AMH and PCOS – another diagnostic tool?

Polycystic Ovarian Syndrome (PCOS) is something that we see in our office regularly. Sometimes it’s already been diagnosed and other times it has not. While there is diagnostic criteria for PCOS, there is still some debate as to what definitively confirms PCOS.

A study published in Clinical Endocinology suggests that Anti-Mullerian Hormone (AMH) has potential as another way to determine if PCOS is present. They found that AMH was able to correctly identify PCOS 79% of the time.

What does this mean for you? If you suspect that you have PCOS, here is a list of tests that you might ask to have completed:

  • Anti Mullerian Hormone (AMH) – typically costs about $65 and is usually an out of pocket expense (your Ontario ND can order this)
  • Glucose Tolerance Test (GTT) – this 2 hour test gives a functional value for blood sugar control (PCOS has a 5 fold increase risk of developing diabetes mellitus)
  • DHEA-s and Testosterone – high androgen levels are often elevated in PCOS and gives a good measure for treatment success

Yours in Health,

Kerri Fullerton ND & Whitney Young ND

 

Rooted has a new PCOS tea blend

There are many different hormonal imbalances involved in Polycystic Ovarian Syndrome  (PCOS).  As such, different herbal blends work for different types of PCOS patients.

Dr. Whitney and Dr. Kerri show off their new PCOS tea at the Bridal Show.

Dr. Whitney and Dr. Kerri show off their new PCOS tea at the Bridal Show.

Our tea blend is geared to those women with high androgens (high testosterone and high DHEA) which is what often causes the acne and hair growth.

Spearmint tea helps lower the DHEA, the total testosterone and free testosterone.

Green tea helps to increase the sex hormone-binding globulin which helps to mop up the extra testosterone.  Green tea has also been linked to a two-fold increase in fertility.

The studies to reduce the hormones were done over two months so don’t expect to drink just one cup every once in a while to see the changes.  Two cups per day is required for this therapeutic effect.

That said, it’s a tasty tea that can be enjoyed by anybody anytime.

PCOS blend is available at Simply Tea and Chocolate downtown Barrie and at Rooted Naturopathic Clinic

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What you need to know about testing women’s hormones

When a woman goes to the doctor and says “I think my hormones are all messed up” she may be given a requisition to test her hormones.  When she’s told that her hormones are fine and brings the results to us, we often ask her to do them again.  Here’s why:

  1. The day of your cycle has everything to do with when you go to the lab.  Hormones vary with your cycle and they peak at different times.
  • Day 3 is when you test estrogen
  • Day 21 (or 7 days before your expected period) is when you test progesterone
  • This means that you need two requisitions
  1. TSH (thyroid hormone) can be tested at any time during your cycle.  If it is a repeat test, go at the same time of day as you went last time as the hormone can vary during the day.
  2. FSH (follicular stimulating hormone) should also be tested on Day3.
  3. Androgens, like testosterone and DHEA are tested to determine if PCOS is an issue.  DHEA and Testosterone can be tested at any point in your cycle.  We want to see free testosterone though as bound testosterone isn’t actively causing symptoms.

What is PCOS?

Polycystic Ovarian Syndrome, PCOS, is a hormonal condition that affects a women’s ability to ovulate.

The cause of PCOS is unknown, however  we know that there is a strong relationship with dysfunctional sugar metabolism – namely insulin resistance or diabetes.   Also, the use of valproic acid for seizures or bipolar disorder has been linked to an increased risk of developing PCOS.

What symptoms do we see with PCOS and why?

Insulin resistance causes too much insulin to be in the blood stream.  Insulin stimulates the ovaries to produce too much of the hormones called androgens – DHEA and testosterone.  Insulin also stops another hormone, sex-hormone-binding-globulin, from working properly.  The end result is that too many androgens are freely flowing through the blood.

All of these extra hormones cause:

  • Acne
  • Hirsutism – male patterned hair growth in women (facial and lower abdominal)
  • Male patterned baldness

Irregular periods or absent periods is one of the most common symptoms.  This leads to:

  • Infertility
  • Progesterone deficiency
  • Thickened endometrial lining (thereby increasing the risk of uterine cancer)

PCOS is also associated with:

  • Depression
  • Anxiety
  • Eating disorders, especially binge eating disorder

If the insulin resistance associated with PCOS is not managed, there is an increased risk of developing:

  • Obesity
  • Type 2 diabetes
  • Cardiovascular disease due to the cholesterol increase
  • Sleep apnea
  • Fatty liver

By restoring proper sugar metabolism, most of the symptoms of PCOS can be managed.  This is why diet and exercise are two key components to any PCOS treatment plan.

