What I Want Everyone to Know Living with PCOS
Twenty years ago when it first dawned on me that I had debilitating hormonal issues, no doctor or medical professional I turned to had a clue about polycystic ovarian syndrome. Today I see medical professionals hither and yon providing their expert opinions about causes and protocols. Increased awareness around this has increased PCOS diagnoses. I believe this is a good thing but I also see a lot of women in my practice still lost about how to “cure” it.
I think the idea that we cure PCOS is the first mis-step in getting it under control. Why? Because maybe it leaves some women thinking so long as they aren’t suffering from text book symptoms, they don’t have anything to do. However, PCOS symptoms eventually return or different ones will arise with biological shifts. With new or returning symptoms, thinking we are “cured” makes us susceptible to amnesia, lack of accountability, loss of morale, and feelings of failure. Yet we don’t have to return to square one to solve the same mystery all over again. We often just need awareness.
I am not suggesting that the medical community has got this all wrong but maybe the western approach to this condition isn’t hitting the nail on the head? At least it certainly isn’t yet. In fact, I find myself often repeating a lot of the same general ideas that medical professionals still aren’t discussing with their patients. Here are “some” of them. The more controversial points I will leave for private discussions ;)
PCOS is often associated with pesticide exposure.
There are many root causes for hormonal disfunction. Living in the Midwest, I see a lot of PCOS in women who grew up or who had parents who grew up in an agricultural community. I am one of them. An insane amount of pesticides were introduced to our ecosystem in just the last 60 years to manage farmland in this country. This trend is slowly changing now that we know the devastating impact it has on soil health. Yet damage is already done. We are seeing a direct consequence of this in SO MANY WAYS. The epigenetic impact of this will resonate with us for several generations. There is no shortage of research studies available to the public on this topic. The liver takes central stage on this point. Understanding how to detoxify from glyphosate at a cellular level, upregulating liver function, and avoiding high pesticide exposure in food AND your environment is critical to long term management of PCOS.
The microbiome and digestion are bedrock for PCOS management.
Why is pesticide exposure so closely associated with PCOS? There is a lot of speculation regarding this. As it relates to the fact that pesticides are designed to kill microorganisms though, perhaps biodiversity in the gut is something we should be focused on here? What we understand about how gut bacteria regulates hormone function, digestion, and neurotransmitter receptors in the body is still in its infancy.
Akkermansia is a good example. This probiotic is the new kid on the block in the supplement industry. We know that when present in the gut, it provides a great deal of blood sugar control in a variety of ways and even will cross talk/optimize with other strains. Yet, it’s fickle. It’s often low or not present in obese people. Indeed low microbiome biodiversity is often found in women struggling with PCOS.
Digestion
You’ve heard the popular saying “You are what you eat”, or even “You are what you digest”. How about, “You are what you absorb?” Just because you eat it, doesn’t mean your body is using it. Worse, for those with inadequate digestive function, many healthy foods become a greater burden on the body. Digestion is foundational to the treatment of EVERYTHING! It’s how we get our nutrients and nutrients are how we are chemically assisted in normal biological functioning. Almost every single person I have worked with who has a PCOS diagnosis also has digestive dysfunction as well. When addressed properly, the body can actually put healthy foods to work which inevitably will change hormone function, therefore moderating symptoms. If this piece is not dialed in sufficiently, we are just spinning our wheels.
The liver, one of the primary, if not a central, detoxification organs in the body, is again so important. On top of the 600+ functions it’s in charge of in the body, the liver is also responsible for metabolizing hormones the body creates. Every single thing that we eat, breath, absorb through the skin, and even the chemicals we make in our body, must be processed or neutralized through the liver before leaving the body. That’s a lot of work! If the liver is backlogged from environmental stressors and sluggish detox pathways, you better believe hormones are going rogue and turning into things like androgens, bad estrogen, and angry chemicals. To free up bandwidth in the liver is one of many ways we also manage blood sugar dysfunction, a central focus in PCOS management.
Different life phase + different symptoms = different protocol
What balances your hormones will change within every life phase. That means so too will the protocols that keep your symptoms in check. It’s important to be mindful that when you receive messages from your body that things are out of whack, embracing this as an opportunity to learn something new about yourself is the most efficient way to get back into flow. It’s okay! It’s just going to be different.
Your PCOS will not go away after you have children but it will change. Your PCOS will not go away if you have a hysterectomy but it will change. Your PCOS will not go away once you stop getting your period, but it will change. Change for the better? Maybe, but for most it’s just different.
A woman with PCOS who has one or both ovaries removed still must always manage blood sugar. Postpartum women and perimenopausal women with PCOS are much more susceptible to developing thyroid dysfunction during this life phase. Awareness of this is key.
Postmenopausal women are still going to have PCOS related issues too. One of the biggest issues is blood sugar management. As we age we become more insulin resistant but those who have had life-long struggles with PCOS symptoms are even more susceptible to developing blood sugar related disorders. They are also higher risk for developing certain cancers related to their condition. Note that I used the word “condition” not “PCOS”. Just because you have a PCOS diagnoses does not mean you’re going to get cancer. It means that living your life at every stage of your life knowing you have to stay on top of this is one way you can avoid complications.
Blood sugar and stress are definitely PCOS focal points but they are not the only factors. While I hear of medical practitioners bringing this up with patients, I don’t hear much discussion at all around digestion and the microbiome. We definitely do not know everything there is to know about PCOS yet (or any disease for that matter). Incorporating new information, especially when it’s based in common sense, is how we’ll shift gracefully into the changes required for us to thrive.