PCOS: How To Restore Hormonal Balance - Conquer Your PCOS Naturally

One of my patients with PCOS had her ovaries removed after being diagnosed with ovarian cancer. She asked me, “So now that my ovaries have gone, does that mean my PCOS has gone too?” My answer was ‘no’. Removing her ovaries might have ‘cured’ her of the ovarian cysts, but it did not entirely cure the underlying culprit. Polycystic ovaries are only one aspect of PCOS.

Our body is such a complicated web of chemical communications, and the functions of our hormones are closely intertwined with one another. PCOS is characterised by a complex interplay of hormones, including well-known ones like insulin, testosterone, and oestrogen, as well as lesser-known ones such as Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH).

If you are to conquer your PCOS, you need to know what your hormones are doing and how YOU can balance their functions.

What are hormones?

Hormones are chemical messengers used by the trillions of cells we each have in our bodies. Hormones are one of the languages our cells use to communicate with each other, to work in an organised and unified manner. They have tremendous control over the functioning of every system in our body, as well as our mind. Hormones are unique in that they exert their actions on organs that are far away from where they are produced.

Where do hormones come from?

Hormones are secreted by specialised glands in our body known as ‘endocrine glands’. These glands include the hypothalamus, pituitary, pineal, thyroid, parathyroid, adrenal glands, pancreas (Islets of Langerhans), and the gonads, which are the testes in men and the ovaries in women. With any changes in our inner or outer environment, these glands release hormones that travel through our bloodstream, telling our cells how to respond.

How do hormones work?

Hormones have specific shapes that can fit into a specialised area on and in our cells, called a ‘receptor’. These hormones fit into receptors like a key in a lock, triggering or stopping specific functions. Every cell has many different receptors, each reserved for a specific hormone.

Hormones interact with each other in a complex manner. The levels of our hormones are relative to each other. They maintain their levels by using what are called feedback loops. In simple words, each hormone has a signalling system to communicate with other hormones and their glands. They can regulate the levels of other hormones by stimulating the secretion of some, while inhibiting the function of others. Your body is innately working to maintain a dynamic balance − called ‘homeostasis’ − of your hormones. It is always trying to keep you safe. However, when chronic hormonal imbalances occur in response to an imbalanced lifestyle, syndromes like PCOS can materialise.

Why learn about hormones?

Hormonal balance is essential for your well-being, growth, development, metabolism, brain function, sexual and reproductive functions and much more. To cut a long story short, your hormones are very important.

Learning about your hormones will give you an understanding of what’s happening to your body, and will give you the much-needed confidence to change your health for the better. Good professional guidance can be critical, but there is no substitute for being the master of your own health − for taking the health reins in your own hands.

When suffering from a complicated hormonal disorder like PCOS, it is important that you understand how your body functions, the effect your hormones have and the steps that you can take to reclaim your hormonal balance. The following section will equip you with the knowledge you need in your crusade against PCOS.

Your hormones and PCOS

The hormonal imbalance of PCOS may present as vague signs and symptoms. Even experienced health practitioners can misdiagnose PCOS due to its many presentations. You may have mild symptoms or severe.

Vague symptoms or definite. In this section, we will discuss the hormones − and other important factors − involved in the development of PCOS, and the steps you need to take to restore your hormonal balance.

The hormonal culprits of PCOS

Insulin

Insulin is a crucial hormone secreted by the pancreas, located in the abdomen. Insulin regulates the processing of carbohydrates and proteins, and is responsible for the metabolism and storage of fat. All our body cells require glucose for energy production, and insulin is the hormone that helps it move from our blood and into our cells.

Insulin Resistance (IR)

Insulin resistance is a condition where our cells cannot correctly recognise or use the hormone insulin. Some women are more prone to Insulin Resistance (Asian and black women); however, poor diet, lifestyle and excessive stress can cause it. Insulin resistance is a significant contributor to PCOS. Between 44 to 70% of women with PCOS suffer from insulin resistance, irrespective of whether they are overweight or slender. However, women who are obese have an increased risk of developing insulin resistance.

