What Causes PCOS?

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One of the most common hormonal disorders is polycystic ovary syndrome (PCOS). It affects about 6% of premenopausal women and is characterized by acne, increased facial hair, irregular periods and infertility. Women with this condition typically have higher levels of male hormones and lower levels of estrogen and very little progesterone. The lack of a normal monthly cycle of female hormones prevents the release of eggs from the ovaries. These partially developed, unreleased eggs develop into a cyst on the ovaries. In the long run women with PCOS are at high risk for developing Type 2 diabetes, cardiovascular disease and endometrial cancer.

Research suggests that women with PCOS have insulin resistance and higher than normal insulin levels. A genetic defect, frequently inherited from a father with early male pattern baldness is believed to make their ovaries produce large amounts of male hormones when abnormally high insulin levels are present. Reducing insulin resistance which lowers circulating insulin levels will lower the production of male hormones and reverse most abnormalities associated with PCOS.1

The safest and most effective way to reduce insulin resistance and lower excessive insulin levels is weight loss. Regular exercise markedly lowers insulin resistance even before significant weight is lost but much of the beneficial effect of an exercise bout on insulin resistance wears off in a day or so. This means exercising daily is ideal. A diet composed largely of fruits, vegetables, whole grains, beans, nonfat dairy and a little seafood will enable most people to lose weight and reduce insulin resistance without the chronic hunger associated with calorie counting and portion control. In most cases regular exercise coupled with a healthier diet and the loss of excess body fat will reverse most of the health problems associated with PCOS. There are drugs such as metformin, oral contraceptives, spirolactone, clomiphene citrate, etc. that may reverse some of the medical complications seen in women with PCOS, but these drugs have risks as well as benefits and people with PCOS should be strongly encouraged to adopt a diet and lifestyle that in the long run will likely leave them far healthier than relying on pharmaceutical agents.
1. Harvard Women’s Health Watch. November 1996

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