When we think about polycystic ovary syndrome (PCOS), we often focus on the elevated testosterone levels associated with the condition. But did you know that PCOS also involves imbalances in oestrogen? In fact, women with PCOS often experience prolonged exposure to high levels of oestrogen due to an extended follicular phase. This extended phase can contribute to many of the symptoms associated with PCOS.

Let’s take a closer look at how oestrogen plays a significant role in PCOS, how this prolonged follicular phase leads to oestrogen dominance, and why it’s important to consider hormonal balance beyond just testosterone.

PCOS: It’s More Than Just High Testosterone

Yes, elevated testosterone is a hallmark of PCOS, but it’s not the only hormone at play. In women with PCOS, the menstrual cycle is often disrupted. Specifically, the follicular phase, which is the first half of the cycle where oestrogen rises to prepare for ovulation, can become much longer than normal. When ovulation doesn’t occur regularly or at all, the body experiences a prolonged period of high oestrogen without the counteracting effects of progesterone, which rises after ovulation, released from the corpus luteum.

This extended exposure to oestrogen contributes to many of the symptoms experienced by those with PCOS, but aren’t always easy to be explained by the evelated levels of insulin and testosterone. So keep in mind it’s not just about high testosterone—oestrogen plays a big role, too!

Signs of Excess Oestrogen in PCOS

If you have PCOS, you might be familiar with some of the signs of oestrogen dominance, such as:

• Breast tenderness
• Heavy or prolonged periods
• Bloating or water retention
• Mood swings and irritability
• Weight gain, especially around the hips and thighs

These symptoms are the result of an imbalance between oestrogen and progesterone. When oestrogen is allowed to remain elevated for too long without progesterone to balance it out, you may start to notice these classic signs of oestrogen dominance.

The Phases of the Menstrual Cycle

To understand how oestrogen dominance happens in PCOS, let’s briefly review the phases of a normal menstrual cycle:

1. Menstrual Phase – This is when you get your period, and the uterine lining is shed.
2. Follicular Phase – Oestrogen rises as your body prepares for ovulation. For many women with PCOS, this phase can be prolonged.
3. Ovulation – Ideally, a mature egg is released during ovulation. Oestrogen needs to peak in order to trigger a surge of LH, which then triggers the egg to be released from the follicle. For many women with PCOS, ovulation doesn’t occur regularly, leading to what’s called an anovulatory cycle, or an extended follicular phase.
4. Luteal Phase – After ovulation, the remainder of the follicle from which the egg from release – the corpus luteum – releases progesterone. Progesterone levels rise in the luteal phase, which balances the effects of oestrogen. However, if ovulation doesn’t happen, there’s no significant rise in progesterone, leading to relative oestrogen excess.

In PCOS, it’s common to have anovulatory cycles, meaning ovulation doesn’t occur, and the body doesn’t produce the necessary progesterone to balance out the high oestrogen levels. This leaves many women stuck in an extended follicular phase with prolonged exposure to oestrogen.

How Testosterone Can Convert to Oestrogen

Another important factor to consider in PCOS is how testosterone can be converted into oestrogen. This happens through a process called aromatisation, where testosterone is transformed into oestrogen in the body’s tissues, including fat cells. For women with PCOS, who often have elevated levels of testosterone, this can result in more oestrogen being produced, contributing further to the oestrogen dominance that many experience (Xu et al., 2024).

Increased Sensitivity to Oestrogen in PCOS

Interestingly, not only are oestrogen levels higher for longer in many women with PCOS, but there’s also evidence to suggest that their oestrogen receptors are more sensitive. This means that even if the levels of oestrogen aren’t dramatically high, the body may respond more strongly to it, intensifying the symptoms of oestrogen dominance (Xu et al., 2024). This heightened sensitivity further contributes to the hormonal imbalance that can make PCOS so challenging to manage.

The Impact of Endocrine Disrupting Chemicals (EDCs)

As if managing PCOS wasn’t complex enough, exposure to endocrine-disrupting chemicals (EDCs), such as bisphenol A (BPA), can further complicate the hormonal picture. Research has shown that women with PCOS often have elevated levels of BPA in their plasma, urine, or follicular fluid. BPA can mimic oestrogen and bind to oestrogen receptors, increasing their activity. This leads to more pronounced symptoms of oestrogen dominance and is linked to insulin resistance, polycystic ovarian morphology on ultrasound, and even markers of chronic low-grade inflammation (Srnovršnik et al., 2023).

If you have PCOS and are concerned about environmental factors like EDCs, it’s worth considering ways to reduce your exposure to BPA and other hormone disruptors, as these chemicals may worsen the hormonal imbalances associated with the condition.

Read more about endocrine disrupting chemicals and their impact on hormones and fertility here and here

Low SHBG Levels in PCOS and Its Effect on Oestrogen and Testosterone

Another key factor in PCOS is the role of sex hormone-binding globulin (SHBG). SHBG is a protein that binds to hormones like oestrogen and testosterone, controlling how much of these hormones are “free” and active in the body. Women with PCOS tend to have low SHBG levels, meaning they have more free (unbound) oestrogen and testosterone circulating in the bloodstream. This not only contributes to higher androgen symptoms (like acne and male pattern hair loss) but also increases the effects of oestrogen on the body (Emanuel et al., 2022).

Want to Learn More About PCOS?

If you’re dealing with PCOS and want to dive deeper into understanding how these hormonal imbalances affect your health, I’ve written several other blog posts on this topic. Check them out here:

Busting PCOS Myths

A Holistic Guide to PCOS

If you’d like to know more about hormones and how they affect your health and wellbeing, and how you can support your hormonal wellbeing and cyclical health, I would love you to look into my e-course The Cyclical Woman

Final Thoughts

PCOS is a complex condition that involves more than just high testosterone. The extended follicular phase, lack of progesterone due to anovulation, increased aromatisation of testosterone to oestrogen, and heightened oestrogen receptor sensitivity all contribute to the hormonal imbalances experienced by those with PCOS. By understanding how oestrogen plays into the bigger picture, you can take steps to manage your symptoms more effectively and work towards achieving better hormonal balance.

References

Emanuel, R. H. K., Roberts, J., Docherty, P. D., Lunt, H., Campbell, R. E., & Möller, K. (2022). A review of the hormones involved in the endocrine dysfunctions of polycystic ovary syndrome and their interactions. Frontiers in Endocrinology (Lausanne), 13, Article 1017468. https://doi.org/10.3389/fendo.2022.1017468

Srnovršnik, T., Virant-Klun, I., & Pinter, B. (2023). Polycystic ovary syndrome and endocrine disruptors (bisphenols, parabens, and triclosan) – A systematic review. Life (Basel), 13(1), 138. https://doi.org/10.3390/life13010138

Xu, Y., et al. (2024). Roles of estrogen and its receptors in polycystic ovary syndrome. Frontiers in Cell and Developmental Biology, 12, Article 1395331. https://doi.org/10.3389/fcell.2024.1395331

The post PCOS and Oestrogen: The Hidden Hormonal Imbalance You Need to Know About appeared first on Alison Mitchell Naturopath.

