PCOS and Hormone Disruption - The Domino Effect

In a previous post, I've outlined that PCOS is largely due to hormone disruption. So where does this disruption come from?

Hormone disruption in the vast majority of cases comes from one of the following sources:

• - Type 1: as a result of another underlying condition (e.g. Hashimoto's Thyroidosis, aka underactive thyroid)
• - Type 2: due to overwhelming stress on the body - both from psychological and physiological sources
• - Type 3: due to obesity, which by definition changes our hormone balance, greatly effects the levels of hormones in the body (e.g. insulin, oestrogen, etc), which is why it also leads to other conditions such as diabetes
• - Type 4: due to failure of the hormone stack to "build" correctly during childhood and puberty. 

The hormones typically disrupted come from across the entire endocrine stack. 

Of course, PCOS sufferers are familiar with the disruption caused to "sex hormones" such as: 

• - oestrogen
• - progesterone
• - testosterone

but this isn't where it stops - the disruption is much wider than this - the following (to name but a few) are also disrupted

• - insulin
• - leptin
• - adiponectin
• - ghrelin
• - cortisol
• - adrenaline
• - vitamin D (actually a hormone, not a vitamin!)
• - thyroxine

Remember that the endocrine hormones work together as a group, all functions are intertwined, which means when one is thrown out of balance for some reason, they all react in order to compensate and actually make matters worse. 

In fact, it seems to me more likely that the disruption starts in the second group and spreads to effect the others.  Think about the groups of sufferers at the top of this page and where their causes most likely lay:

• Type 1: Hashimoto's - due to underactive thyroid, not enough thyroxine, which leads to other hormones being disrupted
• Type 2: Stress - massive levels of cortisol and other stress hormones lead to disruption in the amount of insulin, adiponectin, and other hormones - cumulative effect
• Type 3: Obesity - drives up the amount insulin in the body, and lowers adiponectin
• Type 4: Early Onset PCOS - Endocrinopathy (hormone disruption) in childhood and puberty. The hardest to pin down in terms of cause. Likely from deficiencies passed from mother to child (e.g. vitamin D) which means that the stack is never fully formed

In every case, the problem doesn't start with oestrogen, it starts elsewhere. 

Whichever type you have, and wherever you started, what results is a domino effect: A deficiency or over production of thyroxine or insulin will inevitably affect oestrogen, progesterone and testosterone levels which cause the symptoms of PCOS but the root cause is the endocrinopathy (hormone disruption) which kicked it all off. 

It also absolutely explains the accelleration of the syndrome - the fact that over time, symptoms get worse and are more wide ranging. 

Furthermore, the fact that PCOS sufferers start from a range of differing problems absolutely explains why my symptoms are different to yours, and why 20 PCOS sufferers in a room would struggle to find consensus: we all start from an individual position, our symptoms take their own course.

Does this mean that PCOS is untreatable/incurable?

No, absolutely not. We're just looking too far down in the detail. If we forget about the symptoms just for one minute and look at the problems in the hormone stack, these can be fixed. Whilst it will never be a cookie-cutter treatment plan, with everyone following the exact same steps in the same order, it will provide a treatment framework which will adapt to each case. 

PCOS and the Link with Genetics

There is much speculation that genetics play a part or are largely responsible for PCOS. I sort of agree, a bit. 

I'm absolutely convinced that there is a genetic predisposition - i.e. some people have genes which make them more susceptible to hormone disruption, but I don't believe it's the trigger. Having a susceptibility means that you are more likely than the average person to have your hormones disrupted, but I think it's more likely that the thing that kicks it off in any particular individual is outside this. e.g. I believe there was a disposition for PCOS in my family, but not everyone has it. 

The causes are social, environmental, in some, passed from mother to child. There's studies emerging that Vitamin D deficiency passes from mother to child, so you can be born with a deficiency, and that children born to mothers who are stressed during pregnancy are more likely to suffer depression in later life. 

What do you think? I'd love to hear your comments on any of the above!