Polycystic ovarian syndrome (PCOS) is a common hormonal problem. It affects one in ten women, and the percentage may be even higher among young women. Its principle feature is a lack of regular ovulation. It causes facial hair and infertility. The incidence of PCOS is on the increase and this trend to an epidemic has not yet been explained.

There is good evidence that many cases of PCOS are caused, in part, by insulin resistance, a metabolic problem that also causes weight gain and diabetes. This is bad news for Pill users because as discussed above, the Pill actually worsens insulin resistance. In 2003, the Journal of Clinical Endocrinology & Metabolism published an article called 'A Modern Medical Quandary: Polycystic Ovary Syndrome, Insulin Resistance, and Oral Contraceptive Pills'. (1) The Pill has been standard treatment for PCOS, and yet, perversely, it appears to worsen the metabolic problem that is at the root of the condition. The authors say: ...what has been lacking is a critical examination of whether oral contraceptives might...exert adverse metabolic effects with long-term consequences...

I propose that the Pill may have made additional contributions to the epidemic of PCOS. Many young women have taken the Pill since they were in their early teens. This was done, and yet studies have shown that the Pill causes permanent hormone changes, even once it is stopped.   Most doctors agree that it can take 1 to 2 years for normal menstrual cycles to resume after stopping the pill (2,3,4). Why should we not consider a history of Pill use when it comes to PCOS? Strangely, this question has not been asked in the medical literature.

What is even more worrying is that the hormonal damage from the Pill may not be limited to one generation. A new understanding of genetics has shown that the lifestyle of our parents and our grandparents can affect our health in this generation. In particular, the effects of hormone disrupting chemicals such as pesticides have been shown to cross generations. (5) The Pill definitely qualifies as a hormone disrupting chemical. Young women today have inherited their genes from a mother and grandmother who used the Pill. Has there been a cross-generational effect? No studies have been done to answer this question.

For a fuller discussion of PCOS, see our PCOS article.

References.

• 1. Diamanti-Kandarakis, E et al. A modern medical quandary: Polycystic Ovary Syndrome, Insulin Resistance, and Oral Contraceptive Pills. J Clin End Met 2003.88(5): 1927-1932
• 23.Farrow, A et al. Prolonged use of oral contraception before a planned pregnancy is associated with a decreased risk of delayed conception. Hum Reprod. 2002. 17(10): 2754-61
• 3. Gnoth, C et al. Cycle characteristics after discontinuation of oral contraceptives. Gynecol Endocrinol 2002:16(4): 307-17.
• 4. Vessey, M et al. Return of Fertility after discontinuation of oral contraceptives: influence of age and parity. The British Journal of Family Planning. 1986: 11: 120-124.)
• 5. Anway et al. Epigenetic Transgenerational Actions of Endocrine Disruptors and Male Fertily. Endocrinology 2006.147(6): 43-49

What is the best way to test hormones?

First of all, there is no one perfect hormone test. Blood, saliva and urine test all have their place. Different tests are appropriate for different things.

Blood testing is good for some things, such as detecting menopause and confirming ovulation, but blood testing cannot accurately measure hormone levels during hormone replacement treatment.

Saliva testing is better for monitoring hormone replacement, and it is also a good choice for assessing oestrogen dominance and cortisol. Saliva levels can be somewhat unreliable. Both blood and saliva tests have the disadvantage of being a 'snapshot' look at hormones that fluctuate greatly during day.

24-hour urinary hormone testing is a new approach. It has many  advantages. Firstly, it measures total daily hormone production and metabolism. This avoids inaccuracy due to fluctuations. Secondly, it measures hormone metabolites as well as primary hormones. Hormone metabolites are hormones that have been molecularly changed in order to be excrete from the body. Some metabolites such as 16-hydroxy oestrone are particularly risky for breast cancer.

Testing beyond hormones

Just knowing hormone levels is often not enough. Hormone balance and function is affected by other aspects of health, such as gluten sensitivity and inflammation. Your Naturopath will need to test for basic biochemistry, insulin balance, iodine, inflammation and more. Most of this is done by blood test, but some new urine metabolic testing is available.

Diagnosis by Symptom evaluation

Your symptoms and medical history give us the best information.  First consult is one hour to allow us time to gather this information.

You can start by checking your own hormones with our Self Assessment Quizzes.