8 Steps to Reverse Your PCOS: A Proven Program to Reset Your Hormones, Repair Your Metabolism, and Restore Your Fertility
312
8 Steps to Reverse Your PCOS: A Proven Program to Reset Your Hormones, Repair Your Metabolism, and Restore Your Fertility
312Paperback
-
PICK UP IN STORECheck Availability at Nearby Stores
Available within 2 business hours
Related collections and offers
Overview
Product Details
| ISBN-13: | 9781626343016 |
|---|---|
| Publisher: | Greenleaf Book Group Press |
| Publication date: | 09/20/2016 |
| Pages: | 312 |
| Sales rank: | 297,183 |
| Product dimensions: | 5.90(w) x 8.80(h) x 0.70(d) |
| Age Range: | 3 Months to 18 Years |
About the Author
Dr. Fiona has published several major articles in NDNR, one of the leading journals for naturopathic doctors and other publications for health professionals. Her popular research-based blog receives a monthly readership of 20,000 per month. 8 Steps to Reverse Your PCOS is Dr. Fiona’s first book.
Dr. Fiona is the Naturopathic Doctor advisor to IVF.ca: Canada’s premier online fertility community. As a woman with PCOS, she’s passionate about health education for women with this disorder and holds a position on the medical advisory committee of the PCOS Awareness Association.
Dr. Fiona also frequently lectures to professionals, including naturopathic doctors and integrative medicine clinicians, and to students at the Canadian College of Naturopathic Medicine. She is a strong proponent of evidence-based natural medicine and peer reviews for Natural Standard, an international research group affiliated with Harvard Medical School. Dr. Fiona is a graduate of the Canadian College of Naturopathic Medicine (2001) and the University of Guelph (Biological Science/Molecular Biology and Genetics).
Read an Excerpt
8 Steps to Reverse Your PCOS
A Proven Program to Reset Your Hormones, Repair Your Metabolism, and Restore Your Fertility
By Fiona McCulloch
Greenleaf Book Group Press
Copyright © 2016 Fiona McCullochAll rights reserved.
ISBN: 978-1-62634-301-6
CHAPTER 1
DEFINING PCOS
To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment.
— RALPH WALDO EMERSON
Sophia leaned forward at the restaurant table toward her friend Elizabeth, as if she were hearing an intensely fascinating secret. Sophia and Elizabeth met last year at the marketing company they worked for and had more recently been developing a friendship. Sophia's slim arm rested on the tabletop, her eyes unable to conceal their surprise and interest. She was a tall, lean woman, with a tendency to anxiety.
Elizabeth was far curvier than her friend, with glowing, clear skin. Elizabeth struggled with what she called her "apple shape," carrying a lot of weight around her belly, despite the many diet programs she had embarked on over the years.
"So, you have it too?" Elizabeth spoke to her friend in a hushed tone, looking sideways, as if ensuring that nobody was listening to their conversation.
"I do." Sophia gestured to her jawline, which was inflamed with angry-looking pimples. "You'd think I'd be past this stage by age thirty-four!"
As a young woman of thirteen, Sophia's period began as expected. Around the same time, her skin began to break out terribly, particularly along her jawline and on her back. Her periods were always irregular, arriving at their leisure (usually about two months apart), bringing with them intense cramps and heavy bleeding. Over time, Sophia developed coarse hair on her chin and cheeks. This was a great source of distress. She spent many hours trying different hair-removal techniques and attempting to find treatments for her acne, none of which were particularly effective.
Last year, after doing some online research, Sophia asked to be referred to a gynecologist, and her bloodwork came back with high levels of testosterone. The doctor diagnosed her with PCOS: polycystic ovary syndrome.
Once home, Sophia immediately Googled PCOS, intent on finding out more about the condition that had caused her so much difficulty. What she found was a great deal of confusing information. Descriptions of voluptuous women with ovarian cysts and high testosterone levels seemed to be central to almost every article on the topic. Much of it didn't match Sophia, as her ultrasound did not show any cysts, and she was a very slim woman. She knew that her testosterone was high, but she wondered why her case was so different from most of the other women who had the same diagnosis.
