Polycystic Ovarian Syndrome (PCOS)
Overview
Polycystic Ovarian Syndrome (PCOS) is a hormonal and metabolic disorder that affects women of reproductive age. It is characterized by irregular menstrual cycles, excess androgen levels, and insulin resistance, often leading to fertility challenges, acne, and unwanted hair growth.
PCOS is a hereditary condition, influenced by both genetic and environmental factors such as diet, activity level, and weight.
Causes and Risk Factors
The exact cause of PCOS is multifactorial, but the underlying mechanism is hormonal imbalance—particularly involving insulin and testosterone.
Insulin resistance causes the body to produce excess insulin, which stimulates the ovaries to make more androgens (male hormones).
Elevated androgens disrupt ovulation and contribute to PCOS symptoms.
Genetics plays a major role: women with a mother or sister with PCOS are more likely to develop it.
Obesity increases insulin resistance, further worsening hormonal imbalance.
Common risk factors include:
Family history of PCOS
Obesity or weight gain
Sedentary lifestyle
Insulin resistance
Treatment Options
There is no cure for PCOS, but early diagnosis and proper management can reduce symptoms and long-term risks.
The key goal of treatment is to improve insulin sensitivity and hormonal balance through a combination of medical therapy and lifestyle changes.
Cascades Hormone Optimization Treatment Approach
We tailor each treatment plan to the individual, focusing on optimizing hormonal balance and metabolic function.
Our strategies include:
Insulin sensitizers (e.g., Metformin) to improve glucose control and promote weight loss
Bio-identical progesterone to support hormone balance (preferred over synthetic progestins found in birth control pills, which may increase breast cancer risk)
Thyroid optimization to support metabolism and energy
Spironolactone to reduce excess hair growth, acne, and inflammatory cytokines associated with obesity
Lifestyle interventions: increased physical activity, improved nutrition, and weight management
Symptoms
PCOS can vary widely between women, but common symptoms include:
Irregular periods: infrequent, prolonged, or absent menstruation
Hirsutism: excess hair growth on the face, chest, or back
Acne: especially on the face, chest, or upper back
Weight gain or difficulty losing weight
Thinning hair or male-pattern baldness
Infertility or irregular ovulation
Mood changes: depression, anxiety, or low motivation
Hormone Therapy
Medical therapies for PCOS can be hormonal or non-hormonal:
Non-hormonal: weight loss, dietary changes, and exercise improve insulin sensitivity and may restore normal cycles.
Hormonal: instead of traditional birth control pills, we recommend bio-identical progesterone therapy for safer and more physiologic hormone regulation.
Fertility Considerations
For women wishing to become pregnant, restoring ovulation is essential.
Weight loss and improved insulin sensitivity often normalize cycles.
Metformin can help lower insulin levels and support ovulation.
Progesterone optimization supports a healthy uterine environment for implantation.
Ready to find clarity and take control of your PCOS symptoms?
