Double Board Certified: Dipl. NCCAOM Oriental Medicine
Fellow, American Board of Oriental and Reproductive Medicine
Intro to PCOS
PCOS (PolyCystic Ovarian Syndrome) is a condition that interferes with fertility. It’s really not a good name for this issue because it takes more than resolving the ovarian cysts to create a pregnancy. PCOS is NOT a reproductive disease. It’s a metabolic disease that shows up in your reproductive system. PCOS creates a fundamental imbalance in your reproductive hormones leading to too much testosterone, and not enough estrogen and progesterone. The imbalance is what causes your infertility. But PCOS also increases your risk of miscarriage, cardiovascular disease and diabetes (gestational and type 2).
PCOS: A Quick Look at Fertility Hormones
So what happens with PCOS? To understand why PCOS affects fertility, first, you need a little background on hormones. Hormones are your body’s signaling system. Hormones are the way that your body “talks” to itself and creates action. All hormones are part of the endocrine system, which is a group of glands that secrete hormones. Estrogen, progesterone, luteinizing hormone and testosterone are the main fertility hormones. You are probably familiar with these. You secrete estrogen in the first half of your cycle, secrete luteinizing hormone to ovulate, and then secrete progesterone in the second half of your cycle. As a woman, you secrete a very small amount of testosterone, that is what gives you your sex drive, and wakes up protofollicles to start developing.
So What About The Metabolic Issue?
Insulin is the main hormone for managing blood sugar. Your body makes insulin in response to a rise in blood sugar levels. Insulin is the way that your body gets that sugar out of the bloodstream and into the cells. Insulin, in normal levels, is good. But when too much insulin is generated, it hijacks the testosterone production system and cranks it up really, really high. It also cranks up the production of luteinizing hormone at the wrong time. The high levels of testosterone hyper stimulates follicle production. But it also interferes with estrogen production, which means your follicle growth stalls out. Even worse, the luteinzing hormone closes off the nutrition portals to your developing follicles, so they don’t get the nourishment they need to grow either. And the rest of the cells in your body develop insulin resistance because they don’t need all that extra energy (which gets stored as belly fat, oh joy.)
Explaining the Symptoms of PCOS
In classic PCOS, women have very long, irregular cycles, more hair, have trouble losing weight, acne and dark patches of skin around the neck and belly, and multiple, stalled follicles. All these issues are due to high testosterone and high LH.
In skinny PCOS, women don’t have the above signs, but they tend to be hypoglycemic, and have just enough testosterone and luteinizing hormone imbalance to keep follicles from developing properly.
The result? Your fertility hormones are totally out of synch, and your follicles don’t develop. Or, if you do ovulate because the egg has been bathing in testosterone it isn’t a healthy egg, and can’t sustain development.
It’s Not Just the Cysts
This is why PCOS is not just about the ovarian cysts. Without bringing insulin, testosterone, estrogen and progesterone into balance, your eggs will not be healthy. A better name for it would be Insulin-dependent PolyFollicular Disease, because fixing the insulin issue is fundamental to fixing the fertility issue.
The poor egg quality, by the way, is why many women with PCOS are poor responders to Clomid, or have failed IVF cycles. More eggs isn’t better if the eggs haven’t developed in a healthy hormonal environment. It is also why the rate of miscarriage is higher: the hormones are still out of balance, and your body just can’t compensate. Metformin can help because it addresses the real issue: insulin hypersensitivity.
PCOS, Fertility, and Your Health
If you have been diagnosed with PCOS-caused fertility issues, you are here because you want to get pregnant. I will help you address the fertility issue, but I am also committed to helping you design a lifestyle that will support your health after pregnancy. PCOS can be a very serious disorder. But it CAN be managed, and risk factors significantly reduced with changes in lifestyle and diet and rebalancing your hormones. The beautiful thing is that everything we do to improve your fertility will also improve your general health. It’s win-win.
The Good News
The good news is, I can work with you and change the hormone balance, help healthy eggs develop, and increase your chances of conceiving. It requires a strong commitment on your part to change what you eat, manage your stress, and take supplements.
Treating PCOS fertility issues is very much a partnership between you and I.
It takes time. Egg development is a 3-month process, so treating PCOS takes a minimum of four months. I promise you will feel better and will notice changes during this time.
Please call me at (702) 539-9185 to schedule an appointment, so you can feel better, address your PCOS, and improve your fertility through Las Vegas PCOS Support!