PCOS is confusing, even for doctors.
1 out of 10 women have this hormonal problem!

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PCOS: is confusing because the HORMONAL CHANGES become a puzzling tangled web

The 5 Manifestations of PCOS:
Individualize Your Focus and Treatment

1) Weight gain – usually in torso and abdomen

2) Ovarian problems – irregular periods

3) Acne and male hair patterns – caused by high testosterone

4) Abnormal metabolism, especially insulin resistance (“prediabetes”) – this can be the root cause of all the hormonal changes

5) Depression – from dealing with PCOS and the hormonal changes

You may NOT have PCOS if …

1) You are a NORMAL weight, especially if you don’t carry the extra weight in the abdomen and torso.

2) You periods are regular.

3) Your TESTOSTERONE is low or mid-normal. Some experts use a BLOOD TESTOSTERONE of 31 as a cut-off, below which PCOS is less likely.

4) You have hair loss, but no acne or male hair growth. But, if you are on BIRTH CONTROL this can neutralize the high TESTOSTERONE, and even though you have PCOS, you won’t have the symptoms of ACNE or MALE PATTERN HAIR.

5) Acne and/or abnormal male hair growth (hirsutism) are mild. See above for exceptions (BIRTH CONTROL PILLS).

6) Your ultrasound shows normal ovaries (BUT, you don’t have to have ovarian cysts to have PCOS). INSULIN RESISTANCE is an epidemic in the U.S. due to our damaging high glycemic processed food diet, and obesity – both lead to INSULIN RESISTANCE. So, more and more of the PCOS is related to INSULIN RESISTANCE and ovarian cysts may not be present.

7) You have no family history of diabetes. Since INSULIN RESISTANCE is at the core of PCOS, many have a family history of adult onset diabetes.

The Confusing Puzzle of PCOS

PCOS can be demoralizing because women feel they can’t get a straight answer to their problem.  Both the doctors, and the patients are confused by this complex web or hormonal changes.

Often there is a debate whether someone even has PCOS.

Further, even after a targeted treatment plan it can take years to reverse the hormonal changes.

Endrocrinologist, Diane Schwarzbein, MD, developed PCOS from a sugar addiction as a child.

One famous endocrinologist, Diane Schwatzbein, MD, relates her personal story, and the long struggle she experienced to understand and reverse her own PCOS.

She developed PCOS in her teens from a sugar addiction which triggered INSULIN RESISTANCE.

In spite of her medical training in endocrinology (UCLA), it took OVER 5 YEARS to reverse the INSULIN RESISTANCE.

She had to learn  NUTRITIONAL EXCELLENCE on her own by trial and error. She did not learn how to eat properly and reverse her INSULIN RESISTANCE in her training as a medical endocrinologist.

As she summarizes:

“I had to become healthy to lose weight, not lose weight to become healthy”.

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What matters most is which aspects of the condition you have and which you don’t have (see the 5 manifestations above). From this a treatment plan can be devised.

Each women with PCOS is unique.

What about OVARIAN CYSTS? They are NOT the key. You may or may not have cysts on your ovaries.

How to figure out YOUR PCOS

Treatment should be directed at the manifestations of the 5 problems you have, not at what you don’t

#1 of 5: Testosterone, Skin, and Hair

High testosterone can cause acne, oily skin, unwanted hair growth, and male pattern hair loss.  An example of treatments are: 1) the testosterone blocker SPIRONOLACTONE or 2) Birth Control Pills, which bind the excess testosterone.

#2 of 5: Irregular Periods and Anovulation

High testosterone in the ovary and insulin resistance are involved in ovulation problems. Weight is a big factor. Being overweight tends to make PCOS worse.

With irregular periods, the hormone progesterone is irregular. Progesterone is supposed to make menses regular and normal.  Without a smooth normal monthly progesterone output,  periods may be very irregular and heavy.

TREATMENT may include OC (birth control pills or BCPs). Also, natural progesterone like Prometrium can help. An example, take Prometrium 100mg in the morning and 200 mg near bedtime for at least 12 consecutive days each month or every other month.

#3 of 5: Contraception and PCOS

Irregular periods are common with PCOS.  But, pregnancy is still possible.  Also, the following meds may restore ovulation: metformin, glitazones, dexamethasone, and possibly spironolactone.

#4 of 5: Weight Problems with PCOS

This is the double whammy: PCOS predisposes to weight gain, and weight gain worsens PCOS.

Metformin can help with weight loss. Metformin is an older (safer) diabetes medication that can help with retention of lean muscle and reduction of fat.

The most important weight loss tool is A LOW CARBOHYDRATE EATING PLAN.  Note: colorful vegetables are not BAD carbs.  Vegetables contain phytochemicals that can be an enormous help in reversing PCOS. So, stop the BAD JUNK FOOD CARBS and increase colorful vegetables.   Eating very high quality meat, fats (nuts, avocados), and carbs is very important.  The aim is to MINIMIZE INSULIN LEVELS.

At the heart of PCOS is the junk food laden American diet. This sets the stage for hormonal disruption.  90% of the foods purchased in American are processed HIGH CARB, NUTRITIONALLY DEPLETED JUNK FOOD .