Elizabeth, on the other hand, had been diagnosed with PCOS at a young age. As a child, she had always struggled with her weight, and as she reached adolescence, she began gaining weight quickly. Both her mother and sister had a similar body composition, as did many of her extended female relatives. As a teenage girl, Elizabeth was elated to get her first period, but it did not return again for another ten months. Although many of her friends experienced a similar irregularity at first, eventually their periods became regular. It was not so for Elizabeth. This was how her cycles continued on: She averaged two periods per year. She dreamed of having normal cycles and feeling feminine like her friends, but her cycles never regulated on their own. Unfortunately, Elizabeth usually had to take a course of prescription medication to bring on her monthly menstruation.
Elizabeth had many ultrasounds of her ovaries over the years, and they were always full of small, round cysts — the classic "string of pearls" described in textbooks. Similarly to Sophia, Elizabeth also had hair growth on her chin and cheeks, but it was blond and fine, and most people didn't really notice it.
Elizabeth had married a wonderful man when she was thirty-two, and they desperately wanted to start a family together. Again, things weren't easy: Together, they began an intense battle with infertility that had been going on for the past two years. The fertility clinic felt like a second job to her. It was an extra place she had to go each morning, bright and early at 7:00 a.m., something she despised.
She felt consumed by the "project" of getting pregnant: charting, peeing on sticks, waiting and agonizing for two weeks every month, along with medications, stirrups, ultrasounds, and procedures. When it didn't work, which was always, she had to do it all over again the following month. Why couldn't she just conceive easily, like all of her friends did?
"So, you have PCOS, too? I'm surprised! It's just that you just don't look like ..." Elizabeth trailed off, taking a sip of her sparkling water, feeling a sense of hesitant camaraderie.
"I do, though I find my case isn't the 'typical' sort," Sophia replied. "One thing I do know is that whatever it is that I have going on with my hormones, it's definitely causing me a lot of grief."
How could these two very different women have the same syndrome?
A Brief History of PCOS: A Disorder with Many Faces
Do you ever wonder why PCOS has so much variability? More and more information on PCOS is being revealed at a rapid pace, with hundreds of new studies released each year.
PCOS has long been a mystery in women's health, as the underlying causes were never fully understood. Back in 1935, two researchers, Stein and Leventhal, described a group of larger-sized women that had coarse, male-pattern hair growth (known as hirsutism) on their faces. This group also had enlarged ovaries with multiple small cysts and irregular menstrual cycles. They named the condition Stein-Leventhal syndrome. Since that time, the diagnosis has expanded and includes many women far outside of the typical sort of PCOS that they had initially described.
The information, types, and definitions of PCOS used in this book are based on current research and on my clinical experience in treating hundreds of women with the condition. As the research grows, many of the concepts in this book may be expanded upon or entirely changed. The understanding of PCOS is really just beginning, and I look forward to seeing it grow.
Interestingly, there is a movement to change the name of PCOS from polycystic ovary syndrome, as many women with the syndrome do not actually have polycystic ovaries at all. The new name is still being debated but is hoped to express the many different types of the condition.
As the most common hormonal disorder in women of reproductive age, PCOS affects an estimated 116 million women worldwide and can affect hormones, fertility, the skin, cardiovascular health, and metabolism. PCOS is called a syndrome, rather than a disease, as there is a wide range of ways that PCOS can present and a variety of factors that characterize it.
PCOS can be expressed in women with excessive androgenic hormones like testosterone, producing acne and hair growth as we've seen in Sophia's case. Or it can present similarly to Elizabeth, with abdominal weight gain, infertility, and loss of ovulation and menstrual cycles.
This is why researchers have been puzzled about PCOS for years, with significant argument between professional groups about what constitutes a diagnosis of PCOS. In the last decade, however, there has been some agreement that there are, in fact, different "types" or phenotypes of the disease, which explains why two women with PCOS might look very different.