A diet laden with sugars, empty calories, unhealthy fats, and processed foods, combined with stress and a lack of movement, lowers our body’s sensitivity to normal levels of insulin over a period of time. Our cells have special sites where the molecules of insulin fit like pieces of a jigsaw puzzle. In Insulin Resistance, there is a malfunctioning of these sites, so they cannot bind optimally with insulin. They stop responding to normal insulin levels and are unable to remove glucose from the blood as they should. High blood sugar levels force our pancreas to produce more insulin, in an attempt to manage the increased blood sugar. This leads to a condition in which there is too much insulin in the blood, known as hyperinsulinemia.

You are most likely to develop Insulin Resistance if you are:

Overweight, with a Body Mass Index (BMI) of more than 25
40 plus years of age
Have a waistline more than 35 inches/88cm*
Have PCOS
Have high blood pressure and/or heart disease

How do hyperinsulinemia and insulin resistance cause PCOS?

Insulin Resistance has a two-fold effect in PCOS. On one hand, Insulin Resistance increases the secretion of testosterone from the ovaries. On the other hand, it reduces the production of Sex Hormone Binding Globulin (SHBG), which is required for neutralising excessive testosterone in our blood. Excessive free testosterone in the blood can further increase insulin resistance, creating a vicious cycle.

Due to its dual effect, Insulin Resistance can both cause, as well as amplify, the symptoms of PCOS. It is a major culprit behind the central obesity in women with PCOS. Additionally, Insulin Resistance can prevent the ovaries from producing ova or eggs, leading to anovulation and infertility.

Finally, there is a theory that insulin directly causes excessive adrenal androgen production and favours the hypo-pituitary-gonadal axis (HPG-axis) disorder in PCOS, and is thereby directly responsible for aggravating PCOS.

Tell-tale signs of insulin resistance

Central obesity
Skin tags
Abnormal skin pigmentation − acanthosis nigricans
Acne
Excessive hair on face and body (and/or loss of hair from the scalp)
Irregular or absent periods
Acanthosis nigricans
Increased triglycerides and/or high blood pressure
Intestinal bloating
Sugar cravings
Fatigue and/or brain fogginess and/or depression and/or mood swings

Diagnosis of insulin resistance

Diagnosis may include tests such as the two-hour glucose tolerance test, fasting blood glucose, and insulin testing.

Dangers of insulin resistance

If insulin resistance is not managed in its early stages, you can be at a greater risk of developing heart disease, metabolic syndrome, type 2 diabetes, sleep apnoea, fatty liver disease, and endometrial cancer.

Tackling insulin resistance

Lifestyle improvement is your most potent weapon against Insulin Resistance. A well-balanced PCOS diet and regular physical activity are effective ways to improve your insulin sensitivity. As an added perk, these lifestyle modifications will also improve your fertility. Ensuring enough sleep, managing stress levels, maintaining healthy levels of physical activity, following the food plan recommended throughout this book, and supplementing with nutrients such as fish oil, chromium, and magnesium are vital in overcoming Insulin Resistance.

Testosterone

Testosterone is thought of as a ‘male hormone’ as men produce 10 times more testosterone than women. Male hormones are collectively called ‘androgens’. We, women, need a little bit of male hormone too. Testosterone is needed for normal sexual function in both men and women.13 In women, this hormone is usually produced by the ovaries and adrenal glands.

Too much testosterone = PCOS?

For many women, an excessive blood testosterone level − total and/or free testosterone (hyperandrogenism) − is one of the hallmarks of their PCOS, and part of the diagnostic criteria. The excess testosterone in PCOS is due to two mechanisms. Abnormally high levels of the hormone LH (secreted by the pituitary) cause an imbalance in the hypothalamus-pituitary-ovarian axis (the way your brain talks to your ovaries). High LH levels coax the ovaries to produce more testosterone by developing cysts and causing thickening in the ovarian tissues.

