Polycystic ovarian syndrome

Despite being the most common female endocrine disorder, affecting 10% of women of reproductive age, polycystic ovarian syndrome (PCOS) is frequently overlooked.1 PCOS affects young women and is associated with a decrease in the number of ovulations, infertility, acne, and hirsutism (i.e. abnormal hair growth on face and body). It’s also associated with metabolic derangements, including an elevated risk for diabetes and cardiovascular disease, making it all the more important to diagnose and manage this condition in a timely manner.2

The ratio of total testosterone to dihydrotestosterone (TT/DHT) has demonstrated potential as a new biomarker for diagnosing PCOS. A high TT/DHT ratio and various adverse hormonal, lipid, and glucose metabolism parameters are seen in patients with PCOS.3

Management starts with lifestyle modification — weight management is paramount. A 5-10% loss of body mass is associated with significant improvement in clinical metabolic and hormonal markers.4 A significant relationship exists between PCOS and poor diet and low physical activity.5 In terms of diet, a high intake of omega-3 fatty acids is very important.6 As far as supplements are concerned, N-acetylcysteine is known to increase levels of glutathione (an antioxidant). It also lowers inflammatory markers such as tumor necrosis factor alpha and improves insulin sensitivity.7 It may also improve ovulation and pregnancy rates.8

At Rocky Mountain Regenerative Medicine, we cast a wide diagnostic net to try and figure out the cause of our clients’ symptoms. Once we diagnose this elusive condition, our management approach is multi-pronged, thorough, sustainable, and effective.

  1. R. Hart, M. Hickey, S. Franks: Definitions, prevalence and symptoms of polycystic ovaries and polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol. 18:671-683 2004
  2. American Association of Clinical Endocrinologists Polycystic Ovary Syndrome Writing Committee: American Association of Clinical Endocrinologists position statement on polycystic ovary syndrome. Endocr Pract. 11:126-134 2005
  3. J. Münzker, D. Hofer, C. Trummer, et al.: Testosterone to dihydrotestosterone ratio as a new biomarker for an adverse metabolic phenotype in the polycystic ovary syndrome. J Clin Endocrinol Metab.100 (2):653-660 2015)
  4. M.M. Huber-Buchholz, D.G. Carey, R.J. Norman: Restoration of reproductive potential by lifestyle modification in obese polycystic ovary syndrome: role of insulin sensitivity and luteinizing hormone. J Clin Endocrinol Metab. 84:1470-1474 1999
  5. R. Pasquali, F. Casimirri, V. Vicennati: Weight control and its beneficial effect on fertility in women with obesity and polycystic ovary syndrome.Hum Reprod. 12 (Suppl 1):82-87 1997
  6. C.C. Kelly, H. Lyall, J.R. Petrie, et al.: Low-grade chronic inflammation in women with polycystic ovarian syndrome. J Clin Endocrinol Metab.86:2453-2455 2001
  7. T. Kilic-Okman, M. Kucuk: N -Acetylcysteine treatment for polycystic ovary syndrome. Int J Gynaecol Obstet. 85:296-297 2004
  8. A.Y. Rizk, M.A. Bedaiwy, H.G. Al-Inany: N -Acetyl-cysteine is a novel adjuvant to clomiphene citrate in clomiphene-resistant patients with polycystic ovary syndrome. Fertil Steril. 83:367-370 2005