PCOS and Inflammation

There is a common thread which ties all women with PCOS together, whether they are over- or underweight, young or old. That link is INFLAMMATION – the driving force behind the ills afflicting all PCOS women.

Let me explain a bit about inflammation, how it develops, and how it can create havoc for women with PCOS. The inflammatory process begins during pregnancy as the fetus’ developing estrogen receptors are misprogrammed by the presence of toxic chemicals, such as bisphenol A, a powerful endocrine disrupting chemical found in plastics and thermal printing papers.Since estrogen receptors are present in virtually every cell of the female body, this bodes poorly for the development of proper metabolic functions, as it is estrogen which is the master of metabolism in the female body.

What does inflammation actually mean for the female body and why it is so bad?

Acute inflammation is a normal response to a trauma or an infection. This type of inflammation involves the activation of the innate immune system,which protects the body from invading organisms. This acute, short term inflammation is a normal and very important part of our immune defense system.

Unfortunately, there are times when inflammation becomes chronic, due to a malfunction and misdirection of the immune system. When this develops, bad things follow right behind. A key component of an acute inflammatory response is the activation of white blood cells, called macrophages. They then secrete substances called inflammatory cytokines and enzymes which act something like a natural acid.

The inflammatory cytokines include substances like tumor necrosis factor alpha, which, if produced in an uncontrolled fashion, leads to insulin resistance, elevated levels of glucose and insulin-like growth factor 1, and high production of testosterone. Also produced by macrophages are special enzymes, called matrix metalloproteinases, which are substances designed to kill invading bacteria and aid in the removal of dead tissue. Chronic production of these matrix metalloproteinases causes damage to body structures, such as the interior lining of arteries, which in turn leads to severe acne.

Estrogen is the ultimate controlling force behind the function of macrophages, and receptors for estrogen reside on these cells. When estrogen receptors are not properly developed, estrogen can no longer control the actions of macrophages. With control reduced in women with PCOS, macrophages run amok through the female body, doing much damage. They are perpetually in a state of high alert, ready to release inflammatory cytokines and myeloperoxidase, and they are more easily stimulated compared with immune cells in women without PCOS.

Much of the stimulation to the macrophages originates in the gastrointestinal tract, also known as the gut. Studies now show for the first time that women with PCOS have a more “leaky gut,” meaning that the single-cell barrier between the internal contents of the colon and the rest of the body is compromised. This allows inflammation-inducing particles within the colon, derived from the overgrowth of predominantly gram-negative bacteria called lipopolysaccharides (LPS), to pass through the colon wall and enter into the surrounding immune system, known as the gut-associated lymphatic system (GALT). Within the GALT reside those key cells – the macrophages – which are triggered by the LPS to release their inflammatory substances.

This is a short introduction to a very complex subject. In upcoming articles, I’ll explain more about what is happening within the gut, and I’ll also dive further into the story of inflammation as the driving force behind the suffering of women with PCOS and how to “tame the flames of PCOS!”

What is the condition known as PCOS (Polycystic Ovary Syndrome)?

PCOS incorporates the word, SYNDROME! When that word is linked with a condition, it basically means that no one really knows why someone would develop it, and, as well, it has a great variety of ways it can manifest itself.  PCOS is therefore, a highly individualized condition, resulting from each woman’s unique genetic make-up, along with her mode of delivery at birth, whether or not she was breastfed, her exposures to a variety of chemicals which can act as endocrine disruptors, her nutritional status, her sleep patterns, her exposure to antibiotics and vaccines, her stress levels, and more. Essentially, it is a very complex and variable condition!

Many choices you make can affect how you experience PCOS, which symptoms you get, and how severe they may be. Some women struggle with irregular or no periods at all; some have acne; most struggle with excessive weight gain, while others easily maintain very slim figures. Infertility is a common complaint while thinning scalp hair and excessive growth of facial hair plague other women. And women with PCOS all have elevated risks for developing various cancers, diabetes, irritable bowel syndrome, cardiovascular disease, anxiety and depression, and problems with sleep. PCOS is, at its very heart, a condition characterized by universal insulin resistance and systemic inflammation, regardless of whether the woman is obese or thin. Inflammation is a driving force of the condition.

In fact, since PCOS was first described by Drs. Stein and Leventhal in 1935, physicians throughout the world have debated with defining the syndrome. Today, there are three closely related sets of criteria (NIH, Rotterdam, and AE-PCOS Society) and all revolve around the following issues: infrequent or no menstrual periods, polycystic ovaries (many very small cysts surrounding the core of the ovaries), excessive production of androgens (hormones found in males such as DHEAS and testosterone), and the elimination of other known causes for these symptoms. PCOS is by far the most common endocrine disorder suffered by women around the world, affecting up to 25% of all reproductive-aged women.

Lest you become too distraught over all of these realities, there is a brighter side.  There are things you can and should do, along with choices you can make, all of which will ameliorate your symptoms and transform your life for the better.

And that will be the focus and driving force for this blog – transforming lives such as yours, and creating happiness. The dialogue we will have together will focus on concrete ways to make your life as wonderful and rewarding as it should be, despite your PCOS!