Acne is such a common issue that people ask a naturopath to help with. It can really affect your self esteem, and in some instances can be painful and uncomfortable.

There’s no magic, quick fix for acne whether you see a naturopath or try the conventional medicine route, and sometimes you have to try a few different approaches before finding what works best for you. Typical timelines are often small improvements within two weeks, and more visible results around 3 months. When treating the underlying causes of acne naturopathically, this can sometimes take even longer, however the benefits of treating these underlying causes are often wide reaching.

As with most naturopathic approaches to health issues, it’s about finding out what the underlying cause of the issue is.

In the case of acne, it’s important to consider that skin is connected to other body systems – in particular the nervous system, the endocrine system (that’s hormones) and the digestive system. Imbalances in one or more of these systems will very commonly cause skin problems.

I’ll talk in more detail about these systems later, how to tell whether they’re the issue for you, and what you can do to help them.

Listen to the audio of this article here

It’s been a hot minute since my last episode of Guts and Girl Bits, I have been occupied with my busy home clinic and I have also been writing some e-courses, which I will talk a bit about later. Of course, I have also been spending time with family, would you believe my youngest Lara is now in Kindergarten? How time flies!

It was almost a year ago I started planning this podcast episode but I got rather distracted by everything else. However I’ve had some spare time to sit down and record, and I am hoping to stay on this momentum and release some more podcasts in the next few months. Please get in touch if you enjoy these podcasts, and if you have any questions or requests for future episodes I’d love to hear from you.

Sorting out your skin issues can be sooo frustrating when you’re doing it by yourself – do I need to go on medication? Does my diet make a difference? Are my hormones out of balance? Maybe this skin product will help? No, maybe this one, no, this one, no this one. Maybe I need a skin peel? Maybe I need laser? Maybe I need to go vegan? Maybe paleo? Do I need to detox? AUUUGH!

Rest assured you’re not alone, soo many women (and I do treat men occasionally to) come to me at their wits end with their acne.

Naturopathic approaches to any type of health condition always stem from one of the core naturopathic philosophies: treat the cause.

What the cause of acne is may vary from person to person, and that’s where a naturopaths consultation questions come in handy – delving into the different body systems like gut health, nervous system health and hormones, and sometimes using functional testing to get to the bottom of it. I’m going to try and give you some clues about it later so you can get a bit of an idea for yourself, and I will also discuss some of my favourite treatment options.

Emunctories

When it comes to root cause medicine, the way that the body is able to eliminate waste is an important consideration for any skin concern.

Naturopathic medicine is built around a set of philosophies, and one of these is the theory of emunctories.

The term emunctories is a bit of a funny word, but it refers to an organ or duct that removes or carries waste from the body.

Traditional naturopaths often consider the theory of emunctories when establishing a treatment plan, they may not use the term emunctories (I do, I think it’s a fun word to say, can you tell, I’m saying it a lot) but we always want the body to be eliminating waste efficiently, and to minimise the burden on our elimination systems. If our eliminatory system is unable to handle the load that is placed onto it, this will cause symptoms to express.

The emunctory system exists in tiers. These tiers will prioritise the primary emunctories, and if that system is overloaded it will progress downwards.

Primary emunctories are the main channels of elimination of the body that we want to be carrying the majority of our waste burden.

The primary emunctories are:

• Sweat
• Through the liver and intestines, passing bowel motions
• Through the kidneys and bladder, urination
• Through our breath

We can support our primary emunctories by drinking adequate water, eating lots of fibre and supporting our gut microbiome, breathing exercises, sweating through exercise or saunas.

The secondary emunctories include the skin and the mucous membranes of the urogenital tract, the respiratory tract, the digestive system. If our primary emunctories are overloaded or not working effectively, then toxins can be excreted through the secondary emunctories. This often shows itself as skin conditions, phlegm, diarrhoea (usually this may be a bit more mucousy).

What can commonly occur is that symptoms that express on this level are treated with suppressants, for example cortisone based creams, decongestants or cough suppressants.

If the secondary emunctories are suppressed or unable to cope, symptoms may start to appear in other areas such as in menstruation, emotions, swollen lymphatic glands, fevers and other irritations of mucous membranes.

So if we were to look at treating acne in keeping with this philosophy of emunctories it would look like this:

1. Making sure you’re eliminating properly through your bowels, by working on your diet and using herbal medicines that support this
2. Using herbs that are classed as ‘depuratives’ – these are herbs such as burdock and clivers, and they help to improve the elimination of the primary emunctories
3. Drinking plenty of water to support kidney function
4. Encouraging good lymphatic flow with lymphatic drainage techniques and exercise
5. Making sure you’re getting your sweat on – exercise or saunas

The importance of the gut

So let’s talk a bit about the digestive system how does that affect acne. It’s no secret that the health of your gut will impact on almost every system of the body, so of course it affects skin. There’s a few ways in which it can do this.

Think back to what we talked about with the concept of emunctories and how important that is. An overburdened digestive system will overburden the emunctories, leading to skin congestion and inflammation. Your skin is like a looking glass to your gut health.

Gut health impacts on hormonal health. Oestrogen has to be metabolised through the liver and bowels, and if that’s not eliminating effectively than oestrogen doesn’t get fully eliminated, instead it gets recycled in a more active form, and too much oestrogen will have a proliferative effect on your acne.

Intestinal permeability, or leaky gut, can cause inflammation, often via histamine excess. Histamine and inflammation will often show up as redness and acne. Histamine will also be driven up by oestrogen, which is why acne may be worse at certain times in your cycle.

One of the subtypes of acne which is caused by a fungal overgrowth often goes hand in hand with an altered gut microbiome.

Gut issues are linked to other types of skin condition as well such as eczema psoriasis and rosacea.

Clues that your gut may a problem for your skin health:

• You experience gut symptoms like bloating, altered bowel motions, IBS, gas.
• You experience fungal infections such as thrush or tinea.
• Your acne flares up after eating certain foods
• Your acne is mostly around forehead, mouth and cheeks.

Improving gut health

The main things that we want to be focusing on when improving your gut function is

• making sure that you’re digesting food appropriately with good levels of digestive acids and enzymes
• ensuring that you have the right balance of gut bacteria, and that you are absorbing your nutrients effectively as well
• supporting the lining of the gut health with herbs and nutrients
• avoiding highly inflammatory foods and any foods that you might be intolerant to as these will aggravate inflammation worsening any type of skin condition.