How is PCOS diagnosed?

A woman must have two of the three features listed below, and have other conditions that may cause the symptoms excluded.

1.  Irregular or absent periods

2.  Clinical signs of high androgens or biochemical signs (lab work)

3.  Polycystic ovaries

 

How is PCOS treated?

Since virtually every part of PCOS is better when insulin resistance is managed, that is where you want to start.

A low GI diet and daily exercise are the foundation to a good treatment plan.

There have been many studies to support the use of natural therapies in the treatment of PCOS.  Many different supplements and herbs can help increase ovulation, decrease insulin resistance, and reduce androgen excess.

The ‘trick’ to these therapies working is two-fold.  Choosing supplements that are appropriate for you and taking them in the doses necessary.

Also, most of the studies have been done over the course of two to six cycles.  Patience is surely needed on everyone’s part.

So if you’ve been surfing the web trying to figure out what you should take, you can stop now.  Book your assessment and let us figure out which supplements have been researched and are most suited to you.

Fertility – Frequently Asked Questions

What is infertility? Is it a common problem? Is infertility just a woman’s problem? The Docs answer your most frequently asked questions.

What is infertility?

Infertility is defined as the inability to conceive after a year of regular intercourse or carry a baby to term.

Is infertility a common problem?

In 2010 the Canadian Community Health Survey found that infertility rates ranged from 11.5% to 15.7% of couples. This has increased over the years.

In 1992, 8.5% of women aged 18-44 who were married or living common-law were considered infertile.

In 1984, the figure was 5.4%

Is infertility just a woman’s problem?

No.

  • 30% due to male factors
  • 40% due to female factors
  • 30% due to mixed male and female and/or unexplained infertility

What causes infertility in women?

  • Absent period
  • Blocked fallopian tubes
  • Endometriosis
  • High FHS levels
  • Low progesterone
  • Luteal phase defect
  • Ovarian cysts
  • PCOS
  • Premature ovarian failure
  • Stress & fertility
  • Uterine fibroids

What causes infertility in men?

  • Chromosomal or genetic causes – DNA fragmentation
  • Testicular torsion/injury
  • Drugs, chemicals, or radiation damage
  • Sperm antibodies
  • Injury or infection
  • Retrograde and premature ejaculations
  • Failure of ejaculation
  • Infrequent intercourse
  • Damage to nerves
  • Toxicity, oxidative damage to sperm
  • Poor nutritional status
  • Intake of other cravings: alcohol, coffee/caffeine, cigarettes, poor diet, recreation drugs such as marijuana

How can naturopathic medicine help?

Naturopathic doctors work with the subtle abnormalities not just the big ones.  Just having a period isn’t good enough for us. We want to optimize your hormones and make both partners as healthy as possible.

We do a thorough assessment of preferably both parents.  Lab work and physical exam helps us evaluate the nutritional status of the parents.

From this information gathered we determine which herbs and supplements are appropriate for each parent.  We also make dietary recommendations based on the information gathered.

If your time and budget allows, we perform acupuncture based on your symptoms and what treatments you are undergoing.

We do not believe that one protocol helps all people.  Just because your friend tried this diet or this supplement and got pregnant doesn’t mean that it will work for you.

If you are interested in learning more, please contact us for a free meet the doctor or book your fertility intake appointment to get started. 

Why don’t I get a regular period?

Many women who skip months without a period have a condition called Polycystic Ovarian Syndrome, or PCOS.

PCOS is a condition that includes:

  • high testosterone and DHEA-s levels causing acne, unwanted hair growth, and male patterned baldness
  • ovarian dysfunction with often results in lack of ovulation, hence the long periods of time between periods and often the associated infertility
  • weight gain occurs in many women due to the insulin insensitivity that is often part of PCOS

If you suspect that you may have PCOS, you need to have some blood work done to rule out other reasons for symptoms.  If you have been diagnosed with PCOS, remember that it’s a life-long condition.  You want to make sure that you are being taken care of with respect to the long term risks:

  • diabetes
  • cardiovascular disease
  • endometrial cancer
  • mood disorders

Naturopathic Medicine can not only help you manage PCOS symptoms like acne and infertility, but it can also help reduce your long-term health risks.

Book your assessment today or have your questions asked during our free 15 minute meet-the-doctor.