stress that we like to use because it clarifies more fully that stress may not be emotional in nature at all, but may be coming from disturbance in metabolic function outside of emotional influ- ence).
Lean Type PCOS In lean physically fit women, the chronic stress/tension of
exercise and diet is suspected as a major cause—or at least one of the primary contributing factors. This persistent metabolic tension leads to several disrupted hormonal signals resulting in thyroid, adrenal and ovarian issues. This happens because the ovaries, thyroid and adrenals share a common path of commu- nication through the brain, the hypothalamus and pituitary.
Heavy Type PCOS The primary issue in someone who is overweight or obese is thought to be insulin metabolism. This can be addressed by a lower starch/sugar diet along with exercise. But this insulin re- sistance can occur in those who are not obese as well. The fix here is to restore the brain-ovary connection by lowering the effect of excess stress hormone production (i.e. cortisol), as well as insulin and estrogen production.
Treatment Approaches As you can imagine, treatment is not easy since all women
are very different. One of the things many in the alternative medicine world do is treat with progesterone, which can result in a “resetting” of the system since in PCOS there is not the progesterone priming effect as in the normal cycle (loss of the formation of the corpus luteum). The other thing many people miss is the stress/tension re-
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lated dysfunction that leads to improper brain feedback. This is why adrenal adaptogens and hypothalamic-pituitary-adrenal (HPA) herbs are used. Things like rhodiola, Relora, and holy basil can be very effective here. And of course, a lower starch/ sugar diet is essential. One confusing aspect occurs in those who are more “stress driven”. This metabolic type can be made worse by diets that are too restricted in carbohydrates, actually acerbat- ing the situation (usually the case in lean types). In many others ,keeping lower carb may be the most significant change they can make (usually heavy types). What is described above is a VERY simple story of a complex hormonal condition. There is much more going on than this, but this description does provide a good base of understanding and a good place to start. If you are dealing with PCOS, the most important starting places are highlighted below. Many people will want to jump right to designer supplements, but the ap- proaches listed below provide the best and most important first steps.
1) If you are an aerobics junky, stop. Do low intensity relax-
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