The nervous system

Does stress cause health issues? I’ve heard this concept dismissed a lot, but I am a firm believer that yes, stress can cause physical symptoms, especially things to do with the skin.

When we’re going through high periods of stress we will experience impacts on our inflammation levels due to an increase in our cortisol and histamine levels, and our reproductive hormones can be affected which increases sebum and keratin production, and increased hormone sensitivity in your skin.

Stress will also impact on our gut health, which will contribute towards skin inflammation and increased chance of skin infections.

Signs your nervous system could be a player with your skin health:

• Feeling like you’re constantly on edge
• Oversensitivity to sensory stimulation e.g. noise
• Brain fog, difficulty thinking clearly
• Poor quality sleep
• You’ve been living off coffee and stimulants
• Feeling out of balance emotionally, anxious or depressed
• Fatigue
• Low libido

How to support your nervous system

1. Make sure you’re doing fun things and laughing, as these are great ways to burn off your stress hormones
2. Try to reduce sources of stress, if that’s at all possible – maybe that might be asking for help with something that is putting a burden on your shoulders.
3. Make sure you’re eating enough – low calorie, and nutrient poor diets can be a source of stress to the body. Similarly for those who are in need of nervous system nourishment, focus more on weight training and low intensity exercise rather than high intensity exercise.
4. Get plenty of sleep
5. Practice screen boundaries
6. Practice mindfulness exercises each day
7. Get someone to talk to, perhaps a psychologist or a counsellor.

Stress can have such a big role on our health that I consider it to be one of the most important things to address. I have created an online group Naturopathic program that provides individualised care in a group setting, focusing on the pivotal factors for a healthy nervous system and adrenal gland health. If you are feeling like your nervous system needs some nourishment, I’d love for you to join me in my program Beat Burnout.

Hormone Balance

One of the most well known hormones that cause acne is testosterone. Testosterone and it’s family of hormones, androgens, cause acne by binding to receptors in the skin, increasing oil and keratin production, resulting in oilier skin with a potential for blocked pores. The bacteria (and sometimes fungi) which causes inflammation in our skin loves to feed on this, so extra fuel for the bacteria means the bugs grow, triggering an immune response in the area, resulting in more acne.

If you have a irregular periods, hirsutism (excess hair growth, such as chin hair) or have been diagnosed with PCOS there’s a good chance that high testosterone levels are a driver for your acne.

If your acne tends to get worse around the time that you are ovulating as well as when you are about to get your periods but then gets better when you start your period that’s a sign that the fluctuating levels of oestrogen are playing a role.

We need oestrogen, it can be our best friend but if we’re not metabolising or excreting it properly then it can elevate histamine, causing inflammation. Oestrogen needs to get metabolised and excreted through the gut to be in a good balance, otherwise it can be too proliferative.

Oestrogen and histamine work closely together when oestrogen is at its highest histamine will follow suit and if you have issues with high histamine that can also cause oestrogen to be high as well.

If you are not ovulating regularly or well, you may not have enough progesterone to counter oestrogen, and lack of progesterone doesn’t help skin health either.

Signs you may have hormonal acne

• Your acne worsens around ovulation or premenstrually
• Acne is located on the chin, jawline, back and chest
• Your period is irregular or painful
• You may also experience PMS symptoms
• You have oilier skin than normal
• You have thicker, coarser or more hair than normal for your genetics

How to assess your hormones

There are several ways to get an insight into your hormones

I am a big fan of using the DUTCH test, which is performed using urine sample to measure hormone metabolites. It can give you insight into not just the overall level of your hormones, but also the quality of metabolism of your hormones, whether they are being metabolised down the friendly or the angry pathways.

Blood tests don’t look at metabolites but they are very useful to get insight into your overall hormone balance. It’s vital to test on specific times in your cycle to be able to make use of these results.

Testing at day 2 or 3 of your cycle (the 2^nd or 3^rd day of your bleed) will give a baseline of low levels. Test FSH, LH and Oestradiol at this time.

After you ovulate, your hormones will start to raise, and usually peaks 7 days after ovulation, so at this time you want to do another test, measuring progesterone and oestradiol.

At either of these tests you will want to also measure testosterone profile (SHBG, androstenedione, testosterone, DHEA, free testosterone), prolactin, thyroid profile and fasting insulin.

If you are on the OCP, the female reproductive tests will not be reliable by thyroid function and insulin can be measured.

Does your diet make a difference to acne?

Yes, it does.

Your diet can affect your skin in different ways but one of the big drivers of acne we know is inflammation and then another big driver for acne as well is your hormone balance.

It makes sense that if we’re eating foods that are inflammatory then that’s going to make your gut health and acne worse. Inflammatory foods may be foods that you are intolerant to, or it may be foods which are generally considered to be inflammatory.

Some of the big ones for that is wheat and dairy. I often recommend cutting out dairy as a first step when you try to address acne because it reduces inflammation and so you could swap that for almond milk or oat milk or rice milk whatever your preference is. Lactose free milk isn’t really going to make that much of a difference because a lot of the inflammation comes from the protein. Some people find that A2 milk can be helpful for them but initially I recommend cutting it out altogether to get an insight.

After inflammatory foods, bad guy #2 is sugar. Sugar, in particular refined sugar and highly processed foods are an issue because it can increase the production of a substance called insulin like growth factor 1 (IGF-1). This acts to increase the hormones known as androgens in our body such as testosterone and what these can do is make our skin produce more oil and keratin. Rewind back to the section on hormones if you need a refresher on this.

Insulin is an important hormone but when we’re eating a high GI diet it’s often going to be making acne worse so aiming for a low GI diet is going to make a big difference there. Imbalances in blood sugar levels can also trigger cortisol and histamine imbalance so you really want to be keeping your blood sugar levels nice and stable.

If you have a blood test that shows up high levels of insulin then this can actually be a marker that you do have a bit of insulin resistance which is a sign that you really need to get your blood sugar levels back under control. Insulin resistance is a leading cause of high testosterone and PCOS.

Now don’t get me wrong sugar is not all bad I am a big fan of fruit and potato but what we want to avoid is foods that have a lot of sugar and have a lot of refined carbohydrates and not much else and so that might look like ice creams, jams, juices, packaged foods, excessive amounts of white breads and pasta, sauces with added sugar, soft drinks, lollies, cakes and other sweets.

The other important dietary consideration is your fibre and water intake. Because one of the goals when supporting skin health is improving elimination through the gut and supporting our emunctories, you want to ensure that you’re getting plenty of water and fibre.

Fungal acne

Let’s talk about fungal acne.