#5 of 5: **The Root of PCOS**
Insulin Resistance and a Massive Sugar Overdose

The massive SUGAR OVERDOSE in America can cause HORMONAL DISRUPTION, including PCOS.

The average American eats 1/2 pound of sugar and fructose a day, which causes hormonal chaos leading many of the physical and mental issues faced in the U.S.

If you can reverse INSULIN RESISTANCE,  a healing process can occur.

What are some keys to reversing INSULIN RESISTANCE?

1) Relieving chronic stress

2) Nutritional excellence – a balance of quality protein (quality fish, and lean meats), carbs (mainly vegetables), and fats

3) Vitamins, minerals, and supplements

3) Deep restorative sleep

4) Exercise that improves hormonal balance

5) Fat loss, especially in the abdominal area (this fat worsens insulin resistance)

6) Relief of anxiety and mood problems

How to evaluate your INSULIN RESPONSE

Examples: the GTT (glucose tolerance test), Fasting Insulin, Hemoglobin A1c, Cholesterol Profile, C-reactive protein (inflammation marker), and Blood Pressure.

What “diet” (diets don’t work, a healing nutritional plan is a better term) is best?

I like The PaleoDiet by Loren Cordain, PhD.   Another way of describing a great diet is to call it a “Paleo-Mediterranean Diet”. When Mediterranean is mentioned this does NOT include PIZZA, PROCESSED PASTA, AND PROCESSES GARLIC BREAD!  It does mean a healthy mix of highly colored vegetables, salads, and healthy oils.

The PaleoDiet (and a healthy Mediterranean diet) will eliminate the empty carbs of many “wheat based” products like bread and pasta, which are often processed and thus PURE SUGAR.  Dairy is also limited or eliminated.  The PaleoDiet is high in lean meats (wild, grass fed), avocados, nuts, olives, vegetables, etc.

90% of the foods Americans eat are unhealthy. So, asking someone to change their habits to nutritional excellence is very disruptive and difficult for most people.

Depression and PCOS

Depression is common with PCOS.

First, PCOS is usually very confusing and frustrating.   You may be told many different confusing reasons for your PCOS.

This can make people feel that there is no hope in reversing this metabolic puzzle.

Again, the best approach is to evaluate your PCOS based on the 5 manifestations and build a treatment plan based on those symptoms that you have.

Weight gain, hormonal changes, and treatment difficulties can all lead to frustration, anxiety, and mood problems.

A Summary of Possible Helpful Treatments and Resources:

1) Control INSULIN:

a)  A balanced nutritional plan (low carb).  No processed food.  No sugar. Balanced proteins, fats, and vegetables.  The PaleoDiet is a good example.

b) Metformin 500 mg twice a day can help control insulin.

c) Reducing belly fat and increasing lean muscle with help INSULIN RESISTANCE.  The more belly fat and body fat, the more INSULIN RESISTANCE.


a)  Birth Control Pills can bind testosterone.

b)  Spironolactone (a mild diuretic medication) can help lower testosterone and thus help acne and hair changes.

c) These may LOWER “FREE” TESTOSTERONE and help symptoms (less acne and hair problems), BUT until the INSULIN RESISTANCE is reversed these measure may just be treating the symptoms, not curing the problem.

3)  Weight loss – especially abdominal fat

a) An exercise program that targets healthy hormonal control is critical.  This is usually a daily exercise routine of 30 minutes to 1 hour that doesn’t trigger STRESS HORMONES.  An interval training (“burst” exercise) program is best.

4)  Supplements – there are many supplements that help INSULIN RESISTANCE (cinnamon, alpha lipoid acid, fish oils, benfotiamine, berberine, etc.)

a) Nutritional supplements can be very helpful in reversing INSULIN RESISTANCE, MOOD, and WEIGHT ISSUES:

Omega-3 fish oils, B-vitamins, SAMe, probiotics, sleep aides, multi-ingredient glusoce regulation formulas, fiber, quality proteins (whey protein), etc.

5) Sleep

a) Deep sleep (8 hours) is needed to normalize your weight, rebuild brain neurotransmitters (mood), and balance hormones. If you do not get 8 hours of sleep your stress hormones will be high which increases your weight and makes insulin resistance much worse.

The Silver Lining of PCOS

PCOS will be a challenge for you.

You must go through a difficult learning process and a process of implementing difficult lifestyle changes (even Diane Schwarzbein, MD, an endocrinologist struggled to find answers).

However, this can actually be a blessing to you in the long-term. At an early age you will have to make decisions to place your health first, often giving up those lifestyle habits that are destructive to your overall physical and mental health.

Changing your lifestyle to maintain healthy hormonal balance can be a key to your future health and happiness.

By learning these lessons early in life, you will have the chance to enjoy great health, energy, and beauty for the rest of your life.  You will then have the knowledge and experience to lead others toward a healthier, happier life.

*These statements have not been evaluated by the U.S. Food and Drug Administration.  This information is general in nature, and is not meant to replace a one on one relationship with a medical professional.  Do not implement any changes in your health program without consulting with your doctor.