Ovaries at War
Hello again. I am going to continue to talk about body problems. Sorry. But they’re important! And this is important. I want to get the word out there. Being a woman can be kind of a mess, sometimes.
This fall I was diagnosed with Poly Cystic Ovarian Syndrome (PCOS). PCOS is characterized by a hormonal imbalance that leads to the growth of cysts (rather, follicles) on a woman’s ovaries. Having PCOS sucks, but isn’t the end of the world, because symptoms include: hair loss, male-pattern hair growth, acne, difficulty weight loss, irregular menstruation, decreased sex drive, vaginal dryness, increased risk for diabetes and heart disease, and infertility. The ones that I currently experience are: absent menstruation, decreased sex drive, vaginal dryness, painful acne, and infertility. What’s amazing about this is that an estimated FIFTEEN PERCENT of American women have PCOS. Goodness. Fifteen percent. No wonder I’m one of them.
It’s actually a bit of an anomaly that I have PCOS. Most sufferers of PCOS are older and tend towards obesity. This is because PCOS is marked by excess male hormones such as testosterone in the body, relative to the typically female hormones such as estrogen and progesterone. Older and more overweight women have stressed out adrenal systems and are therefore more prone to chronically high insulin levels, so their testosterone production skyrockets. The best way to treat PCOS, therefore, is to lower insulin levels. Lose weight. Eat fewer carbohydrates. Reduce blood sugar levels. Cool! This appears to be treatable. WITH LOW CARB DIETS, FRIENDS.
Who knew that a low carb diet would be important for womanhood!? But apparently, if we want to be fertile, we have to minimize insulin levels, and therefore our carbohydrate intake. Please, ladies, eat more fat. Eat fewer chocolates. That craving we all get for chocolate is largely a matter of societal conditioning anyway.
Hormones are, more or less, what determine our metabolic health, and our system health in general. In a super simplistic summary: the pancreas secretes insulin to manage blood sugar levels, which spike after carbohydrate consumption. The rest of the adrenal system, including sex hormones, the stress hormone cortisol, and growth hormones are all, more or less, regulated by insulin levels. So over time, if we consume too many carbohydrates (which we typically do), our cells lose a degree of their insulin sensitivity, and we require more and more insulin in order to shuttle away the glucose in our blood. Thus, type II diabetes is born. Thus, hormone levels are disrupted. Thus, a whole slew of metabolic and hormonal problems rush in. Please, please, please, I beg you, take care of your insulin levels.
That said, runaway testosterone levels are a leading cause of American infertility. This isn’t to mention even the overweight, acne, disease, general malaise, and unhappiness all up in our wazoos, too. We barely even fucking know it. Good grief.
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There are, of course, other pathways to hormone imbalance. Insulin insensitivity is one, and stress is another, but another yet is weight loss. This is my problem, I think. Allow me to explain.
It is well known in the medical world that the onset age of menstruation in women is decreasing in developed countries. I began my period when I was 11. The average age today in America is around 11. The average age in Europe, so far as we can tell, in 1860 was 16.6. And before that it was probably even sooner. Why is this happening?
There are many hypotheses for why this is happening. In my opinion, the most parsimonious explanation is that young girls are heavier than they used to be. (An alternative hypothesis is that they have greater health. These two hypotheses are not exclusive.) Estrogen is produced in fat cells. The onset of menstruation is triggered by estrogen levels. Therefore, when girls are fit, this menstruation-inducing estrogen level is achieved first by production in the ovaries. But when girls have extra weight on them, fat-generated estrogen helps boost those levels before the “natural age.” My OBGYN and I believe this is what happened with me. My fat cells gave my ovaries a boost, and I began my period at 11 years old.
However, I believe that this boost ultimately became a crutch. When I got down to an athletic, fit weight last November, I stopped menstruating. I stopped having vaginal discharge. I stopped being fertile. And I stopped having a sex drive. No one, including my doctor, thought that I was underweight. Just…nice. Fine. Whatever. Probably around 19 or 20 percent body fat. What’s remarkable is that, since then, if I have ever inched up in weight around 10 pounds, I have felt symptoms of reproductive reactivation. Clearly, this means that carrying more fat fixes, at least to some extent, my male/female hormone imbalance. My fat cells are giving me the estrogen levels I grew up used to having, and my body is recognizing this as a natural state. My ovaries are broken, and it’s because I grew up heavier than I am now. If I want to reproduce, all I have to do, probably, is put on weight. But that’s not… I don’t know. Fair. And it’s frustrating. And I’m certainly not the only woman I know who has experienced such a phenomena. If my doctor and I are right, we are coddling our ovaries when we are very young, and paying for it in upset hormone balances when we’re older. This is not okay. I am not down with PCOS in any sense of the word.
I have recently gotten on some estrogen pills. They are making up for my ovarian under-production. And perhaps in time my body will adjust its hormone levels naturally to function properly. But…well. Okay, I guess I have a couple of takeaway messages:
1. Paleo has fixed a lot of things in my life, but not this one. It’s great for preventing and sometimes reversing disease, but we must acknowledge the limits of our bodies.