For some people, the cause of their acne is actually fungul.

Some people experience a little bit of a different type of acne that can be more stubborn and doesn’t respond to the typical types of treatments. One of the reasons that this is so stubborn is that because a lot of skin products that are recommended for conventional acne will feed this fungus.

Fungal acne is also known by the term pityrosporum folliculitis – an infection with a type of yeast called Malassezia which lives in the hair follicles and eats our natural oils and any oil that you happen to apply onto it. This type of acne tends to express itself more on your forehead, and may also show up on your back, chest, shoulders and along the hairline and in the T zone.

When tackling this type of acne the treatment goals are to support your immune system, gut microbiome and balance hormonal health.

If you suspect that you have fungal acne, you may like to try an anti-fungal shampoo or cream which, if beneficial will provide insight into your acne cause.

Q&A Transcript

I did a shout out for some questions when planning this podcast:

One of the submitted questions was how to prevent acne coming off the pill and this is such a fantastic question because it’s a really common thing that people consult with me about. If you had acne before you went on the pill there’s a pretty good chance that you’re going to experience some acne when you come off the pill again. Unfortunately taking the oral contraceptive pill doesn’t always fix any underlying issues that might have caused the acne to be there in the first place but what it does a fantastic job of is reducing the oil production in the skin which means that you’re going to have very little acne if any. When you come off the pill this oil production is going to increase and it gets a little bit confused because you haven’t really been making any oil for however long so it’s like hang on how do I do this how much oil do I have to make again and so it goes a bit crazy and usually it’s going to be crazy for around six months or so then it starts to settle down but there are things that we can do to help reduce the intensiveness intensity of the crazy.

So what can you do if you’re about to come off the pill? I recommend starting with cutting down inflammatory foods and for most people I recommend supplementing with zinc. I typically don’t prescribe hormonal regulating herbs for three months after coming off the pill because I want the body to try and set up that communication through that HPO axis itself but what I do like to do is encourage emunctory support with herbs, support liver function to improve the clearance of the contraceptive and to make sure your lymphatic system and your immune system is happy.

Question 2 – How long does it take to fix acne?

How long remedies may take to fix acne will depend on what the underlying cause is.

In my experience the redness and inflammation will settle down within a few weeks, and then the frequency and severity of breakouts reduces, and healing time improves.
It’s different with everyone, and as much as I wish everyone had great results there are some people who take a bit longer to see changes, and some people who get occasional relapses.

On the whole I find 6-12 months a typical length of time until someone is able to ease off the herbs and supplements, they’re feeling good about their skin at this point. If there’s a lot of scarring this then needs to get sorted with a beautician, especially one who does laser treatments for scarring.

Question 3 – Are probiotics helpful for acne?

Yes, I usually do have a focus on gut health when treating acne, especially if it’s on the cheeks. But probiotics can be helpful.

A general reminder with probiotics is that you want to be strain specific. The code at the end of the probiotic name tells you which species it is, and therefore you understand which role it plays.

Some of the strains I look at using are Lactobacillus salivaris ls-03, lactobacillus rhamonsus LL, lactobacillus casei lc03, and some Bifidobacterium such as the breve br03, or the animalis ssp.

Question 4 – My teenager has acne, I don’t want her to go on harsh medications, is there anything that can be done?

Yes of course! Treating teen acne is not too dissimilar to treating adult acne. We want to be balancing blood sugar levels to reduce it’s impact on hormones, and reducing inflammation by cutting down on inflammatory foods such as dairy, and potentially high histamine foods. Supplements can be handy, for instance zinc, vitamin B5, inositol and or berberine rich herbs.

A summary of my favourite treatments for acne:

• A probiotic specific for acne health
• Balancing mineral health – typically this may be zinc, but in some cases copper may be needed. You can use a HTMA to assess mineral levels
• Support gut function with gut healing nutrients and diet
• Lower inflammation by eating a low dairy, or low histamine diet
• If hormones are out of balance you can address this. Here is where it gets a bit more individual. Ensuring good ovulation is an important first step. Some common nutrients I provide for this is inositol which supports blood sugar level balance and ovulation. Zinc has an anti-androgen effect and can be helpful.
• Balancing omega- fatty acids through diet, and potentially supplements.
• Herbal medicine to support emunctories, stress levels and hormone balance, as well as reduce infection and support immune health. Some common herbs I opt for are Coptis, which is rich in berberine, Chaste tree, if indicated for ovulation, Withania for stress support, burdock as an emunctory support.

Thank you for listening, if you have enjoyed this episode please leave a review, subscribe if you haven’t already and as always feel free to get in touch.

The post A Naturopath’s Deep Dive Into Acne appeared first on Alison Mitchell Naturopath.

PCOS, also known as Polycystic Ovarian Syndrome is a complex condition that can significantly affect a woman’s quality of life. One of the biggest ways it does this is by impacting on a women’s ability to conceive and maintain a pregnancy, but it can also impact a woman’s self-esteem by making it difficult to lose weight, it causes acne and hair issues, such as too much hair where a woman doesn’t want it to be, and potentially thinning of scalp hair.

Of course, there is more to it than that, but those are the major things that women report as the issues they’re most upset by.

In this article and podcast I will discuss the lack of awareness and poor understanding surrounding PCOS, how it is often misunderstood and why its name has a role in this. I discuss the common, and not so common signs and symptoms of PCOS and talk about the driving factors that can cause PCOS to develop. I talk about how PCOS is often diagnosed and discuss some of the key ways PCOS can be addressed naturally.

You can listen to this article on the podcast links below, or in the embedded player.

iPhone   Stitcher   Youtube   Soundcloud  Spotify 

Understanding PCOS

Lack of awareness

Sadly, but not unexpectedly there is a lack of awareness and understanding of PCOS, with many people who have not been diagnosed not aware of the condition at all, but also women who have been diagnosed, and some health practitioners as well, not properly understanding the condition. A big part of this lack of awareness is the lack of research into the condition, but also I believe it is part of the bigger picture of gender bias in medicine, and many conditions that are specific to women do not have the attention they deserve, perhaps the exception being breast cancer. One of the other things that doesn’t help this lack of awareness and understanding is the name of the condition itself – polycystic ovarian syndrome.

The name makes a few false implications which cause overall confusion – so here are a few points I want you to know:

1. The condition doesn’t originate in ovaries and the condition is not all about ovaries either, after menopause, the condition can persist. It is more of a metabolic condition, with systemic high androgens and insulin resistance being the core drivers.
2. A PCOS ovary doesn’t actually have ‘cysts’, rather what you can see on ultrasound is immature follicles. Follicles are the little sacks that your oocyte, or eggs sit in waiting for the hormones from the brain to tell it to mature and then ovulate. The issue is these follicles in PCOS is they aren’t developing properly, so if we got them to develop fully these so-called cysts would be a baby (if met with a sperm).

