Women with PCOS exhibit a very high degree of medical complexity, including dysfunctions of key metabolic and immune mechanisms, affecting a wide range of organ systems. Such dysfunctions can manifest as multiple disorders in one body! Identifying the root causes and common conditions that weave their way through these multiple disorders will facilitate finding a unifying remedy, and eventually a cure, for PCOS and its related conditions. By understanding how foundational dysfunctions develop and then lead to a myriad of manifestations, we can take those crucial first steps. Conditions found at higher rates in PCOS women than in the general population includeautoimmune thyroid disease (Hashimoto’s Thyroiditis), endometriosis, uterine fibroids (leiomyomata), adenomyosis (uterine lining glands within the muscle of the uterus), and several cancers. Are women with PCOS simply unlucky to have so many medical maladies in one body, or is there a common theme to explain this? Once you delve beneath the surface, you come to recognize that all of these conditions have similar underlying mechanisms. Uniting all of them are the following: an abnormally functioning immune system, marked by chronic inflammation with elevations of inflammatory signaling agents called inflammatory cytokines, early age exposures to environmental toxicants (chemical endocrine disruptors), nutritional deficiencies, and gut microbiome abnormalities (dysbiosis). The ultimate unifying and underlying cause for all of these maladies in PCOS women is a foundational hormonalproblem: a major dysfunction of estrogen and its receptors, including its production and metabolic degradation. Estrogen is the master hormone, essential for metabolic health,and this requires a properly regulated immune system. Sadly, PCOS women do not have proper metabolic or immune health. Let’s begin with a quick overview of the conditions mentioned above. Endometriosis involves a severe localized inflammation in the pelvis, with high levels of inflammatory cytokines within the intra-abdominal (peritoneal) fluid. Interestingly, most menstruating women have some uterine contents flow backwards with each menses, with fluids and tissue passing through and out the Fallopian Tubes. The body’s immune system normally dissolves and gobbles up that tissue, but in women with endometriosis, this process malfunctions, and little holes in the lining of the pelvis (the peritoneum) are created, allowing living cells from the uterine lining to implant and thrive. This process is controlled by a system of enzymes, called Matrix Metalloproteinases (which remodel tissue) along with immune cells of the body. These cells and processes are under the control of estrogen, which in PCOS women is not functioning correctly. One type of theseimmune cells – the Mast Cell, which isalso controlled by estrogen – accumulates within the pelvis of women with endometriosis, releasingmassive quantities of inflammatory cytokines and chemokines (signaling agents which call other inflammatory white blood cells to the scene.) Thiscreates and sustainslocalized inflammation, promotinglocal estrogen production, and further stimulating growth of the ectopic endometrial cells. In the case of uterine fibroids, malfunctioning Matrix Metalloproteinases and abnormal local production of estrogen and progesterone cause the muscle cells of the uterus to grow abnormally, creating muscle tumors – fibroids (leiomyomata). Likewise, adenomyosis involves the dysfunction of both the Matrix Metalloproteinases and of estrogen, resulting in the invasion of the endometrial (lining) cells into the muscle of the uterus. Hashimoto’s Thyroiditis, an autoimmune disease, also involves dysfunction of the immune system, gut dysbiosis,and impaired gut permeability (leaky gut), all related to abnormal estrogen function. Lastly, cancer, the ultimate immune dysfunction, involves uncontrolled inflammation and estrogen malfunction or deficiency. Not surprisingly, the incidence of many cancers is substantially higher in women with estrogen dysfunctions - PCOS, adenomyosis, fibroids, and endometriosis - compared with the rest of the female population. And what connects PCOS with those other conditions? What is the root cause of PCOS? We now understand that it involves chronic inflammation, gut dysbiosis, and leaky gut;and that estrogen malfunction is at the root of those problems. The cause for this estrogen malfunction involves exposures to endocrine disrupting chemicals at critical points of development – in utero, during infancy, and at puberty, in genetically susceptible women. This inflammatory state is exacerbated by continued chemical exposures and the consumption of a high fat/high sugar diet, filled with processed foods. Despite all of this, there is substantial reason for hope. A fiber rich diet, stress control, exercise, timed eating and periodic fasting, along with the judicious use of bioidentical hormones, can ameliorate these problems. More on my PCOS protocols for health will be forthcoming in future articles. References: Nielsen NM et al. Hum Reprod. 