September 26, 2022
September is PCOS Awareness Month, and we continue our exploration of how this condition – which affects 1 in 10 women – impact fertility and reproductive health.
If you joined us last week, you’ll know that not all PCOS is created equal. In fact, there are 4 kinds of PCOS, and knowing which one you are dealing with is key to understanding how best to manage it.
Today we dive deep into each type of PCOS, including what it is, how it’s diagnosed, and which protocols – such as specific foods, supplements, herbs and lifestyle changes – are best suited for each type of diagnosis.
Insulin-Resistant PCOS is the most common (affecting 70% of women with PCOS). When we eat, our blood sugar rises and the pancreas releases insulin (a chemical messenger) into our blood to take in the glucose from our food into our cells. Insulin Resistance occurs when your body becomes desensitized to this message, therefore the pancreas has to produce more and more insulin to help regulate blood sugar. This can make it difficult to maintain a healthy weight because the body stores excess blood sugar as fat. That’s why women with insulin-resistant PCOS often struggle with weight loss. They also often hold weight around the stomach/abdomen, have sugar cravings and may have other symptoms related to disglycemia (a broad term refering to an abnormality in blood sugar regulation) such as fatigue, brain fog, or increased thirst. It may also be connected to other symptoms of PCOS such as excess hair, male pattern hair loss and acne. That’s because it is the high levels of insulin that drive up androgen levels.
The most common test for Insulin-Resistant PCOS is HbA1c - a screening test to measure for glucose levels in the blood. However, to fully rule out insulin resistance, consider having your fasting insulin tested as well. Normal fasting insulin levels should be below 10 mIU/L (60 pmol/L) and fasting glucose should be under 90.
The key to managing Insulin-Resistant PCOS is to focus on balancing blood sugar and improving insulin sensitivity. This can include (but is not limited to)…
Inflammatory PCOS is the second most common type of PCOS. In this case, the ovaries make excess testosterone as a response to chronic inflammation. This can manifest as physical symptoms (such as headaches, joint pain, fatigue, skin issues and bowel issues) as well as issues with ovulation and fertility.
To check for Inflammatory PCOS, your doctor may take a blood test and look for certain biomarkers in your bloodstream such as C-reactive protein (CRP). Women with Inflammatory PCOS tend to have CRP levels above 5. (In addition to measuring inflammation levels, your doctor may still recommend a fasting glucose test as inflammation can sometimes affect insulin numbers as well.)
The key to managing Inflammatory- PCOS is to focus on reducing inflammatory triggers while increasing anti-inflammatory nutrients. A protocol of this kind can include (but is not limited to)…
Pill-Induced PCOS is a kind of PCOS that can occur after a woman stops taking the oral contraceptive pill. This happens because the pill works by suppressing the communication pathway between your brain and your ovaries, which in turn stops ovulation. For most women, when they stop taking the pill, this communication returns to normal right away, along with regular menstruation and ovulation. For some, however, this can take longer - months or even years. Pill-Induced PCOS may come with other PCOS symptoms such as acne, excess hair growth, a high LH to FSH ratio or possible polycystic ovaries, but no insulin resistance. Unlike other types of PCOS, in Pill-Induced PCOS these symptoms were not present prior to starting the pill at all. The good news is Pill-Induced PCOS is temporary. Once those communication pathways rebalance, and ovulation returns, all other symptoms also stop.
Your doctor may diagnose Pill-Induced PCOS if your period does not return after 3 months of being off the pill, if you are experiencing PCOS symptoms that were not present prior to taking the pill, and if your insulin-levels are normal.
The most important thing about managing Pill-Induced PCOS is having patience. However, you can help move things along with lifestyle changes that include (but is not limited to)…
The final type of PCOS (which presents in roughly 10% of PCOS cases) is called Adrenal PCOS. This type is triggered by an abnormal stress response in the body. Elevated stress can cause the adrenal glands to release more cortisol, which can cause the adrenals to produce more DHEA-S (another type of androgen). Cortisol and DHEA-S disrupt the balance of other hormones that can then lead to PCOS symptoms like irregular periods, acne, and unwanted hair growth or hair loss.
In Adrenal PCOS, DHEA-S will be elevated, but levels of testosterone and androstenedione will usually be normal. A doctor may test for DHEA-S levels in your blood. Most women with PCOS tend to have DHEA-S levels 200 ug/dl or above. Note that you may need to be referred to an endocrinologist to have your DHEA-S levels tested.
Stress management and adrenal support are key aspects of a natural protocol for Adrenal-PCOS. This includes (but is not limited to)…
If you suspect you may have PCOS, I hope this guide has helped to answer some questions for you, but please remember that this is just the beginning. If I can leave you with three final pieces of advice, they would be:
Until next time, take care and be well!
Ewa Reid, RHN
Separate Fact from Fiction learn about the most common PCOS misconceptions in 10 PCOS Myths, Debunked.
Ewa Reid is a Registered Holistic Nutritionist, certifying Fertility Support Practitioner, nutrition & fertility educator, wife, and mother. You can learn more about Ewa on our About page.
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January 02, 2023
Are you tired of feeling less than perfect? Tired of trying to fit other people’s expectations? Tired of feeling badly about things of the past that you cannot change? The path to unconditional love is paved with acceptance, and this article explores what it takes to really accept your imperfections and truly fall in love with your flaws.
Join me on this journey of compassion and self-love. We’ll explore what it means to be truly free. To shed the shackles of self-doubt. To take bigger, more meaningful risks. To sleep a little more soundly. To be bit more productive. To be better friends, daughters, sisters, lovers. To just be better, happier humans.
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