Notes on PCOS

Which came first? The chicken or the egg?

Sorry if my question confuses you but I draw the conclusion that with treatment of this disease we’ve been looking in the wrong place.

Polycystic Ovary syndrome is undoubtedly a medically defined condition. My own ovaries were described the last time I was checked by the gynecologist as looking “like a pair of gooseberries” by which he meant lots of little cysts (eggs) all emerging, all over, none of them ready to burst out.

Of course we all understand that this isn’t the way it should be: to continue the gynecologist’s metaphor, ovaries should look like grapes, smooth, apart from one “cyst” (egg) per month which  becomes ripe and eventually breaks away to begin its merry journey through the fallopian tubes to the womb etc etc. 

Polycystic ovaries literally have what the name suggest poly (many)  cysts half-developed. In some women this prevents menstruation and a proper cycle altogether, in others, it inhibits the natural process and causes fertility problems. I do not question any of that accepted wisdom - that’s exactly what happens, and lots of work is done by doctors all over the globe to treat the condition to restore fertility and to enable the development of lots of lovely babies.

I also understand that this basic need for babies is central to the human condition and is one area of women’s health that the medical establishment is terribly interested to explore - all the research has gone into this. 

BUT there is a fatal flaw here which overlooks the fundamental heart of the condition.

PCOS is a syndrome affecting the ovaries and fertility, but it also gets bundled with a whole host of other conditions caused by hormone imbalance.

Fundamentally, this is incorrect.

PCOS, is caused by hormone imbalance. Hormone imbalance causes PCOS, rather than the other way around. PCOS does not cause the original hormone imbalance in the first place.

Hormone imbalance has many symptoms, one of which is polycystic ovary syndrome, but that’s only one part of it, caused by the general malaise in the rest of the body. 

To suggest that PCOS is responsible for every symptom caused by hormone imbalance is incorrect: It puts the cart before the horse. 

PCOS develops because the entire endocrine system goes into disarray, not thus, it makes sense for us to look at the root cause of the problem, which is the endocrine imbalance, and treat PCOS merely as a symptom. 

To address my opening statement, the chicken has been put before the egg.

It’s a bit like trying to define “runny nose” as a condition, when in fact, a runny nose can have a number of causes, including the flu, the common cold, hayfever and a whole bunch of other ailments. No-one treats a runny nose in and of itself: they treat the underlying cause.  The same applies to PCOS: we have a much better chance of beating this syndrome if we address the hormone imbalance itself rather than trying to pick one symptom from a multitude and trying to “manhandle” the body back to health with heavy drug treatments, often those which throw the body into further disarray (think IVF, phyto-oestrogens, etc etc).

PCOS Types

Viewed in this light, the three types of PCOS all become easier to understand:

• Type A: Caused by Syndrome X. i.e. women who are  already fat develop a resistance to insulin leading to a range of symptoms, one of which is PCOS (others include type II diabetes, heart disease etc)
• Type B: This is primarily the type I’m addressing on this blog: a conflagration of psychological and physiological stress conspires to cause breakdown of the endocrine system, leading to a whole host of symptoms which I’ve addressed throughout this work, including PCOS. In short, an overload of stress which leads to depleted hormones and then consequently an elevated response to their triggers. 
• Type C: PCOS caused by Hashimoto’s Thyroidosis, again, a defined, rare condition in which PCOS is known to be a symptom.

In each case, PCOS is a symptom of something much bigger.

I'm not suggesting for a second that we don't address PCOS and try and treat it - of course we should, but it must be addressed as part of the treatment, but you can’t treat the whole person unless you treat the whole condition, and the whole condition is NOT PCOS, it’s endocrine distress.

No wonder the results of studies on PCOS are so often plagued by unintelligible results, mixed findings, confusing statistics: in many cases PCOS has been addressed as the disease, affecting all three PCOS types, which is nonsense given that these three groups are dealing with different diseases. Inevitably, the results are muddled, it stands to reason that they would be.

It’s 2014, it’s about time we started treating the underlying condition rather than trying to pick off the only bit which the medical establishment is interested to fix.