A new name?

Many physicians and researchers have proposed a name change for PCOS, however, that was being proposed in 2013 and it’s 2020, so who knows when that will happen. I agree the condition does need a name change, as I feel PCOS is not a good representation. One of the names suggested which I like is ‘metabolic reproductive syndrome’, however other names suggested were Poly-follicular ovarian syndrome with metabolic dysfunction and/or hyperandrogenic manifestations (PFOS-MD and/or -HM).

The list of potential signs and symptoms is long for PCOS, which explains why there are so many women out there that don’t know why they have the symptoms they do.

PCOS Symptoms

Most common symptoms of PCOS include:

• Irregular periods or absent periods
• Acne
• Weight gain
• Excessive hair growth, also known as hirsutism. This can vary in locations and intensity and it will also be different dependant on your nationality.

Less well known, but still common symptoms:

• Anxiety and/or depression
• Fatigue
• Brain fog
• Skin tags
• dark patches on the skin
• low libido
• Sleep disturbances and snoring (Sleep apnoea can also be more common due to the higher level of androgens. Poor sleep can worsen PCOS by worsening insulin resistance.)

And more than that, there are other complications, especially regarding fertility and baby’s health. The higher levels of androgens can increase the risk of miscarriage and are also linked with some increased risk for baby such as higher birth weight. Women with PCOS also tend to have difficulty with breastfeeding and a higher risk of diabetes after birth.

Thankfully, many of these risks are modifiable by correcting the underlying causes of PCOS, which I will discuss later.

Causes of PCOS – How does the switch get turned on

There are different ways PCOS can express, and for these different subtypes, there are different causes.

The main cause is insulin resistance, which causes the male hormones androgens to become high. Insulin, when it is too high, can trigger more production of testosterone, but it can also lower the amount of SHBG (sex hormone-binding globulin) which means our bodies can’t bind up the excessive testosterone as well, and so more is circulating our body, causing the symptoms of PCOS such as acne and hair issues. Insulin excess also affects our FSH : LH ratio which is important for ovulation, and high testosterone stops our follicles from maturing completely, so this means woman’s ability to ovulate is affected, and if that is affected their chances of conceiving is reduced, and oestrogen and progesterone balance is also affected.

There are different types of androgens, such as testosterone, DHEA and androstenedione, and depending on which one is elevated we can get an idea of what is driving your PCOS. For instance, if DHEA is high, we know that stress is a big driver.

It is also possible to have PCOS without insulin resistance and this is typically due to inflammation. this is a much rarer subtype, but certainly something to consider.

Something else to consider is your gut health can play a role in both hormone balance and metabolism. Your gut bacteria are responsible for so many things in the body, and if you’ve listened to my previous podcasts or read some of my other blog posts you’ll know that your microbiome is of vital importance in improving health. How does it affect PCOS? Well, if your microbiome is out of balance it can affect your metabolism, which can worsen insulin resistance. And an out of balance microbiome can also cause hormone problems, by allowing more of your ‘bad’ hormone metabolites to cycle back through the body.

Why do you have a PCOS ‘switch’ in the first place?

We know there is a genetic component to it, and there is some possibility that your genetic likelihood can be influenced by exposure to endocrine-disrupting chemicals in past generations, substances that are passed through generations. So effectively, what chemicals and diet your Grandmother was exposed to will impact your risk for PCOS.

This transgenerational effect has been demonstrated in animal studies when mice were fed an obesogenic diet and were given substances that mimic a high androgen state to bring about a metabolic state of PCOS, and it was found that their subsequent generations also expressed this condition.

It was also found that women with PCOS had levels of chemicals in their system that were not in use anymore and was found to have been passed through in utero from their mothers and grandmothers.

These chemicals are increasing the activity of the androgens and also acting as obesogens, contributing to the weight gain and insulin resistance.

Diagnosis issues

So how common is PCOS? The prevalence is about 8-13%, effectively 1 in 10 women. But it is a condition that is it is both over-diagnosed in young girls, and under-diagnosed in older women.

One of the issues in getting diagnosed is that there isn’t one specific diagnostic criteria, so you can get mixed messages.

Three main diagnostic criteria exist- the National Institutes of Health, the Rotterdam criteria and the Androgen Excess Society criteria.

All of the criteria require all other possible endocrine disorders to be excluded.

My criteria of choice is the Rotterdam diagnostic criteria. It requires a female to have two of these three criteria:

1. Irregular periods
2. Clinical and/or biochemical hyperandrogenism
3. “Polycystic ovaries”

Many young girls are being prematurely diagnosed with PCOS. But it is normal for young girls to present with some symptoms of PCOS and this often resolves in a few years without intervention. It can take 3-6 years for a menstrual cycle to regulate itself, however if there is early intervention this can prolong this process, and it is thought that the most common recommendation given at this time – the oral contraceptive pill (OCP) can worsen insulin resistance, which perpetuates the condition.

What are the other causes that need to be excluded?

This could be conditions such as Cushing’s, Adrenal tumours or congenital adrenal hyperplasia. Screening would include blood tests for TSH, prolactin, FSH and anything else your practitioner feels warranted based on your signs and symptoms.

PCOS and Teens

Getting back to teenage girls and their periods, it’s not uncommon for girls to have irregular periods when they’re young, and this will usually regulate itself within 6 years. My personal preference in clinic is to not interfere with hormones in young girls but to allow their bodies to regulate themselves. If hormones are interfered with too early, then it will typically delay the regulation until later. This is relevant to not just herbs, but especially to things such as hormonal contraceptives.

A common understanding is that women with PCOS literally have cysts on their ovaries. But this isn’t the case, as the name implies. the polycystic ovarian appearance that some (but important to note, not all) women have on ultrasound is actually a higher count of immature eggs within their follicles. These eggs aren’t getting the signal from the brain to mature further, triggering ovulation and release.

If you can remember the diagnostic criteria, the presence of 2 of the 3 criteria is what it takes to get diagnosed, so if a woman has irregular periods and signs of high androgens, she can have PCOS without the presences of any ‘cysts’ on her ovaries at all.

A more positive perspective.

One of the perspectives I have heard before about PCOS which I love is that this is an evolutionary trait which in years gone by was protective. if you consider that being pregnant and giving birth was a life-threatening thing at worst, and a depleting event at best, it can make sense why a condition like PCOS which can reduce one’s fertility may be protective in tough times. Insulin resistance is beneficial in times of scarcity as it allows you to store more of the energy from foods, which in famine times if beneficial. In times of plenty such as now, this, unfortunately, works against us. In a time without contraception, women may have gone from one baby to the next without a break, which can be quite a high level of stress and depletion. So, for women with PCOS who have longer times between ovulation, and so fewer opportunities to conceive, this could be considered a positive thing. Nowadays this might not be much comfort especially if you’re wanting to conceive, but I believe anytime you can view your health from more a positive light it is beneficial, so ladies with PCOS you might like to shift your frame of thinking to more of an ‘I’m a survivor’ mindset.  

