PCOS (Polycystic Ovary Syndrome) and Hypothyroidism
Having issues with your periods or ovulation?
Have acne, or excess body hair?
Have very high DHEA?
Have you been diagnosed with PCOS (Polycystic Ovary Syndrome)?
PCOS is a fairly common condition that some women, especially with hypothyroidism, can find themselves with, and the more overweight a woman is, the worse the symptoms can be. Because of a variety of symptoms related to PCOS, what may be true for you as far as symptoms may be completely different from another woman. Those individual variety of signs and symptoms include:
- No menstrual period, infrequent menses and/or irregular bleeding
- Infrequent or absent ovulation
- Increased levels of male hormones
- Infertility (number one symptom of PCOS)
- Cystic ovaries
- Enlarged ovaries
- Chronic pelvic pain
- Obesity or weight gain
- Insulin resistance (overproduction of insulin) and diabetes
- Abnormal lipid levels
- High blood pressure
- High DHEA (at least half with PCOS will have this)
- Excess body hair in unwanted places
- Baldness or thinning hair
- Acne/oily skin/seborrhea
- Depression or depression with anxiety
In most cases, getting the conclusive diagnosis of Polycystic Ovary Syndrome comes from the appearance of your ovaries after an exam by your doctor. Your ovaries can look enlarged and contain many small cysts located on the outer edge of each ovary. The latter is sometimes referred to as looking like “a string of pearls”.
However, some women with polycystic ovaries may not have PCOS and some women with PCOS may not have polycystic ovaries. This is why this is not used as the only sign that you have PCOS. You must also have a menstrual abnormality (eg. irregular periods) and be checked for excess androgen (male hormones aka testosterone).
Are PCOS and hypothyroidism related?
In most cases, it appears so. Newer research has shown that women with PCOS are three times more likely (and some say four times more likely) to also have Hashimoto’s Disease. Women in internet forums have also been surprised to discover that most of them shared the two conditions.
PCOS and hypothyroidism have many symptoms in common, such as “anovulation” i.e. menstration without releasing an oocyte (egg cell). Some propose this is the cause of PCOS if anovulation is long term with it’s related low progesterone. Other symptoms the two conditions share are: insulin resistance, blood sugar problems leading to diabetes, high cholesterol levels, heavy periods, weight gain (obesity), hair loss and ovarian cysts.
In fact, we have seen patients who were erroneously diagnosed with PCOS when they really had thyroid disease. Read this gal’s story here.
Other causes of PCOS can include excess insulin which might boost androgen production, low grade inflammation (which is common with those who have hypothyroidism), hereditary factors (such as mother or sister having PCOS) or abnormal fetal development.
Dr. Jeffrey Dach has an excellent compilation about PCOS and also states: About 10% of patients thought to have PCOS actually have an underlying genetic enzyme defect in adrenal steroid synthesis called Non-Classical CAH. This can be diagnosed with a Cortrosyn stimulation test, and a 21-OH genetic test called CAHDtex from Esoterix. If present, treatment is successful with low dose adrenal steroid tablets (cortef, dexamethasone, prednisone) which restores fertility and reverses the acne. (see below discussion on non-classical CAH).
What’s the treatment for PCOS?
If you are a thyroid patient who has PCOS, learn about the superior treatment with T3 in your treatment, and getting optimal, which can reduce PCOS symptoms and reverse infertility. Read how this gal reduced her PCOS with a working desiccated thyroid, or even T4 with T3, or T3-only.
Also, here’s a study which also includes positive outcomes from treating one’s hypothyroid condition, titled Effect of thyroid hormone replacement therapy on ovarian volume and androgen hormones in patients with untreated primary hypothyroidism.
Standard treatment outside of thyroid treatment includes low dose birth control pills to decrease androgen production and to give your body a break from the effects of continuous estrogen. This decreases your risk of endometrial cancer and corrects abnormal bleeding.
Another alternative treatment is to use progesterone cream for 10-14 days each month which regulates your periods and offers protection against endometrial cancer, but does not improve androgen levels. More on Dach’s page above.
Some use the prescription Metformin to control the higher than normal insulin levels that can go with PCOS. Lowering carbs can be important, as well.
PCOS can be very serious for some and must be treated as it can lead to endometrial cancer. It also causes infertility, miscarriage, insulin resistance, heart disease, strokes, uterine cancer, obesity and hirsutism (excess hair growth of coarse dark hair in a predominantly male pattern such as a mustache or beard).