The second mechanism is Insulin Resistance, which triggers abnormal testosterone production. It also prevents its removal from the blood by reducing the testosterone-binding globulin, sex hormone-binding globulin (SHBG), thus leaving too much free male hormone in the body. Excess body weight and obesity can also contribute to excessive testosterone production. Fat tissue contains enzymes that can produce testosterone (from its chemical precursors).

Too much testosterone not only contributes to PCOS, but it can also lead to various psychological disturbances, such as depression and mood disorders.

Tell-tale signs of testosterone excess

Hirsutism − thick hair growth on the chin, upper lip, chest, abdomen, and back
Acne
Male pattern balding of the scalp hair
Deepening of the voice
Abnormal or absent menses
Mood disturbances and depression

Ways of calming down raging testosterone

Conventional treatments with synthetic medicines may help reduce testosterone levels. However, you must understand that these easy options come at the cost of your health and do not address the underlying drivers of PCOS.

The best and safest way to balance testosterone levels is to adopt a healthy lifestyle. Improving your insulin sensitivity and reducing excess body weight, if necessary, combined with a healthy diet and suitable physical activity, will gradually yet effectively reduce your body’s excess testosterone.

Typical Western foods rich in unhealthy fats and carbohydrates favour testosterone production. Research shows that dietary changes play a significant role in balancing hormone levels in women. A study conducted in Milan, Italy, found that substituting meat, eggs, and dairy products with vegetarian sources of nutrients, such as fruits, vegetables, whole grains, and legumes, significantly reduced the levels of excess testosterone in women. Refined carbohydrates, such as sugar, white bread, and refined flour, should be avoided.

Consuming at least one portion of organic soy products, such as tofu, miso, or tempeh, can provide you with natural plant hormones or phytoestrogens, which may help balance your hormones. Fish cooked with minimal oil or fat, seaweed, and flaxseeds (also known as linseeds) are some other foods found to be beneficial. These food changes also increase the levels of SHBG, which is required to inactivate excess active testosterone.

Decrease or eliminate your alcohol consumption. Alcohol has also been shown to increase the levels of plasma dehydroepiandrosterone sulphate, a weak male hormone in women.

Liquorice root (glycyrrhiza) has also been shown to be effective in decreasing testosterone levels. Research by P. Bergner in Medical Herbalism showed a significant reduction of circulating testosterone in women with PCOS with liquorice root.

What tests can be done?

Total testosterone and free (or bioavailable) testosterone are two blood tests taken to check testosterone levels. Tests to detect SHBG levels should also be performed.

Sex Hormone Binding Globulin (SHBG)

SHBG is a glycoprotein that serves as an escort for testosterone, oestrogen, and progesterone, once they are in the blood. It functions to bind excessive circulating steroid hormones and inactivate them, thereby maintaining their concentration in our blood. SHBG shows more affinity in binding with androgens than oestrogens. SHBG is produced mainly by our liver and in some amounts by the breast tissue in women. Oestrogen stimulates, while testosterone inhibits the production of SHBG.

Women naturally have higher levels of SHBG as compared to men, which helps to keep testosterone levels in women in balance.

The SHBG and PCOS connection

Folks with PCOS often have low levels of SHBG. This increases the levels of free, or active, testosterone in the blood.

Insulin Resistance and high levels of insulin (hyperinsulinemia) are believed to lead to a lowered SHBG production in PCOS. Women with diabetes also suffer from Insulin Resistance, which leads to lowered SHBG levels. In fact, studies have shown that low SHBG levels can be considered an integrated marker of insulin resistance. Increased testosterone production by the ovaries, adrenals and fatty tissue in obese women with PCOS may also contribute. More fat, especially around the belly, can lower your SHBG levels. Women with lowered thyroid hormones (i.e. hypothyroidism) also have low SHBG levels.