Other considerations for PCOS

Sleep

Sleep disturbances are reported to be twice as likely for women with PCOS. Studies show found that women with PCOS are more likely to report difficulty falling asleep, to have restless sleep occasionally and often feel severely tired. Sleep problems also occurred in women with PCOS who were in the normal weight range.

It’s still unclear how PCOS affects sleep but we know that the metabolic impacts of the condition play a big role. The hormones melatonin and cortisol are responsible for our sleep cycles to a large degree and these are strongly influenced by insulin resistance and elevated testosterone, as well as the stress placed on the body if obese.

Sleep apnoea is also often reported in women with PCOS, more often in those who are overweight. In those people who are considered to be ‘severely obese’, (BMI >40kg/m2) the prevalence of sleep apnoea in both men and women can be as high as 92%.

The mental health impacts of PCOS which is an increase of anxiety and depression have a bidirectional association with poor sleep quality and insomnia.

Weight loss and exercise is one of the best ways to improve sleep quality in women with PCOS, and if needed there are herbal medicines which can be of support.

Nutrients such as magnesium and calcium and the amino acid l-theanine can also be supportive to calm the nervous system and promote relaxation and sleep.

PCOS and Mental Health

Women with PCOS have higher rates of anxiety and depression. PCOS can be a very distressing condition for many women and this varies from person to person, with some of the highest reported contributors to the anxiety and depression is the impact to fertility, the impact on physical appearance and self-esteem such as weight issues, hirsutism and acne, and also the frustration about the lack of a clear cut solution, and a lack of awareness and understanding of the condition. There was a study that found that women with PCOS were physically active reported less depression and anxiety than those who were inactive. So, while I love to use herbal medicines to support mood and the nervous system, I do frequently recommend exercise to support mood in women with PCOS.

Potential pregnancy risks

There are a few things to consider when trying to conceive, as women with PCOS have an increased risk of some complications during pregnancy. The good news is that if PCOS has been treated, these risks return to almost the same levels as women who do not have PCOS. The risks include an increased likelihood of developing gestational diabetes, pregnancy-induced hypertension and preterm birth, and an increased risk of neonatal complications.

The increase in birth weight of babies born to women with PCOS also suggests an increased likelihood of c-section deliveries.

The treatment used in the study I mentioned before was anti-androgenic therapy, which means correcting hormonal balance before conceiving will improve pregnancy outcomes.

one small study looked at the incidence of gestational diabetes in women with PCOS and found the prevalence was 30.2%, and that these women had impaired blood sugar levels after having their babies. What we can take from this is that PCOS can have a long term impact on glucose metabolism, and again it highlights how important it is to try and take steps to improve your hormones and blood sugar level balance before conceiving.

I recommend that all couples do a preconception care program before conceiving, which at a minimum entails taking a high quality preconception care nutrient complex for 3-4 months before conceiving but if there are hormonal imbalances its important to work on this with a practitioner before trying to conceive.

Complications with breastfeeding

A lesser-known complication with PCOS is that it can cause some difficulties with breastfeeding and milk supply – however, this can also be supported by working on hormones before pregnancy, and with the support of a lactation consultant after birth. Thankfully not all women with PCOS experience difficulties breastfeeding and the information that says it is potentially problematic is only based on small studies. In the research that we do have available, the breastfeeding difficulties were only experienced in the first 3 months and seemed to regulate after that time.

Breastfeeding requires the hormones prolactin and oxytocin to work properly, but we also need adequate progesterone during pregnancy for the breast tissue to develop properly. Insulin resistance and high androgens can affect hormones in all these aspects.

How to manage PCOS

There are so many options for treating PCOS, and as it usually the case with naturopathic remedies, you get the best results when you are treated holistically. This means considering various things like what exactly is happening with your PCOS subtype.

The information I am giving you is a starting point to take to your practitioner to discuss whether it is right for you and to give you hope that there are so many possibilities to help.

while there have not been studies finding some remedies that tend to be universally helpful for most PCOS sub-types, and one of that does seem to be of great benefit is the amino acid Inositol. Taking 2g twice a day is my recommended dose for this.

Diet and lifestyle changes are great for treating insulin resistance, and while it’s tricky to find research specifically for this in PCOS we know it helps address the cause.

I recommend 150 minutes of exercise a week, which can be split into small blocks of exercise such as 30 minutes 5 times a week, or larger chunks such as 50 minutes three times a week. Eating a low GI/GL diet is also very important to address insulin resistance, and having a diet rich in antioxidants and low in inflammatory foods is also very helpful.

If you are overweight and have PCOS, then aiming to lose 5-10% of your body weight is a fantastic goal, and this amount seems to be the magic number that improves fertility rates and reduces risks for diabetes. Losing weight ideally would be done through a combination of diet and exercise.

Nutrients such as magnesium, b vitamins, particularly activated B vitamins, vitamin D and chromium can also be helpful.

Omega-3 fatty acids such as fish oil or algae oil can also help with some of the components of PCOS such as high cholesterol and inflammation.

Other herbs that I would consider is Berberine containing herbs such as Phelledendron which helps with improving insulin resistance and regulates blood lipid levels. There is also evidence showing that Black Cohosh can be helpful alongside other PCOS treatment.

The combination of Peony and Licorice has been looked at in Chinese medicine studies, and this is still a good inclusion in treatment, depending on the individual. Bulgarian Tribulus can also be helpful to regulate ovulation.

Spearmint can be helpful to reduce excessive androgens. I like this when used in a tea and is why I included it in one of my tea blends that supports skin health, to address this aspect.

Supporting gut health is also very important, as a poor microbiome can impair metabolism and worsen inflammation. So eating a diet rich in vegetables with lots of diversity is fantastic for improving the flora diversity in the gut, but it can also be helpful to take probiotics or prebiotics, so discuss this with your practitioner to make sure you’ve got the right type for you.

