{"id":29422,"date":"2021-10-03T14:45:30","date_gmt":"2021-10-03T19:45:30","guid":{"rendered":"https:\/\/wholehealthchicago.com\/blog\/?p=29422"},"modified":"2022-11-14T13:48:33","modified_gmt":"2022-11-14T19:48:33","slug":"pcos-overlooked-and-under-treated","status":"publish","type":"post","link":"https:\/\/wholehealthchicago.com\/blog\/2021\/10\/03\/pcos-overlooked-and-under-treated","title":{"rendered":"PCOS: Overlooked and Under-Treated"},"content":{"rendered":"\n

A recent report<\/a> revealed that there are so many cases of polycystic ovary syndrome (PCOS) in the US that costs for diagnosis and lifetime treatments are estimated to be $8 billion a year.<\/em><\/p>\n\n\n\n

If you have PCOS, obviously you\u2019re not alone. It\u2019s estimated that PCOS affects one woman in seven (estimates go as high as 15-20% of reproductive-age females), and, sadly, most go undiagnosed for years.<\/p>\n\n\n\n

The most common PCOS symptoms are irregular periods, a disruption in metabolism leading to weight gain, and elevated levels of the male hormone testosterone. All of these frequently result in infertility. Untreated PCOS is also linked to obesity, diabetes, acne, and heart disease.  <\/p>\n\n\n\n

When I was in med school, PCOS was quite uncommon. Now you see articles in magazines and experts on daytime talk shows trying to explain a condition no one really understands. At least today there\u2019s hope for affected women, who find themselves becoming overweight and infertile, growing facial hair, and getting acne.  <\/p>\n\n\n\n

The average woman sees five doctors before being diagnosed with PCOS. Most don\u2019t actually even make it to five doctors and millions more go undiagnosed because they have limited or no access to the US health care system.<\/p>\n\n\n\n

This diagnostic delay is a good example of a serious flaw in the specialized education of doctors. Ovaries, infertility, and irregular periods are considered the purview of obstetrician-gynecologists. Obesity, excess facial hair, metabolic syndrome, and cholesterol are internist territory. PCOS requires that an obstetrician-gynecologist think like an internist\u2026and vice-versa.<\/p>\n\n\n\n

And it\u2019s only been recently that the two groups of physicians sat down and started discussing what seems to be a near-epidemic of PCOS.<\/p>\n\n\n\n

What causes PCOS?<\/strong><\/h3>\n\n\n\n

The situation is further complicated by the absence of straightforward tests to make a clear-cut diagnosis, not helped by the fact that doctors are uncertain what triggers PCOS in the first place. There appears to be a genetic predisposition. PCOS is common in sisters and mothers, and brothers of PCOS patients have high levels of pre-testosterone DHEA, though it\u2019s harmless to them.<\/p>\n\n\n\n

Some researchers attribute the explosion of PCOS to hormone disruption caused by the massive amounts of toxic chemicals in our environment, which can trigger PCOS in genetically susceptible women.<\/p>\n\n\n\n

The underlying problem in PCOS begins when the ovaries develop fluid-filled sacs called cysts and begin to secrete an excessive amount of the male hormone testosterone. This in turn disrupts menstrual regularity and ovulation and leads to infertility. It\u2019s the testosterone that also causes excessive facial hair and acne.<\/p>\n\n\n\n

To complicate matters, women with PCOS develop resistance to the blood sugar-lowering hormone insulin, a situation similar to Type 2 diabetes that leads to high levels of glucose (sugar) in the blood, weight gain, high cholesterol, and even more testosterone production.<\/p>\n\n\n\n

To compensate for insulin resistance and high blood sugar, the body produces even more insulin, which in turn produces even more male hormone, like a snowball rolling downhill out of control. After years of elevated glucose and cholesterol levels, women with untreated PCOS become susceptible to heart disease and high blood pressure.<\/p>\n\n\n\n

In short: High levels of insulin lead to pre-diabetes, diabetes, and obesity. High levels of testosterone lead to irregular periods, infertility, facial hair, and acne.<\/p>\n\n\n\n

Helpful treatments, conventional and alternative<\/strong><\/h3>\n\n\n\n

I recommend that any woman experiencing a combination of irregular periods (with or without infertility), unexplained weight gain, and\/or new facial hair ask her doctor about PCOS.<\/p>\n\n\n\n

The standard diagnostic tests for PCOS are:<\/p>\n\n\n\n