Tell-tale signs of low SHBG

Look for the same signs as those seen in increased testosterone levels, i.e. hirsutism, acne, a disturbed menstrual cycle, etc.

What tests should be taken?

Blood tests to detect the SHBG levels should be performed along with tests to detect total and free testosterone in women with PCOS. These tests collectively give a clear picture of your SHBG levels and their impact on your testosterone levels.

How to boost SHBG levels naturally

An appropriate food plan and regular physical activity can improve insulin sensitivity, reduce excess testosterone, and help you lose weight.

It will also give you the additional benefit of boosting your SHBG levels. You should know that SHBG and body weight are inversely related to each other, meaning the higher your body weight, the lower your SHBG level will be.

Vegetarian food plans are highly effective in improving hormonal balance in PCOS. Women who consume a high amount of high-fibre vegetables and fruits tend to have higher levels of SHBG. Additionally, diets low in meat and dairy may lead to higher SHBG levels.

Oestrogen

Oestrogen is produced mainly by the ovaries, and also by the placenta during pregnancy.

It is vital for the development of the breasts, widening of the pelvis, and increasing the amount of body fat at the hips, thighs, and bottom. It is also vital for the growth of the uterus, development of the ovum and for normal menstruation.

Oestrogen prepares the uterus for possible fertilisation and pregnancy every month, by developing an egg in the ovary and by thickening the lining of the uterus. Oestrogen is also critical for the normal functioning of a woman’s body, from digestion to water and salt balance in blood and tissues, fat metabolism, and the health of the heart, blood vessels, and bones. It softens your cervix (mouth of the uterus). It helps produce vaginal secretions, which both lubricate and facilitate the sperm’s ability to swim effectively. The functions of this hormone are essential even for the health of our brain, as it has a significant impact on our memory and emotions.

An imbalance in oestrogen levels can be devastating for a woman’s health due to the sheer magnitude of functions performed by this hormone in the body.

Oestrogen in PCOS

Women with PCOS often have oestrogen dominance. This can occur with high levels, or even with normal levels, of oestrogen.

This ‘dominance’ is not in terms purely of the levels of oestrogen alone but in comparison to the levels of the hormone progesterone. Oestrogen is said to be dominant when the ratio of progesterone to oestrogen is lower than ideal. According to Dr. Lam, for optimum health, the progesterone to oestrogen ratio should be approximately 200 to 1.

An absence of ovulation, as occurs in many women with PCOS, leads to a drop in progesterone levels (as progesterone is released after ovulation, from the corpus luteum). This shifts the ratio of oestrogen to progesterone towards one of oestrogen dominance.

In obese women with PCOS, their fat tissue can convert the free circulating testosterone to oestrogen. This surplus oestrogen contributes to higher levels of oestrogen, also creating an environment of ‘oestrogen dominance’.

Relatively high levels of oestrogen in PCOS can affect the feedback loop to certain parts of the brain (the hypothalamus and pituitary) and can alter the levels of Luteinising Hormone (LH) and Follicle Stimulating Hormone (FSH). This can upset the menstrual cycle.

Tell-tale signs of oestrogen dominance in PCOS

Infertility
Absent or abnormal periods
Severe PMS-like symptoms such as breast tenderness, headaches, mood swings, weight gain, and water retention
Decreased sex drive
Fatigue
Insomnia − difficulty falling and staying asleep
Hair loss
Decreased memory

Dangers of oestrogen dominance

Oestrogen dominance can increase the risk of developing high blood pressure, breast cancer, endometrial cancer (cancer of the lining of the uterus), infertility, osteoporosis (brittle bones), stroke, diabetes and heart disease.

Tests to detect oestrogen dominance

Simple tests, such as a saliva test, can be used to assess the levels of oestrogen, progesterone and many other hormones. These tests can be done at home and are easy, non-invasive, inexpensive and accurate. Some of the latest ‘Female hormone profile − capillary blood test kits’ provide you with the freedom of testing your hormonal levels within the comfort of your home. They are simple, minimally invasive and accurate.36 Your medical doctor or other health care professional can also refer you for these tests.

