"Does my daughter have PCOS?"

A typical patient story:

Sally brought her sixteen year old daughter Rebecca to the physician. Rebecca is pre-diabetic, overweight, has acne and facial hair due to high testosterone levels. Over the last few years, the timing of Rebecca's menstrual cycles had become erratic and eventually stopped. She was diagnosed with PCOS (Polycystic Ovary Syndrome) and was given birth control bills to help regulate her menstrual cycles. The birth control pills resulted in high blood pressure and further weight gain so Rebecca stopped taking them.

What is PCOS?
At its core, Polycystic Ovary Syndrome is a hormone imbalance. It can cause problems with periods and make it difficult to get pregnant. It affects as many as 1 out of 15 women. Often the symptoms begin in the teen years.

The ovaries normally make a small amount of male sex hormones (androgens). In PCOS patients, the ovaries make excess androgens such as testosterone. Excess testosterone production can lead to irregular (or cessation of) periods, increased facial/body hair, weight gain, male pattern baldness and acne. PCOS is a leading cause of infertility. Additionally insulin resistance may occur which can cause elevated blood sugar levels and increase the risk for diabetes.

What causes PCOS?
PCOS is caused by a lack of ovulation ("anovulation") resulting from insufficient progesterone production for an extended period of time. The anovulation causes increased testosterone production by the ovaries.

Some believe that environmental chemical exposures and the effect on the endocrine system are to blame. Anecdotal evidence can be seen by observing how some girls are starting puberty as early as age nine.

How is PCOS treated?
The traditional treatment of PCOS involves birth control pills which serve to regulate menstrual cycles and help lower testosterone levels. However, potential risk factors for using oral contraceptives include:

• Increased insulin resistance resulting in increased risk for diabetes.
• Increase risk of heart attack or stroke even at low doses.
• Decreased levels of vital nutrients such as: folic acid, zinc, magnesium, Vitamins B, C and E which can result in hormone imbalance as well as increased weight, depression and heart disease.
• Decreased libido.
• Oral contraceptives can lead to digestive problems such as candida (yeast) by killing off friendly bacteria. A major component of oral contraceptives is estrogen which can result in increased yeast growth leading to carb and sugar cravings.

Alternative Treatments for PCOS
The use of BioIdentical Hormones (BHRT), such as natural progesterone, can be used to treat PCOS, along with alleviation of stress, increased exercise and better nutrition. If progesterone is missing it makes sense to replace it. Progesterone stops the ovaries from producing too much testosterone.

Bio-Identical Hormones (aka Human Identical Hormones) are exact duplicates of those the body produces. People with hormone imbalances simply have too much or too little of particular hormones. Many of the bioidentical hormones used are made from soybeans and wild yams, which contain unique compounds that are processed chemically and made into identical replicas of hormones the body produces.

BioIdentical hormones are uniquely tailored for each patient through a compounding pharmacy. The prescriptions are based on a series of tests ordered by a medical provider and are available in a range of doses.

In the end, PCOS patients may want to explore whether BioIdentical progesterone should be part of their treatment plan. Patients should make sure they work with a medical provider experienced in natural hormone therapy.

A few months ago Rebecca started taking natural progesterone twice daily for two weeks on and two weeks off. The result was a normal menstrual period and the alleviation of many of her previous symptoms.

Dr. Lauren Loya of the Hormone Restoration Center, can be reached at (412) 432-7909 or visit www.hormonecenter.net.

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