PCOS and Contraception: A Wrench in the Works
Thara Vayali MSc, MA, ND
Polycystic Ovary Syndrome (PCOS) is also referred to as Anovulatory Androgen Excess, and a yet-to-be-determined name under development.1 This diagnosis of exclusion has thrown its net far and wide; as such, the assessment is fuzzy, the treatments are disheartening, and prognosis is confusing.2,3Fundamentally, we are dealing with a broad-ranging female endocrine error syndrome that is increasing in incidence.1,2,4,5 As naturopathic physicians, we often see patients that fall into these sweeping diagnoses; there is no definitive box to fit within, so patients arrive forlorn and hoping for help from alternative medicine. If we can deconstruct the overarching diagnosis into its varied syndromes, we may be able to treat the wide range of root causes individually or – better yet – circumvent the preventable factors. To do this effectively, we must assess and treat the different patterns of female endocrine abnormalities as separate diagnoses. One pattern, which I think is worth spending time on, is the distinct effect of Low-Dose Estrogen (LDE) Combined Oral Contraceptives (COCs) on ovarian follicle growth, insulin sensitivity, and androgen release. The dosing schedule for LDE COCs may be creating symptoms that lie within the PCOS spectrum. This unexpected consequence can throw a wrench into the modern woman’s health plan. A realistic solution may be surprisingly simple. Read More