How to balance oestrogen levels?

To reduce oestrogen levels to optimal levels, you need to achieve your ideal weight and improve your diet and lifestyle. Here are some suggestions:

Increasing your physical activity can help you lose weight and, in turn, help balance your oestrogen:progesterone ratio.
Healthy ways to manage stress, such as yoga and meditation, can help you balance your oestrogen levels.
Avoid the birth control pill − birth control pills often contain synthetic oestrogen, adding to your oestrogen load and oestrogen to progesterone imbalance.
Processed and refined foods need to be removed (or at least reduced). Processed and sugary foods include white bread, cake, and bakery products.
Eliminate, or reduce, alcohol consumption.
Eat plenty of fibre from fresh fruits, vegetables, and some gluten-free whole grains.
Indole-3-carbinol is a compound contained in cruciferous vegetables like broccoli, Brussels sprouts, cabbage, and kale. It is essential for balancing oestrogen levels.
Omega-3 fatty acids, such as those found in flaxseeds, tofu, walnuts, olive oil, and in fish like tuna, salmon, mackerel, and swordfish, also help restore the oestrogen balance.

Xenoestrogens

Chemicals such as parabens, commonly used as preservatives in foods, toothpaste, cosmetics, shampoos, and many other products, act like oestrogens when they enter our bodies. Similarly, breakdown products of DDT, other insecticides, laboratory detergents, industrial surfactants, wood preservatives, dyes and plasticisers may contain Xenoestrogens.

Artificial hormones can also enter our bodies through the consumption of meat, poultry, and dairy products. Heating our food in plastic containers, or drinking from warm plastic bottles, can increase our xenoestrogen load, as can exposure to pesticides and fertilisers. These artificial oestrogens can upset our hormonal balance.

Progesterone

Progesterone is secreted by the ovary after ovulation (from the corpus luteum) and by the placenta during pregnancy.

Progesterone is vital for normal menstruation and fertility. It helps the uterus to prepare a cosy and nurturing environment in anticipation of receiving a fertilised egg. It also prevents shedding of the endometrial lining after the fertilised egg embeds in the womb. Additionally, it inhibits uterine contractions.

Progesterone is essential in maintaining a pregnancy. A drop in progesterone levels can cause a miscarriage. Progesterone is rightly dubbed the ‘pregnancy hormone’.

Progesterone is an essential precursor for the production of other hormones. It also helps maintain healthy blood sugar levels, thyroid function, and normal water balance, is a natural antidepressant, and promotes regular sleep.

Progesterone in PCOS

Women with PCOS who do not ovulate have decreased levels of progesterone. Remember, you can have a period, but not ovulate.

The corpus luteum is produced after ovulation when the ‘empty eggshell’ becomes this gland. The corpus luteum produces progesterone. If no ovulation occurs, the corpus luteum is not produced, and so progesterone is not produced. Some progesterone is produced in the adrenal glands, but this is insufficient for maintaining healthy levels of this vital hormone. Lowered progesterone levels, even with normal oestrogen levels, cause an oestrogen-dominant situation.

Tell-tale signs of low progesterone

Hair loss
Irregular periods
Heavy and/or painful periods
Unexplained infertility
Inability to maintain a pregnancy
Extreme mood swings, panic attacks, and depression
Headaches, including migraine, are often cyclical
Tender or lumpy breasts
Bloating and weight gain
Back pain
Fatigue
Excessive premenstrual food cravings, especially for chocolates and sweets.

Tests to detect progesterone levels

The saliva test and the capillary blood test (as described for oestrogen) can also be used to ascertain progesterone levels. You can also be referred by your medical doctor or health care professional.

Balancing progesterone

PCOS-related low progesterone levels have been effectively treated using physiologic doses of progesterone. Doses of natural progesterone in various forms aim to improve the level of progesterone, especially during the luteal phase of your menstrual cycle. We discuss your menstrual cycle and the luteal phase in Chapter 13 – ‘Boost Your Fertility – Learn how to increase your chances of not only becoming pregnant but carrying your healthy baby safely through to term’ on Conquer Your PCOS Naturally.