In 1990, the National Institute of Health (NIH), one of the world's foremost medical research centers, defined PCOS as requiring three criteria:
1. Delayed ovulation or periods, known as oligoovulation
2. Excess androgens, such as testosterone or DHEA, causing acne, hirsutism, male-pattern hair loss, or high androgens on a woman's bloodwork
3. Other conditions that would create a similar syndrome would have to be excluded
Interestingly, the NIH did not require a woman to have ovarian cysts to receive a diagnosis of PCOS. Overall, the NIH criteria are stricter, and fewer women have PCOS according to this definition.
Rotterdam and the Three Criteria
In 2003, there was a meeting in Rotterdam, the Netherlands, sponsored by two of the top reproductive medicine groups: one European (ESHRE) and one American (ASRM). Together, leading experts gathered in this northern city to focus on refining the definition of PCOS. The meeting produced what are known as the Rotterdam criteria, which are arguably the most widely accepted criteria for the diagnosis of PCOS.
This meeting produced something else that caused quite a stir in the world of endocrinology. What made the Rotterdam criteria different in diagnosing PCOS was that women didn't need to have all three of the characteristics. Only two of the three were required for a diagnosis. This gave birth to the idea of different phenotypes or "PCOS Types." It also produced two totally new "types" of PCOS, which didn't exist before.
The three criteria introduced by the Rotterdam consensus were —
1. Delayed ovulation or menstrual cycles (anovulation)
2. Hyperandrogenism/high androgenic hormones like testosterone
3. Polycystic ovaries on ultrasound
It's important to note that PCOS is a very complex disorder, and that these types are mainly a holding place for what we understand as of now. These types will likely change over time as we learn more about what makes up this complex and common condition in women's health.
Symptoms of PCOS
PCOS has myriad symptoms, ranging from hair loss to fatigue and weight gain. These various symptoms fall into three main categories, as evidenced by the Rotterdam consensus. For a woman to be diagnosed with PCOS, she must exhibit two of the three required criteria (anovulation, hyperandrogenism, and polycystic ovaries). Let's take a moment to explore each of the criteria in more detail.
Anovulation
Anovulation translates as "lack of ovulation," but in medical terms, it can also mean ovulations that are delayed past the typical timing. The average length of a woman's menstrual cycle is twenty-eight days. Day one of the cycle is the first day of the period, and most women will ovulate on or around day fourteen, give or take a few days.
Anovulation is technically defined as fewer than ten menstrual cycles per year. This would be equal to having menstrual cycles thirty-five days or longer in length. If you'd like to know more about menstrual cycles, please see chapter 6 for a comprehensive explanation of how the hormones, ovulation, and menstrual cycles work in PCOS.
As you can see, if you have regular menstrual cycles, but they are longer than average, you may still have anovulation. This is something I see often in practice: longer-than-average cycles, though they may appear regularly. Many women actually believe this is a normal thing, but it's most definitely not. Cycles that are thirty-five days in length or longer (even if they are regular) are a red flag for PCOS, particularly if a woman's cycle has been longer since her teenage years.
As women age, their cycles often naturally become shorter, so anovulation may be resolved by Mother Nature as a woman matures. That said, if a woman had long cycles for many years when she was younger, as well as the other characteristics of PCOS, it is a sign that she should be assessed more closely.
Hyperandrogenism
Hyperandrogenism is a very long word that basically means there are high levels of hormones, such as testosterone, DHEA, or androstenedione. These particular hormones are responsible for causing male sexual characteristics like the growth of facial and body hair and hair loss in specific patterns.
In chapter 5, there will be a comprehensive discussion with more details on these symptoms.
PCOS "Cysts"
At Rotterdam, researchers went through what it means to have polycystic ovaries. They determined that there must be twelve or more follicles measuring from two to nine millimeters or an ovarian volume bigger than ten centimeters in a single ovary. Follicles are the spherical structures in the ovary that house the eggs. On ultrasound, many women with PCOS have a larger than average number of follicles. Even if only one ovary shows an excess number of follicles or "cysts," this can be suggestive of PCOS.
If you request an ultrasound, you can ask the technician to include the ovarian volume and to look at the number of smaller follicles in your ovary and to count them. It's often best to have this ultrasound done on the third day of your menstrual bleed, but if you're not having menstrual cycles regularly, you can also have this done on any given day. In women who don't menstruate often, there is an increased chance of seeing these types of follicles regardless of the cycle day.