References

Bahri Khomami, M., Boyle, J. A., Tay, C. T., Vanky, E., Teede, H. J., Joham, A. E., & Moran, L. J. (2018). Polycystic ovary syndrome and adverse pregnancy outcomes: Current state of knowledge, challenges and potential implications for practice. Clinical Endocrinology, 88(6), 761-769. https://doi.org/10.1111/cen.13579

Bahri Khomami, M, Joham, AE, Boyle, JA, et al. Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta‐analysis, and meta‐regression. Obesity Reviews. 2019; 20: 659– 674. https://doi.org/10.1111/obr.12829

Fernandez, R. C., Moore, V. M., Van Ryswyk, E. M., Varcoe, T. J., Rodgers, R. J., March, W. A., Moran, L. J., Avery, J. C., McEvoy, R. D., & Davies, M. J. (2018). Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies. Nature and science of sleep, 10, 45–64. https://doi.org/10.2147/NSS.S127475

Guerrero-Bosagna C, Weeks S, Skinner MK (2014) Identification of Genomic Features in Environmentally Induced Epigenetic Transgenerational Inherited Sperm Epimutations. PLOS ONE 9(6): e100194. https://doi.org/10.1371/journal.pone.0100194

Guo Z, Qiu H, Wang L, et al. Association of serum organochlorine pesticides concentrations with reproductive hormone levels and polycystic ovary syndrome in a Chinese population. Chemosphere. 2017 Mar;171:595-600. DOI: 10.1016/j.chemosphere.2016.12.127.

Holton, S., Papanikolaou, V., Hammarberg, K., Rowe, H., Kirkman, M., Jordan, L., McNamee, K., Bayly, C., McBain, J., Sinnott, V., & Fisher, J. (2018). Fertility management experiences of women with polycystic ovary syndrome in Australia. European Journal of Contraception and Reproductive Health Care, 23(4), 282-287. https://doi.org/10.1080/13625187.2018.1483020

Mo L, Mansfield DR, Joham A, et al. Sleep disturbances in women with and without polycystic ovary syndrome in an Australian national cohort [published online December 26, 2018]. Clin Endocrinol (Oxf). doi:10.1111/cen.13922

Rosenwaks, Z. (2017). Polycystic ovary syndrome, an enigmatic syndrome begging for a name change. Fertility and Sterility, 108(5), 748–749. https://doi.org/10.1016/j.fertnstert.2017.09.030

The post A Holistic Guide to PCOS appeared first on Alison Mitchell Naturopath.

PCOS affects so many women but it’s not spoken about as much as it should be. This condition has many faces and because of that it can be really confusing to understand.

In this webinar I will help you to understand what’s going on in your body with PCOS , and what you can do to help it.

We will go through :

• What is happening in PCOS
• How is PCOS properly diagnosed
• What are the symptoms you might experience with PCOS
• What are some nutrients that you can take to help with PCOS
• How PCOS affects other hormones
• How you can improve PCOS with your diet
• Herbs that can help with PCOS

The live recording is 26th July 2019 – 12:30pm AEST

If you can’t make the life event there will be a replay available afterwards.

As an extra bonus you will receive 5 healing recipes to help with PCOS.

Related articles:

https://www.naturopathnsw.com.au/busting-pcos-myths

The post All About PCOS – Webinar appeared first on Alison Mitchell Naturopath.

WHAT IS ANDROPAUSE?

It is both scientifically documented and socially accepted that when a woman reaches her mid 40’s to 50’s, she will experience “change of life” or menopause. But did you know that a similar “change of life” can also affect men?

This phenomenon goes by many names: testosterone deficiency syndrome, male menopause, andropause or Partial Androgen Deficiency in Ageing Men (PADAM). This condition affects every male beginning from roughly the age of 40 to varying degrees, however it is a condition that very few people know about.

Colloquially, men experience a midlife crisis and may eventually develop ‘grumpy old man’ syndrome. These somewhat derogative notions are well entrenched in our un¬derstanding of male behaviour. Now at last, we have a medical condition to make sense of it all.

Androgens (Testosterone) peak at 20 and are relatively stable until 30-40, and then they slowly begin to decline. Unlike menopause which leads to a sudden withdrawal of progesterone and a steep decline in oestrogen, testosterone tapers off more gradually but its affects are profound.

Andropause, like Menopause is a normal part of aging although some men who experience this often experience negative symptoms. A common experience is a feeling that they are losing their sense of self.

Men who experience Andropause often feel they have no-one to talk to about this condition. There is a huge lack of awareness of this condition, and more awareness and open discussion about this can help men to realise they haven’t just become a ‘grumpy old man’, that they are not alone, and that something can be done about it.

SYMPTOMS

While women are aware of the approach of menopause because of the cessation of their periods, there is no clear-cut signal for the arrival of Andropause. The condition develops gradually, often resulting in a lack of awareness and diagnosis.

Andropause is responsible for a variety of symptoms such as:

• decreased muscle mass and strength
• decreased bone mass
• decreased libido and virility
• erectile dysfunction
• lower energy
• depressive mood
• anxiety
• insomnia
• difficulty in concentrating, and memory impairment
• hot flushes 1

While not all men experience the symptoms of andropause (just as not all women have difficulty with menopause) if you experience any of the above symptoms it is worthwhile to get your testosterone levels checked to see if your hormone changes are severe (keep reading for more information about testing). If your levels are too low, not only could you experience some of the above symptoms, which are uncomfortable, but decreased testosterone levels are associated with increased risks of osteoporosis, metabolic syndrome/insulin resistance, type 2 diabetes and increased mortality. 2

Keeping this in mind, it makes sense that in order to protect yourself from diabetes, osteoporosis and heart disease as you get older, it is important to keep your testosterone levels healthy.

WHAT ABOUT THE PROSTATE?

One thing you need to know is that testosterone does not cause prostate disease – it is a poorly metabolised form of testosterone called Dihydrotestosterone (DHT) that does! If testosterone caused prostate disease and made you lose your hair, don’t you think that every 20 year old male would be bald? All hormones (including the female hormones) go through several pathways in the body to get to their end form, and it is when problems occur in these pathways (such as if a particular enzyme is missing) that hormones can wreak havoc.

According to the author of a 2009 study that analysed the connection between treating low testosterone and cancer risk: “To date, as documented in many reviews on the subject, nothing has been found to support the evidence that restoring testosterone levels within normal range increase the incidence of prostate cancer. In our experience, during a long-term clinical study including 200 hypogonadal patients receiving a patch of testosterone, 50 patients ended 5 years of treatment and no prostate cancer have been reported.” 3

TESTOSTERONE AND CHOLESTEROL

Testosterone is a steroid hormone, and this is derived in the body from cholesterol. There are several steps involved in making hormones in the body which require certain vitamins and minerals at each stage. However it all starts with the ‘mother hormone’, cholesterol.

We actually need cholesterol to make hormones and in some cases the body will increase its production of cholesterol in response to low hormone levels. It certainly makes you think… Is cholesterol rising because of hormone deficiencies? Does lowering cholesterol with medications result in a drop in our ability to make hormones?

