Can PCOS be Treated with
A majority of women with PCOS take birth control pills to regulate their monthly cycles and to control androgen excess. Yet, studies have shown that some formulations of the pill may actually increase insulin resistance. Furthermore, some women experience negative side effects of the pill such as mood swings and loss of libido. This leaves many wondering, is there a safe alternative to produce monthly cycles and decrease male hormones?
Dr. Jerilynn Prior, a physician-researcher and professor of endocrinology at the University of British Columbia, actually prefers to treat her PCOS patients with natural progesterone rather than the pill. She believes that the underlying problem of PCOS is that the body does not produce enough progesterone for two weeks during the menstrual cycle. Dr Prior explains, "Progesterone is the hormone made by the ovaries after an egg is released. This lack of progesterone in women with PCOS leads to an imbalance in the ovaries, causes the stimulation of higher male hormones and leads to irregular periods and trouble getting pregnant. Progesterone is usually missing - replacing it therefore makes sense.
"Progesterone talks back to the hypothalamic and pituitary (brain) hormones that control the ovaries and stops them from stimulating the ovaries to make too much testosterone."
Dr Prior recognizes that the pill, with its synthetic type of progesterone, does help women with PCOS to a certain degree. But her goal for PCOS patients is, "to return the brain/ovary system to a normal balance. The goal of the Pill is the opposite - it must suppress the brain-ovary system to prevent pregnancy."
To help her PCOS patients achieve a normal hormonal balance, she prescribes oral micronized progesterone (trade name Prometrieum) which is a bio-identical hormone. Taking this natural progesterone for two weeks every month (called cyclic progesterone therapy) may help the brain to develop the normal cyclic rhythm that is missing in PCOS.
Interestingly, Dr. Prior believes there is another benefit of cyclic progesterone therapy. She explains, "most doctors don't realize progesterone antagonizes and inhibits the enzyme (called 5-alpha reductase) that is needed to make testosterone into dihydrotestosterone. Dihydrotestosterone is the powerful male hormone that talks hair follicles into making coarse hair and too much oil that causes acne."
The late John R. Lee M.D. was an international authority and pioneer in the use of natural progesterone. He stated that, "Natural progesterone should be the basis of PCOS treatment, along with attention to stress, exercise and nutrition." He recommended using 15 to 20 mg of progesterone cream daily during the last two weeks of your cycle and to give the treatment at least six months in conjunction with a diet and exercise program. If symptoms begin to fade, Dr. Lee suggested easing off the progesterone by reducing the dose by half with the goal being to return your body to its own "hormonal rhythms."
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