If PCOS doesn’t start in the ovaries. where does it start?
It would be easy to view PCOS as simply a condition of the ovaries that negatively impacts fertility but, if you’ve been reading any of my Facebook content you know that PCOS is far more diverse, complex, and far reaching than this.
PCOS is a condition that can affect just about every aspect of the women that have it. It can impact metabolism, energy balance, hormones, the immune system, sleep, weight, appetite, hair, skin, I could keep going here.
PCOS is deeper than the diagnosis
What makes PCOS hard to wrap your head around is the highly individual nature of it. Just about every woman with PCOS will experience a slightly different PCOS. This is tricky because being diagnosed with PCOS is just an umbrella diagnosis. Very rarely will you find a medical expert willing to investigate further to find underlying root drivers of your PCOS.
Being diagnosed with PCOS is simply the confirmation that you have a collection of symptoms. To take control of your PCOS you must investigate the underlying root causes of your PCOS and the hormonal issues they are creating. It’s really unfortunate that not many doctors are willing to take the time to do this with their clients.
You could take three women with PCOS whose underlying root cause of their PCOS are all different. One could be driven by insulin resistance, the next by stress, and the third by inflammation. Understanding what’s driving your specific PCOS is crucial in taking control of the condition.
The ovaries are just another symptom of PCOS
It’s important to understand that your ovaries are affected by PCOS, they aren’t the underlying root cause of your PCOS. For example, polycystic ovaries are caused by follicular arrest, a condition that blocks the maturation of your follicles early, leaving a number of half-mature follicles in your ovaries, this will show up in an ultrasound as polycystic ovaries.
Follicular arrest is triggered by the early release of luteinizing hormone, caused by elevated levels of ovarian androgens. These androgens are driven either by insulin or stress. This follicular arrest is also the cause of some women with PCOS not ovulating, having irregular periods, having enlarged follicles, and having issues trying to conceive.
Because your ovaries are not the root cause of your PCOS is why a hysterectomy or menopause does not resolve your PCOS. The true cause of your PCOS lay elsewhere in your system and therefore, the trigger is still there.
Possible Cause of Your PCOS # 1: Insulin Resistance
Around 70% of women with PCOS will be caused by insulin resistance, which is obviously by far the most common cause of PCOS. Insulin resistance (IR) is a condition where the cells of your body no longer respond to the hormone, insulin, as normal. Insulin is a hormone produced by your pancreas (a gland that sits behind your stomach) that helps to regulate your blood sugar levels.
This is the link between PCOS and medications such as metformin, a type II diabetes medication, and why 40% of women with PCOS will be at risk of prediabetes by the age of 40. Symptoms of PCOS that can be traced back to insulin resistance include.
👉 High testosterone levels (free and total testosterone in blood tests)
👉 Acne, hair loss, excessive hair growth, depression (all being driven by high testosterone)
👉 Irregular periods and fertility issues
👉 Weight gain
👉 Poor energy levels
👉 Low thyroid output (hypothyroidism)
👉 Sleep disorders (sleep apnea & insomnia)
👉 Increased cravings and hunger
IR is also a risk factor for serious health conditions such as type II diabetes and metabolic syndrome (high blood pressure, abdominal obesity, high blood triglycerides, low levels of good cholesterol). It is important to note that Insulin resistance is a major feature of type 2 diabetes, but you can have insulin resistance without having type II diabetes.
In short, to understand if your PCOS is being triggered by insulin resistance, you will likely:
👉 Struggle with your weight
👉 Struggle with energy levels
👉 Struggle getting a good night's sleep
👉 Suffer from symptoms such as acne, hair loss, excessive hair growth, mood issues
Possible Cause of Your PCOS # 2: Stress
A lesser known trigger for PCOS is stress. Now, it’s been long known that stress can disrupt a female's menstrual cycle but, what’s less understood is stress’ ability to trigger PCOS.
Stress is the body's way of responding to demand or pressures, these pressures can be emotional, like worrying about bills, children, work etc. Or, they can be physical such as undereating, overexercising, eating too much processed foods, suffering from a lack of sleep.
Chronic stress triggers your adrenal gland to produce cortisol, excess cortisol is a problem in it’s own as it’s related to midsection weight gain, extreme fatigue, irritability, and sleep issues. Now, while the ovaries are typically blamed for elevated androgens in PCOS, due to it being the most dominant reason, it’s estimated that 20% - 30% of women with PCOS have adrenal androgen excess.
Your adrenal glands produce all of the DHEA sulfate (DHEA-S) and 80 percent of the DHEA in your body. Since DHEA-S and 11-androstenedione are not produced by the ovaries, these hormones can be used as markers of adrenal androgen secretion when you get your blood work done by your medical expert.
In short, to understand if your PCOS is being triggered by stress, you will likely:
👉 Struggle with your stress levels
👉 Struggle with fatigue, concentration, and possibly headaches
👉 Struggle getting a good night's sleep, feeling wired but tired
👉 Possibly suffer with digestive issues
Possible Cause of Your PCOS # 3: Inflammation
Inflammation can also be the cause of your PCOS but is harder to diagnose because inflammation can also be triggered by insulin resistance or stress. Typically speaking, when inflammation is triggering PCOS is generally down to either environment factors such as plastics or following an inflammatory diet like gluten.
Signs of inflammatory PCOS are;
👉 Digestive issues such as IBS
👉 Joint pain
👉 Food sensitivities or symptom flare ups after consuming certain foods
👉 Vitamin D deficiency
👉 Frequent infections or sickness
👉 Elevate levels of CRP in tests
After reading this article, which of these 3 possible triggers do you feel your PCOS is being driven by? Let me know.
About Drew Baird:
Drew Baird is a qualified Personal Trainer, PCOS expert, who also has qualifications in sports nutrition and psychology. Drew takes a scientific approach to PCOS by combining the latest clinical research with empirical evidence from working with his PCOS clients. He is the owner of Drew Baird Fitness and Healthy PCOS.