Such natural supplementation can be in the form of one or more of the following:

Natural progesterone (in oral form)
Natural progesterone skin cream
Vitex agnus-castus (Chasteberry) (promotes the production of progesterone)

I would always err on the side of nature. Supplementation has been shown to be incredibly safe and effective. Skin creams applied to the inner thigh, under the arms, and the chest are the most effective, as absorption is faster. You may need to see your medical doctor regarding natural progesterone. Vitex can be purchased from your health care professional.

A wholesome food plan and physical activity to promote weight loss, where needed, of as little as five to 10%, is often effective in restoring ovulation and so boosting progesterone. Vitamin C, zinc and vitamin A are essential in the production of progesterone.

Foods like rockmelon, organic liver, and eggs have more than one of these crucial nutrients. There are reports that wild yams contain hormone-like compounds similar to our progesterone. These compounds may boost progesterone levels.

Luteinising Hormone (LH)

Produced by the pituitary gland at the base of the brain, luteinising hormone (LH) is an essential hormone for normal menstruation and fertility. A surge in the level of LH during the menstrual cycle leads to ovulation.

The status of LH in PCOS

The production of oestrogen from the ovaries is stimulated by LH. The pituitary gland then produces a surge in LH, designed to bring about ovulation. Ovulation leaves an empty egg shell, which becomes the corpus luteum and then produces progesterone.

High levels of LH are found in approximately 60% of women with PCOS.42 An imbalance of hormones such as LH and FSH (follicle-stimulating hormone) in PCOS may lead to the incomplete maturation of an egg and a lack of ovulation. The elevated LH stimulates luteinisation of the cells around the follicle. This can produce more testosterone and upset the menstrual cycle.

In a woman with PCOS, LH levels of 18IU/L and FSH levels of 6IU/L are typical findings. Although these figures are ‘within normal range’, they represent an elevated LH:FSH ratio, also known as a ratio of 3:1.*

* Measurements vary during the menstrual cycle.

Why are LH levels often higher in PCOS?

Gonadotropin Releasing Hormone (GnRH) is secreted by the brain (the hypothalamus), released in pulses at a particular frequency and amplitude. Typically, slow frequency release favours the secretion of FSH, and high amplitude release favours the secretion of LH. This difference regulates the secretion of Gonadotropins (LH and FSH). In PCOS, GnRH is released more often and at increased amplitude than usual, which favours the secretion of more LH than FSH.

Consequences of high LH

High levels of LH cause an imbalance of the LH to FSH ratio, shifting it to the higher side. The ovaries respond to increased LH stimulation by producing more androgen than oestrogen. The most common symptom of high LH levels is menstrual irregularity. The most dreaded side effect of high LH levels is infertility. Studies have shown that women with high LH are less likely to conceive despite artificial reproductive therapies like in vitro fertilisation (IVF). To make matters worse, 65% of women with high LH levels are prone to early pregnancy loss and higher recurrent miscarriage rates.

How to test your LH levels

You can check your LH levels by using a urinary ovulation predictor kit (LH-kit), typically around the time ovulation is expected. Your doctor and some other health care professionals can also refer you for blood tests to measure your LH levels.

How to balance the LH levels

Research studies conducted on obese women with PCOS-related infertility found that a low-calorie diet for six weeks helped to lower their LH levels. This diet also helped balance the LH to FSH levels and aided in weight loss.

Follicle Stimulating Hormone (FSH)

Produced by the pituitary gland, FSH is responsible for stimulating the growth of ovarian follicles. It also helps choose one egg to mature each cycle.

Women with PCOS may have low absolute or relative levels of FSH. This means the FSH level may be low according to its outright value, or may be considered ‘within normal limits’ according to its outright value, but may be low when looking at the LH to FSH ratio. The LH:FSH ratio is essential for fertility.

