Chris D. Meletis, N.D., with
Nieske Zabriskie, N.D
Polycystic ovary syndrome (PCOS) is a complex medical condition involving multiple body systems. The etiology of this condition is unknown. In addition, there is currently no consensus on the diagnostic criteria for PCOS. It is accepted that hyperandrogenism, insulin resistance, and menstrual abnormalities are commonly present. An estimated 6–10 percent of reproductive-age women have PCOS, making it one of the most common endocrine reproductive disorders. 1
The cause of PCOS is unknown. Many studies have indicated that either insulin resistance or endocrine dysfunction can cause the symptoms associated with this condition. 2 Many theories have been suggested to explain the primary defect that causes PCOS pathology. They inc lude abnormal insulin action and secretion, endocrine abnormalities causing an increased luteinizing hormone (LH) pulse frequency and amplitude, increased androgen production from the ovaries, and abnormal cortisol metabolism. 2 There is also evidence that genetic factors play a role in PCOS. 3 Eating disorders, such as bulimia and binge eating, have been also been associated with this condition. 4
PCOS involves metabolic, endocrine, and clinical manifestations. Studies have suggested that 75–80 percent of women with PCOS have irregular menstrual cycles. These women typically have 5–9 menstrual cycles per year, ranging from 40–65 days in length. Increased androgens cause hirsutism in 60–80 percent— as well as alopecia in 40–70 percent—of these women. Acne is also increased and prevalent in 40–60 percent of women with PCOS.
Obesity is common in this condition and studies have suggested that 75 percent of women with PCOS are overweight or
obese. 5 These women often have increased abdominal adiposity with an average waist-to-hip ratio of 0.86. 6 Of these overweight women, an estimated 10 percent have acanthosis nigricans, commonly found in the axilla, nape of the neck, and skin folds . Increased prolactin can also cause breast discharge in 8–10 percent of affected women. Finally, sleep apnea may also occur in approximately 8 percent of women with PCOS. 5 Other endocrine diseases with similar symptoms must be ruled out in order to diagnose PCOS.