The Story of PCOS - By Dr. Kerusha Naidoo

Hi ladies, if you have ever asked your doctor the question “ What is Poly Cystic Ovarian Syndrome (PCOS)?” and just got the answer “ It’s a hormonal imbalance”, given the pill and left your doctors rooms more confused than you started, well this article is for you.


I remember being 13 years old, given this diagnosis by my gynecologist (who actually delivered me when I was born, by the way) and was filled with all sorts of questions, “what is it?”, “Can it be cured”, will I have acne and painful periods forever?”, “What should I eat?”,” Is there anything else besides the pill I can take?” etc. but was too scared to even ask. So rather I just complied with my treatment which lead me on a path of good and bad times but I reached a point where the bad outweighed the good by far. So as a medical professional I took up the challenge of debunking PCOS and learning everything there was to it.

My first step was learning how my body was functioning on the inside so that I could figure, which hormones needed more attention and help other women do the same.

So I came up with a fun analogy (F.Y.I, I am a medical diagnostic’s lecturer but I promise not to bore you) that helps you understand your hormones and take back your power.

Imagine you are watching a relay race, the racers are at the starting point, the whistle blower is getting ready to get the race started; “on your marks, get ready, set, goooooooo” (the whistle is blown).


Brain

Well that is basically what happens with our hormones, the whistle blower is a gland in our brain called the Hypothalamus which sends a message to your racers (hormones) to go, go, go.

Racer 1 (LH) speeds off getting a lead start (2-3 times faster) over racer 2 (FSH) but normally they (FSH, LH) ran side by side (released at equal amounts). This is where much of the confusion lies.


Ovaries

Racer 1 (LH) travels to the ovaries to hand over the baton(stick) to Racer 3 (outer follicle cells – Thecal cells) who are so excited that he starts creating a hormone called androgens but creates way too much of this (that is why we experience increase hair growth – where no lady should have hair growth- on the face, chest, navel, etc. areas) and acne . Racer 1 (LH) is so strong and powerful (always in excess amount) that she prevents ovulation from occurring thus progesterone is not manufactured (which can only happen if you ovulate) .Do you experience symptoms like; weight gain, mood swings, decreased libido, irregular periods, heavy bleeding, fibroids, etc., now you know why.

Racer 2 (FSH) also travels to the ovaries but because she is smaller (in amount) she isn’t as powerful as she should be. She hands over the baton to Racer 4 (inner follicle cells – granulosa cells) who are lazy thus do not reproduce enough cells to surround the egg. These inner cells take up the androgens from Racer 3 (Thecal cells) and produce estrogen normally, but in PCOS this step does not happen efficiently. Racer 2 (FSH) is not strong enough, hence she does not stimulate the follicles (that contain the egg) to ‘grow up’(mature). The follicles (many ‘grow’ during a cycle) remain behind in the ovary and can become cysts.


Liver

You must be wondering, what does the liver have to do with a reproductive system condition? PCOS is an endocrine disorder that affects multiple organs not just our ovaries.

Let’s take a look at how the liver contributes to this mayhem. Sex Hormone Binding Globulin (SHBG) produced in your liver transports androgens (testosterone, DHT) and estradiol (form of estrogen) to where it is suppose to go but in PCOS there is decreased amounts of SHBG which cause a further increase in androgens (contributing even more to that unwanted hair growth and hair loss) and estrogen (estrogen dominance – weight gain, mood swings, no period, etc.) Lastly, a crucial function of the liver is to detox the body of excess hormones, but the liver is unable to do its job and guess what happens, hormone levels rise even further.


Adrenal Glands

These little babies are found sitting on top of your kidneys and are so important to support and nurture in your PCOS journey (which I had no clue about). So, what does it do? This multi-tasker organ, releases cortisol (in response to stress) which is sometimes elevated in PCOS patients ( cause lets face it, we are always stressing) which leads to an increase in inflammation (can cause joint pain, acne, difficulty losing weight, etc.) which I see in most of my PCOS patients and myself. Another hormone the Adrenals release are different forms of androgens which contribute even more to our elevated androgen levels (like, hello Adrenal, can you not add more unwanted hair to my body).


Pancreas

Insulin resistance is the best friend of PCOS and hates to leave her alone. But what is insulin resistance, you might ask? Insulin is a hormone which is created in the pancreas and released into the blood stream, every time you eat. Insulin aids in the transportation of glucose (received from food) into muscles to be converted into energy or it takes excess glucose to the liver to be stored. But this process can not occur, due to your muscle and liver not accepting insulin to entre hence glucose cannot go in (and here is where the dreadful symptom of fatigue comes in). Excess glucose in the blood gets stored as fat. The story does not end there, the pancreas detects as if there is excess glucose in the blood and releases even more insulin which favors fat storage over fat burning (leads to weight gain and difficulty losing weight). The fat stored can also be broken down into estrogen (contributes to estrogen dominance).

PCOS is known to be a metabolic disorder meaning that it affects many organs as you can see. Its important to understand your body (the in’s and out’s) so that you can learn to love her, the way she needs to be loved. Ladies, listen to her, understand her and love her because loving her means loving you.



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