2011;26(6):1555-9 Smarr MM et al. FertilSteril. 2016 Jul 15. Soo15-0282(16)61389-4 Khoufache et al. Minerva Endocrinol. 2012;37(1):75-92 Burney et al. Fert and Steril, 2012;98(3):511-19 Konno et al. Human Cell. 2003;16(3):144-49 Cuevas et al. Reprod Sci.2012;19(8):851-62 Theoharides.ExpDermatol. 2017 Nat Rev Immunol. 2010 Hart, David. 2015. Intern J of Inflam. 2012;452095 Urb et al. PLOS Pathog. 2012;8(4) Abraham et al. Nat Rev Immunol. 2010;10(6):440-52 Menzies et al. 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The newly developed vaginal lasers for rejuvenation are getting more and more common in the US and I was given the opportunity to buy one at the very onset ... and did not do so. Here's why: 1. Only a very small subset of women should truly not use hormones, particularly vaginal application of hormones. The laser folk make no claims that lasers are superior to hormones, they are just a novel approach. You know they create micro-injuries which Induce healing mechanisms to be instigated-increasing blood flow and tissue regeneration. I'll not deny it may work. But it is not superior to hormones. If I'm giving just vaginal hormones, then my preference is for Vaginal DHEA cream. Second is vaginal estriol, and last is vaginal estradiol. 2. I view the development of vaginal atrophy as the "canary in the room!" A woman with such damaged tissue from hormonal deficiency has many more sites of damage. The vagina is just the obvious issue. I view menopause as the drying up of the woman - dry eyes, dry bladder, dry brain, dry arteries, dry GI tract ... and yes ... dry vagina. A vaginal laser will do nothing for those other sites!! I am not into just symptomatic treatment (though symptoms do matter), I'm into addressing the root cause of the problems which is a hormonal, not a laser, deficiency!! 3. I see the vaginal lasers and those who speak for them, as a money grabs on menopausal women still inappropriately fearful of hormones. In fact, the laser mentality further embeds the fears they have deeper - for why use a laser if hormones are safe? 4. The cost for the single purpose laser was $220,000 and I think it's now $245,000. For a low price, I'd say, use it as a jump start only and also begin hormones for true rejuvenation. A doctor would have to push it like crazy to see a return on investment! I'd hate to see doctors who own these lasers working all the time trying to convince all women to get treatments! If you give the vagina the hormones it needs, it stays healthy. Same for all organs. I heartily believe in physiologic hormones. Cells do as they are told and hormones do the telling. It's that simple to me! And estrogen is the master of metabolic homeostasis! To function like a healthy woman, you need healthy hormone levels! So now you have my take on vaginal lasers!
Sweet potatoes are available all over the world, and if you only eat these delicious root vegetables when they've been baked until they are virtually unrecognizable, then you are missing out on one of nature's greatest nutritional gifts. They are not only rich in a vast range of nutrients, but they are also one of the best natural ways to regulate your blood sugar levels, making them an exceptionally beneficial food for diabetics. It also helps that they are absolutely scrumptious, and their sweet flavor is completely unlike any other found in the vegetable world. Indeed, sweet potatoes are so versatile that they're sure to liven up a whole range of dishes, even desserts!
Selecting and Storing Sweet PotatoesThere are different varieties of sweet potato, and many come in different colorings and hues. Here are some tips for selecting, storing and preparing the vegetable, so that you can benefit from as much goodness as possible.
- Choose the darker variety of sweet potato at the grocery store if possible, because they have the higher carotene content, essential for the production of vitamin A. Purple sweet potatoes, more commonly found in Asia, are also a great source of nutrients. Paler varieties are healthy but don't offer quite the same number of benefits as darker types, and many people often confuse them with yams.
- Avoid wrinkly, soft sweet potatoes and take time to select ones with good, firm flesh. If there are signs of green discoloring, then leave them alone.
- Store sweet potatoes in a cool, dark and well-ventilated place. Do not leave them in plastic bags, or keep them in the fridge. Consume within 7-10 days of purchase.
- Prepare sweet potatoes in the same way you would prepare normal white potatoes. However, bear in mind that the skin contains a large percentage of the nutrients, so try to leave it on if possible. You can make fantastic sweet potato fries by leaving the skin on, and chopping the vegetable into strips.
- You can steam, bake, boil or roast sweet potatoes, and still benefit from plenty of nutrients. But as with any vegetable preparation, try not to over-cook them.