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PCOS and Progesterone

Polycystic ovary syndrome(PCOS), also referred to as Stein-Leventhal, is an endocrine(hormonal) disorder characterized by irregular, abnormal or absent menstruation; excessive amounts of body hair; excessive body weight and decreased fertility. Most often, symptoms first appear in adolescence, around the start of menstruation. However, some women do not develop symptoms until their early to mid-20's and even later. Although PCOS presents early in life, it persists through and beyond the reproductive years.

PCOS is estimated to affect between 5% and 10% of women of reproductive age, thus making it the most common hormonal disorder among women in this age group. It affects women of all races and nationalities.

No two women have exactly the same symptoms. The following characteristics are very often associated with PCOS, but not all are seen in every woman:
  • Hirsutism (excessive hair growth on the face, chest, abdomen, etc.)
  • Hair loss (androgenic alopecia, in a classic "male baldness" pattern)
  • Acne
  • Polycystic ovaries
  • Obesity
  • Infertility or reduced fertility
In addition, women with PCOS appear to be at increased risk of developing the following health problems during their lives:
  • Insulin resistance
  • Diabetes
  • Lipid abnormalities
  • Cardiovascular disease
  • Endometrial carcinoma (cancer)
Because there is such variability in how PCOS presents itself, there is no universal agreement among health professionals on how to best define PCOS. What is clear, however, is that women with the disorder do not ovulate in a predictable manner and that women with PCOS also produce excessive quantities of androgens (particularly testosterone).

It is important to note that polycystic ovaries are not present in all women diagnosed with PCOS. Also, many women with regular menstrual periods and normal testosterone levels have cystic ovaries.

If women with PCOS don't always have polycystic ovaries, why is it called "polycystic ovary syndrome"?

It is important to make the distinction between polycystic ovaries and polycystic ovary syndrome. Polycystic ovaries are often, but not always, seen in women with PCOS. But, approximately 20% of women without menstrual or hormonal abnormalities have polycystic ovaries. The syndrome is thus defined by the menstrual and hormonal abnormalities with or without polycystic ovaries.

PCOS is also sometimes called "functional ovarian hyperandrogenism" or "ovarian androgen excess."But, because the term "polycystic ovary syndrome" has been used for more than six decades, and is well-entrenched in both common usage and medical literature, its use is likely to continue.

What causes PCOS?

PCOS develops when the ovaries overproduce androgens (eg, testosterone). Androgen overproduction often results from overproduction of LH (luteinizing hormone), which is produced by the pituitary gland.

Research also suggests that when insulin levels in the blood are high enough, the ovary can be stimulated to produce more testosterone. That is, the combination of having ovaries which are responsive to insulin and high insulin levels in the blood, can result in the overproduction of testosterone.

Obesity, which itself can cause insulin levels to rise, may intensify PCOS. Yet, not all women who are overweight develop PCOS. Thus, there appears to be something unique about PCOS both in the excessively high insulin production and the increased sensitivity of the ovaries to the insulin that is produced.

How is PCOS diagnosed?

Initially, many of the symptoms of PCOS — acne, obesity, excessive hair growth, and irregular periods — are viewed as unpleasant but unrelated. Many women are not diagnosed until the symptoms become advanced, or until they experience difficulty with fertility.

There is no single, quick test to identify PCOS. Accurate diagnosis depends on the experienced skills of your health care provider, a detailed medical history, and laboratory studies. Some health care providers may choose to use some of the following diagnostic tools:
  • Ultrasound, to assess whether ovaries are enlarged and cystic.

  • Blood tests, to detect elevated levels of androgens.

  • Blood test to detect high levels of LH (luteinizing hormone) or an elevation in the ratio of LH to FSH (follicle stimulating hormone).

  • Monitoring of the ovary's response to either a stimulatory dose of gonadotropin-releasing hormone agonist (such as leuprolide -- This test was developed at the University of Chicago and has been used worldwide) or a suppressive dose of medications such as dexamethasone.

Your health care provider will also try to rule out other possible causes of irregular menstruation and excessive hair growth, such as Cushing's syndrome, congenital adrenal hyperplasia, or other disorders of the pituitary or adrenal glands.

Does PCOS run in families?

Evidence is accumulating to suggest that there is likely to be a hereditary basis for PCOS and its associated metabolic abnormalities such as diabetes.

Polycystic ovary syndrome also has a complex relationship to depression and anxiety. Depression is not considered a symptom per se, but the range of physical, cosmetic and physiological symptoms experienced by Polycystic ovary syndrome sufferers present a suite of underlying causes. In some women, correction of insulin-related problems through diet, exercise and medication help to alleviate depression and anxiety.

Natural Alternative for Polycystic Ovary Syndrome (PCOS)

Bioidentical Progesterone Cream

Women with PCOS always have low progesterone levels. The best solution is begin to supplement with progesterone, and not synthetic progesterone, rather bioidentical progesterone.

Progesterone is created by the ovaries at the time of ovulation. It is critical to understand that a woman can have her period and still not be ovulating. If she does not ovulate, she will not create the progesterone necessary to remove the fiber and lining that has been stored. The repeated storing without the essential cleaning can eventually result in fibrocystic breast disease, endometriosis, uterine cysts, bloating, weight gain and depression.

Bioidentical progesterone is progesterone; it is derived from a natural plant source and then converted to progesterone. Bioidentical progesterone has the same molecular configuration as the progesterone produced by the body and can be used to supplement the progesterone produced by the body and to balance estrogen and progesterone levels. Bioidentical progesterone has no side effects when 20 mg to 40 mg a day is used.

You can use  20 mg of progesterone cream up to twice daily from day 14 to day 28 of your cycle, adjust accordingly. The disappearance of facial hair, acne and weight loss are usually obvious signs that hormones are becoming balanced, but to see these results, you’ll need to give treatment at least 6 months, even though women with a good diet see changes in as little as 2 cycles. In conjunction with proper diet and exercise your PCOS should improve quickly enough that you and your health care provider will be pleasantly surprised.

If your symptoms fade, No, when your symptoms fade try gradually easing off the bioidentical progesterone (take half the dose, for example) and see how it goes. If your symptoms return, stay on the full dose for six more months. Ideally, as a young woman you would use the natural bioidentical progesterone cream only during the months you need it, and encourage your body to return to its normal hormonal rhythms as much as possible. Some women with many damaged follicles may always need to supplement with a little bit of bioidentical progesterone cream.

Herbal Formula (ProSoothe)

Herbal Relief is an all natural herbal formula that contains the herbs chaste tree, wild yam, dandelion, bupleurum act together to respond to hormonal changes that occurs with polycystic ovary disease. This synergistic formula also contains dandelion and vitex (chaste tree) that helps the body remove exogenous (external excess estrogen) that builds up from exposure to contaminated foods (xenosteriods).

Polycystic ovary syndrome Information & resources from The National Womens Health Information Center

InterNational Council on Infertility Information Dissemination-This website offers a frequently asked questions section to help you learn more about the short and long term effects of PCOS.
Verity is the self-help organisation for women whose lives are affected by Polycystic Ovary Syndrome (PCOS).
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