Polycystic Ovary Disease
Saul Yudelowitz BSc (Hons)
Many women with polycystic ovary disease (PCOD) also present clinically with anxiety from depression. These women are typically overweight and develop insulin resistance (IR). They have amenorrhea or oligomenorrheic, this results in infertility. If depression precedes POCD, life stresses shall stimulate the overproduction of corticotrophin releasing hormone (CRH). CRH has a number of effects on the body.
When humans are stressed it is normal to release CRH. It is released into the portal vessels and makes it way to the anterior pituitary gland (APG).
This results in the release of adrenocorticotropic hormone (ACTH).
ACTH results in the release of cortisol and DHEA. Cortisol maintains blood glucose levels during the fight or flight situation. It also helps the kidneys to reabsorb water to maintain blood perfusion. In the normal physiology cortisol has a negative feedback so when a certain level is reached CRH stimulation is reduced.
In chronic stress the cortisol levels remain elevated due to an inappropriate stress adaptive response. This causes the deposition of fat in certain areas like the classical buffalo hump, thighs, gluteus and the abdomen. These results in IR, fluid retention, hypertension, proteolysis in: muscle, bone and connective tissue. As well as the inhibition of protein hormone formation. Chronic elevated levels of cortisol also depress the immune system.
CRH is well known for its stimulation of ACTH however it also has other affects on the body.
As a neurotransmitter it stimulates the sympathetic outflow from the central nervous system (CNS) which inhibits parasympathetic tone to the periphery. This in turn will elevate cortisol levels from its overall affect. From this it should be rather easy to join the dots in seeing that many people have chronic elevated cortisol levels. The affects are felt all over the body: Gut function decreases and bloating with flactuance being common. This can lead to many different conditions like irritable bowel syndrome or leaky gut however for sure the immune system will be suppressed as 75% of the immune system resides in the gut. There is an increase once again in water retention this time via the renin system, leading to another increase in hypertension. The areas mentioned earlier, where fat is deposited is referred to syndrome X, centripetal obesity. Excessive insulin levels from chronically elevated cortisol or from IGF-1 causes the receptors on ovarian stromal and thecal cells to produce more androgen hormone. Excess androgen is converted to estrogen by the extra adipose tissue in obesity. Elevated estrogen disrupts the ratio of LH to FSH. Too much LH results and this once again stimulates androgen hormone production.
THIS IS WHAT LEADS TO AMENORRHEA and infertility begins as a result. At this stage the patient may present with the following symptoms: acne, hirsutism, clitoral enlargement and male hair distribution.
While PCOD has been given some light in the media this condition of chronically elevated cortisol levels can and does occur in the male population.
Syndrome X is also a presenting factor along with even higher levels of abdominal fat, impotence, testicular atrophy, thinning skin as well as all the other symptoms like IR, fluid retention, hypertension, proteolysis in: muscle, bone and connective tissue and the inhibition of protein hormone formation.
The first step in addressing this problem is to correct gastrointestinal health and then hormonal health. I do wish the established medical model the best of luck for the future in treating patients as until they adapt this functional integrative approach they shall continue to FAIL.
As a side note, nothing that I mentioned here is reinventing the wheel; I am just showing you the same old wheel from a different perspective.
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