of irregular or absent periods, hirsutism (excessive body hair), obesity and slightly enlarged ovaries containing at least ten cysts 2-8mm in diameter.

Although 25% British women examined by ultrasound are found to have polycystic ovaries, fortunately only a small proportion of these women develop symptoms.

Why does PCOS occur?

It is not known why some women develop the syndrome but it is known that it is caused by an imbalance of the female hormones resulting in the production of many cysts, called follicles, within the ovaries.

Normally a hormone called follicle stimulating hormone (FSH) causes a small cyst to form in the ovary. This follicle contains an egg which is released in the middle of the woman’s menstrual cycle in response to another hormone called luteinising hormone (LH).

In polycystic ovarian syndrome there is an excess of LH and a relative lack of the hormone FSH. This causes lots of follicles to form, none of which burst to release the egg.

As part of this rather complicated hormone imbalance, women tend to produce too much male hormone (androgen), which results in abnormal hair growth, occurring in a male distribution and the formation of acne.

The obesity associated with the condition is thought to be tied up with causing the syndrome but may also be a result of the hormone imbalance.

What are the Symptoms of PCOS?

The usual symptoms of PCOS are:

• Irregular or absent periods
• Infertility
• Unwanted hair
• Acne
• Obesity
• Miscarriage – there is thought to be an increased risk of miscarriage in women with PCOS who do manage to become pregnant.

How is PCOS Diagnosed?

The doctor may suspect that polycystic ovarian syndrome is the cause from the symptoms listed above. Blood tests may be used to confirm hormonal imbalance underlying the problem or an ultrasound scan of the woman’s pelvis may confirm enlarged cystic ovaries.

Sometimes the diagnosis is made by a specialist during an investigation called a laparoscopy.

This involves inserting a telescope into the woman’s abdomen under general anaesthetic, allowing the specialist to see the structures inside the pelvis and abdomen.

What is the treatment for PCOS?

The treatment varies depending on which particular aspect the woman finds most troublesome.

• Obesity
• Irregular periods
• Infertility
• Excessive hair growth

PCOS and Complementary Treatment

Many women find complementary treatments useful in PCOS and often integrate them with conventional medicine. Other treatments include:

• PCOS and Nutritional Therapy
• PCOS and Acupuncture
• PCOS and Reflexology

Associated problems for women with PCOS

Women with PCOS are more likely than women of the same age to have risk factors for cardiovascular disease, to develop diabetes mellitus later in life, particularly in pregnancy and need screening, and they are more likely to have a stroke or develop womb cancer.

What is the treatment?

Obesity

Change in lifestyle, paying particular attention to diet and exercise may alleviate this, as well as correcting any period problems.

What is the treatment?

Irregular Periods

If the main concern of the woman is the symptom of irregular periods then the usual treatment is the oral contraceptive pill which will almost always restore regular periods.

This treatment is obviously not suitable for women trying to conceive. The oral contraceptive pill can also help the treatment of the acne and hirsutism.

There is now evidence to support the use of acupuncture in PCOS – to regulate irregular cycles or start cycles that have stopped and increase the chance of ovulation.

There is some evidence to show that reduction of excess weight can improve most of the problems related to polycystic ovarian syndrome by helping to restore the normal hormone balance, since fat plays a part in the production of certain hormones.

What is the treatment?

Infertility

The irregular and infrequent ovulation caused by PCOS can make it difficult to conceive.

Ovulation can be stimulated artificially using drugs. The most commonly used drug is Clomiphene (Clomid). If the tablets fail, hormone injections such as Puregon or Menopur can be used to stimulate the ovaries.

Careful supervision by a specialist is necessary as there is a danger that the ovaries become over stimulated.

For women unresponsive to medical treatment, surgery in the form of laparoscopic ovarian diathermy or drilling can be used to burn part of the ovary, thereby correcting hormonal imbalance and allowing ovulation to occur.

There is now evidence to support the use of acupuncture in PCOS – to regulate irregular cycles or start cycles that have stopped and increase the chance of ovulation.

What is the treatment?

Excessive Hair Growth

Local techniques such as depilatory creams, shaving, waxing, bleaching, plucking and electrolysis may prove useful but need to be repeated.

Suppression of male hormone production with tablets such as the oral contraceptive pill or an anti-male hormone drug such as cyproterone acetate may reduce excessive hair growth if used for at least 9 months.

What is the treatment?

PCOS and Acupuncture

Acupuncture can be beneficial for women with PCOS because it can help to regulate the menstrual cycle and increase the chance of ovulation.

Women with PCOS will have fine needles inserted along the channels which relate to the reproductive system. This will help to stimulate the organs, improve blood flow to the uterus and ovaries, contribute to regulating hormone levels, and promoting proper functioning of the reproductive system.

Acupuncture may also be helpful in reducing stress levels, increasing energy levels and helping with weight loss. Acupuncture can safely be used in conjunction with metformin and clomid.

In Traditional Chinese Medicine [TCM] PCOS is often seen as the accumulation of damp in the body. By selecting points to treat the dampness effective results may be seen, although treatment may take several weeks/months.

PCOS and Nutritional Therapy

Improving diet and a weight management programme are helpful in PCOS because the underlying causes of the health concern are being addressed.

Ensuring the body can excrete excess hormones by making the liver more efficient, can have a substantial effect on hormone balance.

Lifestyle factors such as stress and exercise can also be helped by nutrition. A low GI diet will help to regulate blood sugar levels and as a result blood insulin levels.

As diet improves so do energy levels and the body will naturally heal itself. A nutritionist can address individual needs: every woman is different.

What is the treatment?

PCOS and Reflexology

Reflexology is based on the principle that there are certain reflex points on the feet which are linked to different organs in the body.

When certain points are stimulated they in turn stimulate specific body parts.

The main use of reflexology is as a stress inhibitor as it helps the whole body to relax and increase the endorphin secretion.

Reflexology as a treatment for infertility is useful as a complementary therapy.

Apart from relaxation it can also boost the blood circulation, help balance hormone levels and regulate the menstrual cycle.

It has been found to be of assistance to those women suffering from PCOS, endometriosis and unexplained infertility.