Now, let's talk about the cysts in the ovary and what they actually are. They are not true ovarian cysts, like those found in women without PCOS. One of the most common types of non-PCOS cysts is the simple functional cyst: these are large, fluid-filled sacs within the ovary that resolve on their own and happen in many women occasionally. Another type of non-PCOS cyst is the "complex" ovarian cyst: These are larger cysts that contain a variety of different types of cells and may contain blood or other tissues. In most cases, the number of simple or complex cysts is far lower than the number of "cysts" found in a woman with PCOS (often only one cyst is present, or just a few).
PCOS cysts are in fact different from both of these and are not even true cysts at all! So why do some women with PCOS have so many follicles on ultrasound? In a healthy ovary, the follicles go through a slow state of growth known as folliculogenesis for many months before the egg is ready to be ovulated.
In PCOS, this process can become stalled because of high testosterone and insulin in the ovary. The outer layer of the follicle known as the theca, which produces testosterone, thickens, and the follicles stall in their development process and accumulate in the ovaries rather than going through ovulation.
As such, PCOS "cysts" are actually just ovarian follicles that are in a state of partial development. Over time, these partially developed follicles pile up in the ovary, creating the look of multiple tiny cysts, or what is often referred to in textbooks as a "bunch of grapes" or a "string of pearls."
PCOS Cysts and Age
Ovaries with multiple small follicles are very common in the ultrasounds of younger women, particularly in teenagers, as there is a natural abundance of follicles/eggs in this age group, which can in many cases exceed the threshold count for PCOS. In addition, during puberty, there is recruitment of many follicles as the ovary activates, without consistent ovulation as of yet, so girls in puberty naturally have a form of polycystic ovary. This, however, should resolve as girls begin to have regular ovulation and menstrual cycles.
So, for teenagers, it's always important to be cautious when looking at your ultrasound results. This is one important reason that we don't use the "cysts" alone to diagnose PCOS.
Conversely, women over thirty-five may have PCOS, but they have fewer follicles due to their egg bank becoming smaller with age and are less likely to have polycystic ovary appearance on ultrasound. As such, age really does matter when it comes to the "cystic" criteria. The good news is most women will decrease their likelihood of belonging to a "cystic" type as they get older.
Technology and Ovarian Cysts
Newer technology may be changing this long-held definition of what constitutes a "polycystic" ovary. In March 2013, a study concluded that a new threshold should be used to determine if a woman actually had cystic ovaries characteristic of PCOS.
This is because diagnostic equipment has dramatically improved in its ability to detect follicles in the ovary. Over the past several years, many women without PCOS (and especially teenage girls who naturally have many follicles and are almost in a temporary PCOS-like state) were being diagnosed with polycystic ovaries on ultrasound, because the ultrasound technology has become so sensitive. Follicles that would have normally remained undetected by older equipment are now being picked up much more easily, increasing the number reported by the ultrasound technician.
(Continues...)
Excerpted from 8 Steps to Reverse Your PCOS by Fiona McCulloch. Copyright © 2016 Fiona McCulloch. Excerpted by permission of Greenleaf Book Group Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
Foreword ix
Preface xiii
Acknowledgments xvii
Introduction xix
Chapter 1 Defining PCOS 1
Chapter 2 Step 1. Address Inflammation 21
Chapter 3 Step 2. Treat Insulin Resistance 35
Chapter 4 Step 3. Balance Your Adrenals and Improve Your Mood 49
Chapter 5 Step 4. Treat Excess Androgens 66
Chapter 6 Step 5. Address Hormonal Imbalances 82
Chapter 7 Step 6. Balance Your Thyroid 95
Chapter 8 Step 7. Create a Healthy Environment 116
Chapter 9 Step 8. Eat a Balanced Diet 125
Appendices
Appendix A PCOS and Fertility 167
Appendix B PCOS and Menopause 199
Appendix C Obesity, Diabetes, Cancer, and Cardiovascular Disease in PCOS 206
Appendix D Recommended Diets and Recipes for Women with PCOS 213
Appendix E Resources 241
Notes 247
Index 265
About the Author 279
Customer Reviews
Explore More Items
