As a Sydney naturopath, meeting women in my wellbeing clinic to support regular menstrual cycles, balanced female hormones, weight issues, hair growth known as hirsutism on the face and all parts of the body and acne that just won’t go away is a weekly occurrence.
Whilst insulin driven PCOS that drives elevated testosterone is a common cause, more and more in clinic I am finding women that been diagnosed with PCOS, yet their testosterone levels are normal and when I check insulin at fasting, 1 and 2 hours I find that insulin is also normal.
Often the hair growth or hair loss on the head, acne and fertility issues are the main trigger for women to seek answers as they are all events that can seriously impact quality of life and life dreams.
So, its androgens that are normally to blame but they can be stimulated by not just insulin. I also see many women with hair growth and male pattern baldness that assume they have PCOS however they are having regular periods and testosterone on a blood test is normal. Women in these cases can be suffering from a hypersensitivity to a normal amount of testosterone so the support I give is to reduce the impacts of testosterone on hair growth and also on acne and look I depth at why they are so sensitive.
There are several interpretations of how to correctly diagnosis PCOS, however it absolutely cannot be diagnosed on simply having polycystic ovaries as you must show signs or symptoms of excess androgens. This may not just be on a blood test but can be acne, hair growth on the face or male pattern baldness.
- Androgens to test: sometimes total testosterone and free testosterone are normal however our adrenal glands also produce androgens so in some cases, and I look at whether androstenedione and DHEA have also been tested. I explain the different types of PCOS in my last PCOS blog (here) as even inflammatory conditions in the body such as eczema, arthritis, gut disorders, food sensitivities may be driving the excess androgens due to the impact that inflammatory chemicals produced by your body have on hormone receptors
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It is important that other causes for androgen excess have been considered and they can include:
- Having just come off the pill = post pill means disrupted hormones and a surge of testosterone
- Non classical congenital adrenal hyperplasia: This is a genetic condition and is an often forgotten cause of excess androgens and I always make sure it has been ruled out. It is a condition where an important enzyme, 21-hydroxylase that changes progesterone into cortisol doesn’t work as it should and progesterone becomes testosterone and other androgens. It can look like PCOS and is often diagnosed as PCOS. The test recommended to know for sure is 17-OH progesterone.
- High prolactin: this can be a cause and be a result of thyroid issues, stress and even excess stomach acid tablets so it needs to be looked at too.
- Lack of nutrients in your diet: Hypothalamic amenorrhea is when you don’t ovulate, and this is common when you under eat especially carbs.
- Cushings Syndrome: This would be rare however this condition shows similar symptoms to PCOS.
As you can see, PCOS does not always mean inositol and zinc. It is a deep investigation to make sure you are strategically focussing on the right treatment and strategies.
For support on managing or investigating your PCOS more thoroughly or an investigation as to hair growth/loss or acne please book an initial naturopathic consultation here.