There is much that can be said about cholesterol and the best way to manage it, and this goes beyond the scope of this article. If you or your man has problems with cholesterol, consider that andropause might be contributing to it. Similarly if you or your man is taking cholesterol lowering medication over a long period of time, watch out for changes in hormone levels. As this can be a much more complicated issue, always discuss concerns and treatment with your health care practitioner.

TESTING FOR ANDROPAUSE

When testing for Andropause, the right test needs to be done. If ‘total testosterone’ only is checked, the results will invariably come back indicating that your testosterone levels are fine. This is because Andropause causes more of a man’s testosterone to be bound to Sex Hormone Binding Globulin (SHBG) which is not available for use in the body.

Only ‘free testosterone’ which is not bound to SHBG is available for use in the body, therefore ‘free testosterone’ is the only effective marker of Andropause. When screened for ‘free bioavailable testosterone’ a man with these symptoms will typically show a testosterone deficiency.

In the past the test for ‘free testosterone’ was not very accurate and the results were too variable. Today, there are excellent screening techniques which can be done with either blood or saliva. Saliva tests are non-invasive and are able to measure ‘free’ hormones (those not bound up by proteins in the blood). If you think that you or your man may have andropause, talk to your healthcare practitioner about getting tested.

TREATMENT

The first step is diagnosis which can be obtained with blood or saliva testing from your healthcare practitioner (see Saliva Testing under ‘Testing’ on http://www.naturopathnsw.com.au for more information).

The next step is treatment.

Naturopathic management of Andropause depends on the individual and the symptoms that they are experiencing, but core treatment focuses on supporting hormone balance and healthy conversion of testosterone pathways (making sure it doesn’t turn into the evil DHT).

Every pathway and process in the body consists of a biochemical reaction or equation. With that particular reaction nutrients are required at each and every single step of the way. A naturopath can use various nutrients and prescribe them to rectify and normalise those particular pathways. Vitamins and minerals, when used correctly and in the right form have the ability to support hormone levels and encourage them to convert correctly through their pathways.

There are some excellent herbs that when used in the right dose and way can support testosterone levels and allow men to regain their ‘sense of self’ (and also help bring their loved one a little sanity too). One of the main herbs used in this condition is Tribulus terrestris. It is very important to ensure good quality and that correct species is used with this herb, so ensure you are getting it from a herbalist who sources good quality medicines.

Naturopaths also aim to support general wellbeing and supporting the person as a whole. In the case of people with Andropause this may also include supporting mood, stress levels, cardiovascular function, healthy circulation, good liver and digestive health and lowering inflammation. When you see a Naturopath they will support you individually.

If you or your man may be struggling with andropause, seek help from your healthcare practitioner today.

Contact me to book a personal consultation

Works Cited

[1] M. Amore, F. Scarlatti, A. L. Quarta and P. Tagariello, “Partial androgen deficiency, depression and testosterone treatment in aging men,” Aging Clin Exp Res., pp. 21(1):1-8, 2009.
[2] B. B. Yeap, “Testosterone and ill-health in aging men.,” Nat Clin Pract Endocrinol Metab, pp. 5(2):133-21, 2009.
[3] J. P. Raynaud, “Testosterone deficiency syndrome: treatment and cancer risk.,” J Steroid Biochem Mol Biol, pp. 144(1-2):96-105, 2009.

The post Andropause – Grumpy Old Man Syndrome appeared first on Alison Mitchell Naturopath.

This article follows on from the previous article, which discussed the thyroid gland and the differences between and over and underactive thyroid. In this article I am talking about how an issue with the thyroid can cause imbalances in the rest of the endocrine system, in particular the endocrine system.

Thyroid Health

 The endocrine system

Endocrine is the term used for the complex system of glands and their secretions (hormones).  The endocrine system includes the glands (pituitary, thyroid, para-thyroid, adrenal and pineal) as well as organs and tissues which are able to produce hormones (fat tissue, the hypothalamus, ovaries, testes, pancreas, thymus, kidneys, stomach, liver, small intestine, skin, heart and placenta).  There is a cross-over between different systems such as in the digestive system which includes organs also classed as endocrine.

 In the previous newsletter I gave you an overview of the thyroid and the differences between hyperthyroidism and hypothyroidism.  In this newsletter I want to give you some information about the ways in which the thyroid can affect the endocrine system over all.

 The endocrine system is all connected and an imbalance in one particular organ or gland can disrupt everything else.  One of the biggest ways that we can see this is looking at the impact of stress.  Have you noticed that when you’re stressed you’re more likely to catch a cold (remember the thymus is an endocrine organ and has a big role in our immunity), break out (the skin is responsive to hormones, pumping out more oil to feed the bacteria that causes acne) and your digestive system can get upset too(the stomach, pancreas and liver are all endocrine organs)!

Thyroid health and the reproductive system.

The thyroid gland is another big player in keeping our endocrine system balanced.  One of the most common things that an unhappy thyroid will affect is the reproductive system.

In both men and women hypothyroidism can affect libido. In men, they may experience infertility and mpotence.  In women they may experienced an irregular menstrual cycle or irregular bleed.  Fertility is also greatly affected by the thyroid gland especially in women with autoimmune thyroid disease.  It may result in not being able to conceive altogether or an increase in miscarriages.  In women of fertile age, autoimmune thyroid disease is the most common cause of hypothyroidism.

How?

• A reduction in thyroid function will leave to elevated TSH, and depressed secretion of dopamine, leading to elevated prolactin levels.
• Elevated prolactin levels, also known as hyperprolactinaemia is implicated in 1-3% of women with problems ovulating.
• Hypothyroidism interferes with an important hormone for the development of the egg and ovulation – gonadotrophin-releasing hormone (GnRH).
• Hypothyroidism can lead to a delay in luteinising hormone (LH) which causes ovulation and stimulates the secretion of progesterone.  Because of this is can cause a reduction in progesterone synthesis.
• Thyroid antibodies which can be present in both hyperthyroidism and hypothyroidism can affect fertility due to it’s impact on implantation and increasing the risk of miscarriage.  In some people antibodies
  can be present without having any signs of thyroid dysfunction.  Thyroid antibodies can be managed with herbs that modulate the immune system.

Thyroid dysfunction affects the hormones needed for healthy egg development and ovulation, which affects fertility and creates an imbalance in other reproductive hormones.

If you are having difficulty conceiving it is important to assess thyroid function and screen for the presence of antibodies to rule out any complicating involvement from this gland.

If you believe that you have a thyroid problem, don’t despair.  We can assess for and manage a thyroid imbalance using safe, effective natural remedies.

[fb_button]

The post Thyroid Health – Part 2 appeared first on Alison Mitchell Naturopath.