2. It is important to be healthful throughout our entire lives.
3. Mistakes we make in the past can haunt us for ages.
4. But that doesn’t mean we can’t mitigate them in the present. Eat well! Live well! Be happy!
5. Low-ish carbohydrate diets are not fads, and they’re not stupid. They’re important.
More on my relationship with PCOS in the future.
*The information on PCOS used here can be read in any number of informative books, including A Patient’s Guide to PCOS: Understanding–and Reversing–Polycystic Ovary Syndrome
* The information on menstruation can be read in the phenomenal and accessible text : Ancient Bodies, Modern Lives: How Evolution Shaped Women’s Health.
*For a great Paleo perspective in-depth treatment of PCOS, see Girl Gone Primal’s post on it.
There is a big link between PCOS and Hashimoto’s Thyroiditis- about 40% of PCOS sufferers also have positive thyroid antibodies. This is something that’s vital to check into (and it could explain why the PCOS isn’t healed yet).
Hashimoto’s is, at its core, an autoimmune disease, not a true thyroid condition, so when it’s present, it’s likely that other body tissues are also being affected (ovaries, joints, brain and skin are common targets). Balancing the immune system is the objective.
As someone with Hashimoto’s (and many symptoms of PCOS, though never diagnosed), I recommend finding a functional health practitioner because they can help with the PCOS whether it’s autoimmune related or not. With immune balancing treatment, I’m beginning to see some hormonal improvement after years of no improvement:)
A lot of these people will work with you long distance if there’s no one near you:
http://www.thyroidbook.com/practitioner-locator.html
Dr. Brady seems to know a lot about PCOS and how to treat it with functional medicine (he works distance with people):
http://doctorbrady.wordpress.com/2008/11/14/dr-brady-on-polycystic-ovarian-syndrome-pcos/
Erin–
I can’t thank you enough for chiming in with this. I have been looking at the link between thyroid and PCOS recently, too. I heard Robb Wolf mention in a podcast a little while ago that many women ‘display pcos like symptoms’ and have low thyroid, etc, and then once they begin supplementing with iodine he finds that a lot of their symptoms clear up. I was on iodine for a while but I stopped, so as soon as I can find some in Taiwan I’m going to give it another try.
I did some reading on Hashimoto’s and while it’s fascinating, and I think I would like to get some blood work done for it, I also don’t experience any of the symptoms except for the PCOS and the lowish T4 levels.
I wonder what triggers Hashimotos. Goodness, this is fascinating. I’ma have to do some reading and then write about it
Is there anything I should or can do for my immune system in the meantime before I get a doctor situation worked out here? Cut autoimmune foods from my diet? I think I’ve done all of that already, just in case.
Your diet should already be pretty good. Gluten (go figure) is the main Hashimoto’s trigger, with casein being a distant second (but it doesn’t cause nearly the cytokine shitstorm that gluten does!) and a small amount of people cross-react with coffee as if it were gluten. Other factors, like antigens can be an issue, too. The only time I seem to have symptom flare ups now are after I’ve had a virus (antigen) that seems to wig out my immune system.
Some safe, general immune modulators you can use are high-dose D3 (I use emulsified), colostrum (I like Symbiotics) and Apex Energetics Oxicell Glutathione/SOD transdermal cream (I use a pea size amount 3 x’s/day on places like my neck, wrists, inner elbows, bottoms of feet). These items will be good for most autoimmune conditions and for people without autoimmune problems too! N-A-G is another that modulates the immune system and heals the gut lining.
Since you’re in Taiwan, iherb.com is a good place to shop for discount supplements.
I would hold off on the iodine until you’ve had TPO and TAA antibody tests and know that they’re negative- iodine exacerbates Hashimoto’s as it ramps up TPO production, which then the immune system wants to attack, destroying thyroid tissue in the process (the thinking is that TPO gets mistaken for gluten molecules).
As far as test results go, anything over 20 for TPO and 10 for TAA is considered positive by functional medicine ranges. You might want to eat some small amounts of gluten throughout the week before your tests to give your body something to have a chance to create antibodies to. Hashimoto’s can have the most random and atypical symptoms- everyone is so unique in their symptom set.
If your tests come back positive, the next step will be working with a functional medicine practitioner to determine which pathway of the immune system is overactive and then stimulating the opposite one (like a seesaw;). I can’t tell you what a difference this approach has made for me in how I feel! I feel like a (mostly) normal human being again!
Awesome, thank you, Erin. Thoughts on nightshades and eggs?
I don’t personally have an issue with nightshades (nor the kinds of inflammation they tend to induce, i.e. joint pain) so I think that’s a pretty individual thing. I’m not anti-nightshade on principle like some Paleo folks are (I think that’s a little retarded;-)
A lot more people are egg sensitive. I did test as being egg sensitive via electrodermal screening, but I believe it was more of a leaky gut thing, since we tend to become sensitive to whatever foods we eat the most of, as opposed to gluten sensitivity, which is often genetic. I had an NAET allergy clearing for the eggs (that will usually resolve a leaky guy induced sensitivity or even a full blown food/chemical allergy).
I have to admit I haven’t tried eliminating eggs, but Robb Wolf does strongly recommend a trial of elimination for anyone with autoimmune issues.
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