“Spirituality is not a separate part
of us, it is bound up with the body and the whole person, long before
we enter this world. The word “spiritual” is often off-putting or
misunderstood, because it is thought to be something esoteric and hard
to define. But it is not, it is about coming from the heart.”
~ Unknown
PolyCystic Ovarian Syndrome
PolyCystic Ovarian Syndrome or PCOS is acknowledged as one of the most frequent causes of infertility and one of the most common hormonal abnormalities in women. Although the symptoms of PCOS vary widely, it is now recognised that there is a connection between PCOS and metabolic abnormalities, including insulin resistance, hyperinsulinemia, and glucose intolerance. (Futterweit, 2006)
Overseas research suggests PCOS affects between 5 and 10% of all women of childbearing age regardless of race or nationality. However, a Melbourne study published in February 2005 suggests the figure could be much higher, at 12% of Australian women or one in eight women. This means about half a million Australian women and teenagers with PCOS. (www.posaa.asn.au/modules What is PCOS?, cited 4th April 2008)
Disorders resembling PCOS
have been recognised in women for millennia. Hippocrates, in about 400
B.C. described two cases of women with excess hair growth and who
stopped menstruating. In more recent times the ovaries have been
recognised as the hormonal origin of these symptoms. (Futterweit, 2006)
Some people think of „polycystic ovaries‟
as being very large cysts on the ovaries. But the cysts are in fact
quite small. On an ultrasound, they look like black dots on an ovary,
which are eggs that have failed to properly mature and release from the
ovary. But polycystic ovaries are a symptom only, not the cause of
PCOS. (Futterweit, 2006) The many cysts in a polycystic ovary are
follicles that have matured but, due to abnormal hormone levels, were
never released. In a normal ovary, a single egg develops and is
released each month.
www.pcosupport.org/medical/whatis.php, cited 10th September 2008
Syndrome
means a condition that has a number of diagnostic symptoms with no
definitive diagnostic test. Most women with PCOS have a different set
of symptoms. It would be unusual that two women share exactly the same
symptoms. PCOS is a master of disguise. (www.posaa.asn.au, cited 20th
August 2008) The American Society for Reproductive Medicine, states
that “PCOS is defined by having any two of the following signs and
symptoms:
- Lack of ovulation for an extended period of time, which probably manifests itself as the stopping of the monthly period.
- High levels of androgens
- Many small cysts on the ovaries (normal ovaries have 5-6 follicles (cells) whereas polycystic ovaries have ten or more. Polycystic ovaries are detected by ultrasound in 90 percent of women with PCOS.” (www.asrm.org, Fact Sheet, cited 4th April 2008)
In his book, A Patient‟s Guide to PCOS, Dr Walter Futterweit (2006, page 7) lists the following list of possible symptoms of PCOS:
- Hirsutism (excessive hair growth on the face, chest, abdomen, etc.)
- Alopecia – (thinning or loss of scalp hair in women)
- Polycystic ovaries
- Weight gain with tendency to an androidal (apple) shape
- Infertility or reduced fertility
- Irregular or absent menstrual periods
- Low self-esteem
- Acne
- Skin tags
- Gray-white breast discharge
- Sleep apnoea (a sleep disorder characterized by pauses in breathing during sleep)
- Pelvic pain
- Depression, anxiety other emotional disorders
- Other sleep disturbances
The cause of PCOS
is unknown, but studies suggest that women inherit a predisposition to
PCOS. Some other proposed causes are ovarian dysfunction or lifestyle
factors – smoking, alcohol, drugs, inactivity and poor nutrition. There
is much controversy about the origin and cause of PCOS. There may be
more than one cause and this would account for why symptoms vary so
widely. Dr Walter Futterwiet lists the following as the most likely
causes of PCOS:
- A defect in the hypothalamus leading to exaggerated LH pulses that stimulate the ovaries to secrete more than normal amounts of male hormones;
- A defect in the ovarian production of testosterone and other male hormones due to abnormal enzyme action on the pathways leading to testosterone. ;
- High insulin levels (hyperinsulinemia) as a result of insulin resistance, which further strengthens the effect of LH on the ovaries.
- Genetic causes: Forty percent of women with PCOS have a sister with PCOS, and 35 percent have a mother with PCOS. (ibid, page 11)
Excess weight and insulin when combined with PCOS can lead to diabetes and cardiovascular disease among other serious health disorders. Weight gain will usually aggravate PCOS
symptoms. Insulin is a major anabolic (tissue building) hormone of
metabolism, governing glucose regulation, storage of body fat among
other functions. Insulin helps to move glucose from the blood into
cells that need glucose to survive. Insulin also moves glucose to fat
cells which is stored for energy needs. When food is converted to
glucose in the body, the pancreas will release insulin. With PCOS
the body will make too much insulin in response to food and stays at a
high level and causes fat to be stored rather than used as energy.
Hunger will be a response to this as the cells are not getting
sufficient fuel, even though glucose levels are high. (Bussell, 2006)
The hormonal fluctuations underlying PCOS
can mean that it is difficult for women with PCOS to get a full night‟s
restful sleep. Lack of good quality sleep also means you‟re more prone
to tiredness and exhaustion. Anxiety, worry and frustration can also
make it difficult to get a good night‟s rest. With PCOS, blood sugars can fall to low levels overnight, which will result in fatigue the following day. (Bussell, 2006) Women with PCOS
frequently experience strong feelings of anxiety. Shortness of breath,
a rapid heartbeat, trembling, and sweating are among the physical
symptoms of anxiety. The hormonal and metabolic fluctuations underlying
PCOS can wreak havoc with moods
and the physical symptoms such as thinning hair, acne and weight gain
can all contribute to anxiety. The presence of pain in the pelvic area
is one of the symptoms generally not mentioned in reviews of PCOS. But many PCOS
patients complain of such pain. Many women experience acute episodes of
sharp pelvic pain. Walter Futterweit in his book A Patient‟s Guide to
PCOS, notes that “The pain is caused by small ruptures of ovarian
cysts, which irritate the pelvic cavity lining.” (Futterweit, 2006, p
22)
Exploratory qualitative research was conducted where by a
subject, diagnosed with PCOS undertook a 12 week yoga therapy
intervention, where she attended for weekly assessment and treatment.
The treatment involved various asanas, pranayama, relaxation
techniques, lifestyle and nutrition changes. The results of this study
suggest that Yoga therapy can be an effective complementary treatment
of PCOS symptoms.
A larger study would be beneficial to
better evaluate the benefits of a yoga therapy intervention with
relieving symptoms of PCOS.
Written By: Jackie Allen