Many chronic conditions are caused by the disruption of hormone cycles in the human body. This might happen due to genetic predisposition or environmental triggers: poor nutrition, stress, sedentary lifestyle, sleep deprivation, chronic dehydration and many more.

One such hormonal disruption is known as polycystic ovary syndrome (PCOS) - a very common endocrine and metabolic disorder in women. Around 10% of females are affected in developed countries and it is estimated that 75% remain undiagnosed and live without knowing the root cause of their physical and mental challenges.^1,2

WHAT IS PCOS?

Medically speaking, PCOS is characterised by the appearance of many little sacs on the ovaries. What it really means is that a lot of your hormones are messed up and your hormone cycles are disrupted.

Mounting evidence suggests that PCOS is a disease with strong epigenetic and environmental influences. In other words, diet and lifestyle choices have a major impact on how PCOS will be experienced in a women.³

UNMET NEED 

Unfortunately, more often than not, conventional Western medicine offers treatment with a focus on masking the symptoms, rather than identifying and addressing the root causes of the hormonal disruption.  Insulin sensitising agents, oral contraceptives, anti-androgens, and anti-obesity drugs are effective in achieving quick and visible improvements, however, they are not solving the underlying issue and only postponing the day, when you might want to look at the part of the iceberg, which hides underwater. Moreover, most of these medications come with a  long list of side effects and divert patients from prioritising the basics of chronic disease prevention - diet, movement and stress management.

WHY PCOS IS HARD TO DIAGNOSE AND TREAT? 

PCOS is a heterogeneous disease, which means it is defined by a combination of symptoms, which vary from woman to woman, including ovarian dysfunction, excess of androgen hormones, insulin resistance (30—40% women) and obesity (80% women).⁴

What is common among every girl with PCOS is the emotional impact of the disease on her wellbeing. Many patients experience anxiety, stress, frustration and embarrassment because of their symptoms, which can significantly undermine self-confidence, especially among young women.⁵  We know how challenging it might be to break this vicious cycle of illness, find the motivation to build healthy habits and bring change into life.

4 PILLARS OF PCOS

What is also common among all PCOS patients is the 4 hallmarks of the disease, 4 pillars that combine endocrine, metabolic and reproductive changes that significantly affect women's health.

INSULIN + ANDROGENS

Recent research suggests that there is a single common thread among each of the pillars and each woman with PCOS - a hormone called insulin. Disruption in insulin signalling, caused predominantly by the modern diet, leads to a cascade of disbalances in the levels of other hormones, directly linked to insulin.^6,7,8 As a result, more and more, we observe how unhealthy glucose patterns in our diet lead to various inflammatory diseases and disruptions in hormonal cycles, such as PCOS or diabetes.

While not a single cause of PCOS, insulin resistance is definitely one of the main root causes of the disease. A plethora of evidence also shows that improving insulin sensitivity in this condition improves reproductive, hyperandrogenic and metabolic features.

We also know that high blood glucose inhibits hepatic production of the sex hormone binding globulin (SHBG), which leads to an increase of free androgens in blood circulation.⁴

The good news is that whether you are genetically predisposed to insulin resistance or not, you can sort the issue by relatively simple lifestyle interventions.

LIFESTYLE IS KEY

It is a fact that lifestyle modification can and should be your first-line PCOS therapy. Even such a small intervention as the order of your food intake can influence your blood glucose levels and significantly improve your general health, while also managing your PCOS. Additionally, natural insulin sensitisers like Myo-inositol & D-chiro Inositol and glucose metabolites such as Alpha-lipoic acid are potent natural aids in your search for hormonal balance.

The last but not the least important step on your healing journey is your state of mind. Many chronic conditions, but especially PCOS can be a huge mental toll. Society dictates unrealistic and unnatural moulds: women without facial hair, girls with impeccable skin, and ladies who always smile while fitting themselves in size S trousers. It's time we normalise the imperfections of the human organism, cut our bodies some slack and embrace self-care as a daily necessity rather than an indulgence, making our physical and mental wellbeing a priority. 

References:

1. Broekmans FJ, et al. PCOS according to the Rotterdam consensus criteria: Change in prevalence among WHO-II anovulation and association with metabolic factors. BJOG. 2006 Oct; 113(10):1210-7.
2. Carmina E, et al. Diagnosis of polycystic ovary syndrome: from NIH criteria to ESHRE-ASRM guidelines. Minerva Ginecol. 2004 Feb; 56(1):1-6.
3. Escobar-Morreale, H. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nat Rev Endocrinol. 2018. 14, 270–284.
4. Merviel P, James P, Bouée S, et al. Impact of myo-inositol treatment in women with polycystic ovary syndrome in assisted reproductive technologies. Reprod Health. 2021Jan 19;18(1):13. 
5. Martin ML, Halling K, Eek D, et al. Understanding polycystic ovary syndrome from the patient perspective: a concept elicitation patient interview study. Health Qual Life Outcomes. 2017;15(1):162.
6. Ciaraldi TP, Aroda V, Mudaliar S, et al. Polycystic ovary syndrome is associated with tissue-specific differences in insulin resistance. J Clin Endocrinol Metab.2009; 94:157-163.
7. Nestler JE. Insulin regulation of human ovarian androgens. Hum Reprod. 1997 Oct;12 Suppl 1:53-62.
8. Nestler JE, Jakubowicz DJ, de Vargas AF, et al. Insulin stimulates testosterone biosynthesis by human thecal cells from women with polycystic ovary syndrome by activating its own receptor and using inositolglycan mediators as the signal transduction system. J Clin Endocrinol Metab. 1998 Jun;83(6):2001-5.