Hypothyroidism, which is more common in women with PCOS, can also decrease FSH levels.

The FSH connection in PCOS

Women with PCOS may have low levels of FSH. The levels of FSH should typically peak during the early phase of the menstrual cycle and mid-cycle. However, due to the negative feedback resulting from high oestrogen levels, the pituitary gland lowers its production of FSH. This lowered FSH level results in both decreased egg maturation and the maturation of one egg (usually) for release. These immature follicles are less sensitive to FSH and therefore degenerate. A chronically low FSH level is a leading cause behind the poor development of eggs and anovulation (absence of ovulation) in women with PCOS.

High levels of testosterone, oestrogen and Insulin Resistance in women with PCOS interfere with the action of the hormone prolactin, which can significantly reduce milk production in these women during the post-delivery period.

Losing weight, if needed, can help you balance the LH:FSH ratio and boost your ovulation and fertility.

Prolactin

Prolactin is a hormone produced by the pituitary gland. Its function is to stimulate and support the production of breast milk. This is the hormone of pregnant and breastfeeding mums.

However, this hormone has another function − it suppresses two primary hormones that are necessary for ovulation: FSH and GnRH (Gonadotropin-Releasing Hormone). Now you know why breastfeeding is a natural contraceptive!

Prolactin in PCOS

Prolactin is great for breastfeeding women. However, when it comes to PCOS, this hormone may not make you produce a lot of breast milk, but it may ruin your menstrual cycle and ovulation.

It also acts against the corpus luteum, resulting in decreased production of progesterone. Up to 30% of women with PCOS have high prolactin levels.

Elevated prolactin stimulates the production of androgens from the adrenal gland, thereby aggravating PCOS. Moreover, elevated prolactin levels may sometimes be the presenting evidence of an underlying hypothyroidism, which is another potential aggravating factor of PCOS. Hyperprolactinemia also causes sexual dysfunction in women by increasing the risk of painful intercourse (dyspareunia), causing a loss of libido, and decreasing arousal and orgasm.

How to balance prolactin

Foods that are high in zinc and vitamin B6, like fish, shrimp, tuna, sunflower seeds, soybeans, pinto beans, and gluten-free whole grains, may help your body to naturally reduce high prolactin levels. Vitex (Chasteberry) may also help to balance abnormal prolactin levels.

Tell-tale signs of increased prolactin

Irregular or absent periods
Milky discharge from the breast
Tender breasts
Signs of excess testosterone − hirsutism, acne, infertility, anger, etc.

Certain medications, stress, and a tiny tumour of the pituitary gland called a prolactinoma are some other causes that can increase prolactin levels. The levels of prolactin can be measured by a blood test. The test results are more accurate if the samples are taken just after waking, or after a person has been quietly resting for 30 minutes, as the levels of prolactin vary with the level of activity.

Dehydroepiandrosterone (DHEA)

DHEA is a weak ‘male’ hormone secreted mainly by the adrenal glands, and in small amounts by the brain and the ovaries. It is synthesised from cholesterol. It is a prohormone, serving as a precursor molecule from which oestrogen, androstenedione, and testosterone are synthesised. During puberty, DHEA facilitates the growth of armpit and pubic hair. DHEA also helps to maintain a healthy cholesterol balance and helps in managing body weight. Also, DHEA has stress-relieving effects and is believed to be a hormone that gives you natural protection from depression.

DHEA connection in PCOS

DHEA levels are found to be high in women suffering from PCOS. Insulin resistance and high-stress levels may cause excessive DHEA in PCOS sufferers.54 Other causes, such as abnormalities and tumours of the adrenal glands, can also cause high DHEA levels and may need to be ruled out by appropriate testing.

DHEA has some properties that are similar to testosterone.

When you have high levels of DHEA, the signs and symptoms will be similar to those of high testosterone:

Oily skin
Acne
Excessive body and facial hair
Irritability.

Blood tests can determine your DHEA level.

How to balance DHEA levels

The first step to balancing DHEA is to address Insulin Resistance. Eating plenty of healthy fibre will improve your SHBG levels, which will bind excessive DHEA in your blood.

Adopt healthy stress management techniques to bring your cortisol hormone level under control. As the levels of cortisol reduce, so will the DHEA.

Thyroid hormones and PCOS

Your thyroid is a butterfly-shaped gland located in the front of the neck, just below the windpipe. Thyroid hormones (thyroxine, T4, and triiodothyronine, T3) are essential in regulating your metabolic rate. In PCOS, there is a higher incidence of poor thyroid function and thyroid autoimmune disease. The combination of low progesterone relative to normal/excessive oestrogen levels may stimulate the immune system to attack the thyroid gland (autoimmune thyroiditis or Hashimoto’s thyroiditis), causing hypothyroidism.

Hypothyroidism contributes to obesity, lipid abnormalities, menstrual disturbances, and lowered FSH levels and is linked with diabetes, all of which in turn aggravate PCOS.

It also increases the risk of death from all causes, including coronary heart disease.

In addition, hypothyroidism may inhibit SHBG synthesis, leading to increased levels of free (and so active) oestrogen and testosterone. Thyroid levels can be assessed by measuring free T3, free T4, and thyroid-stimulating hormone (TSH) levels, as well as thyroid autoantibody levels in blood after an overnight fast.

Homocysteine

Homocysteine is a metabolite − a product of normal metabolism.

It is used to build and maintain tissue. However, high levels are dangerous to our health. With higher levels, there is an increased risk of heart attack and cardiovascular disease. A study in the Journal of the American Medical Association found moderately high levels of plasma homocysteine were associated with a greater risk of heart attack. To reduce homocysteine to ideal levels, vitamins B6, B12, and folic acid are required. These are involved in the process of ‘breaking it down’. If a person is deficient in these vitamins due to inadequate intake, poor absorption, or the use of medications such as Metformin, which is known to decrease the levels of these vitamins, homocysteine levels can remain high. Metformin has been associated with increased homocysteine levels. Levels of homocysteine have been found to be higher in PCOS.

How to balance your homocysteine level

Implement the changes discussed throughout this book. Plus, add vitamin B6, B12, and folic acid-rich foods and supplements.

Cholesterol

Cholesterol has been given an undeserved bad reputation by the media and in medical circles. Did you know that without cholesterol, you wouldn’t stay alive, let alone thrive? Cholesterol is essential for our cell membranes. It plays a critical role in cellular communication and is essential for energy production. It is essential both structurally and functionally for our brain. As Dr. Dingle states:

“Cholesterol is the starting material of many essential chemicals, including vitamin D, steroid hormones and the bile acids necessary for digestion”. It even helps the function of our happy hormone, serotonin, and is vital for our immune system. High cholesterol has been linked to heart disease.

However, low levels of cholesterol are also harmful to our health and increase all-cause mortality − that means death from all causes. As a woman with PCOS, you are more likely to have dyslipidaemia − an imbalance in the lipids in the blood. Please do not jump to the dangerous conclusion that a cholesterol-lowering medication will do anything to either address the underlying condition manifesting itself with a cholesterol imbalance, or in any way extend your lifespan or improve your health. These medications can also have serious − and deadly − side effects.

Balancing and maintaining healthy cholesterol levels is best and most safely done by adopting a healthy lifestyle.

PCOS affects the balance of many of your hormones. The levels of one hormone are influenced by those of other hormones. Your body is like an intricate web, where one thread influences another; nothing occurs in isolation. With knowledge and action, it is possible to balance your hormones and conquer your PCOS.

From PCOS to perfect health, with love,

Dr. Rebecca Harwin
The PCOS Expert
Chiropractor & Bestselling Author of
Conquer Your PCOS Naturally
www.ConquerYourPCOSNaturally.com