Can progesterone help recovery from Polycystic Ovarian Syndrome (PCOS)?

I think a third of all the emails I get are from women who have PCOS. Its a condition that is rising alarmingly all over the world.

Progesterone levels are always low in PCO, as ovulation occurs very infrequently or not at all. Many authorities believe insulin resistance (IR) causes it. IR causes insulin to rise, which in turn causes androgens to rise. This is what causes the main symptoms of PCOS. By reversing IR it has been found that androgen levels drop, the symptoms disappear and ovulation resumes.

I also believe all the oestrogen now found in our environment, in the food we eat, our drinks, the air we breathe and in most of the skin care products we rub on ourselves are involved too.

Progesterone is certainly needed to help reverse PCOS as its normally very low in those suffering the condition. Progesterone also helps to regulate the cycle.

It could take a while for things to sort themselves out, so have patience. Researchers have found it takes three and a half months to reverse insulin resistance.

I have put together a plan of action and listed research papers with web links to aid further...

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PCO is the most prevalent reproductive problem in young girls and women, affecting between 5 to 10%.

Women with PCOS have...

If insulin resistance is reversed insulin levels drop, this in turn lowers androgen levels, which in turn prevents the suppression of ovarian function, allowing the ovaries to start functioning normally. Two studies have found that the B vitamin inositol helped control insulin resistance.

Women are normally given The Pill to prevent ovulation and Metformin, a diabetic drug, to bring the sugar level down.

The Pill contains synthetic progesterone and oestrogen, which also stops ovulation, but it also reduces the level of natural progesterone in a woman, plus the many adverse side affects it has. Synthetic progesterone or progestins increase insulin resistance.

Plan of action

• Reduce insulin levels - eat organic protein (with no growth hormones), avoid all starchy carbs, including fruit, eating only the non-starchy leaves, shoots, sprouts etc
• Reduce androgen levels - use progesterone and avoid all food which converts to glucose (as above), to reduce insulin, which causes androgens to rise
• Use 6ml/day of a 3.33% progesterone cream (this will give 200mg progesterone/day) every day to prevent any eggs from growing and maturing, as they only result in more cysts. Continue for 3 to 6 months, another scan will confirm if they've gone
• Once gone revert to a normal cyclic use of progesterone. This should prevent any further cysts and hopefully initiate ovulation. As there are usually no, or very erratic periods to begin with, chose any date to start
• Take 4000mg/day of the B vitamin inositol, this reverses insulin resistance. Very important
• The amino acid L-glutamine is amazingly helpful. Take 4000-8000mg/day. It's best dissolved in a water bottle and drunk throughout the day. The brain can use it in place of glucose for energy, so it stops all binging, tiredness, cravings for sugary foods and alcohol, it heals the lining of the gut, it boosts the immune system and is the most abundant amino acid in the muscles, so helping with muscle weakness
• The probiotics can be very helpful, take one which has at least 10 billion bacteria per dose
• Have a homocysteine test, if its high take...
  • 150mg B2-riboflavin
  • 75mg B6-pyrodoxine
  • 1000mcg B12-cyanocobalamin
  • 1200mcg Folic acid
  • 3000mg TMG-tri-methyl glycine (anhydrous)
  • 20mg Zinc
  • the amino acids L-arginine, N-acetyl cysteine and L-lysine help too, especially with the triglycerides
• MCT oil (medium chain triglyceride) is a wonderful source of energy which is not converted to fat, but can be used directly by the cells for energy, take 5-60ml/day. It's extracted from coconut oil, which can also be used specially for cooking. MCT is 60% caprylic acid, which kills candida, and 40% capric acid

Additional information

Progesterone

Apply 100-200mg of progesterone per day. This equates to 3-6ml of Natpro. Up to 6ml per day might be needed for PCOS.

To give the ovaries a rest and to prevent ovulation, progesterone should be used every day for three to six months.

If a further scan reveals no cysts, a return to the normal menstrual cycle should then be resumed. The progesterone should be continued, using it to regulate the cycle and prevent a return of the cysts.

Nutrients

The nutrients given below are to be taken daily in the appropriate proportions (to learn more please send a brief request using the form in the right margin). They all assist in...

• the insulin response
• reverse insulin resistance
• prevent tiredness and weight gain
• lower triglycerides
• assist in the energy transfer within the mitochondria
• cleansing the liver

• arginine
• carnitine
• cysteine (N-Acetyl-L)
• L-glutamine
• glycine
• isoleucine
• leucine
• taurine
• valine
• chromium amino acid chelate
• selenium
• zinc amino acid chelate
• vitamin B1
• vitamin B2
• vitamin B3
• vitamin B6
• vitamin B12
• biotin
• folic acid
• inositol
• ALA (alpha lipoic acid)
• CoQ10
• green tea extract (EGCG)
• milk thistle (82% silymarins)

Take the probiotics Lactobacilus acidophilus and Bifidobacteria bifidum/lactis with at least ten billion bacteria per dose.

MCT oil (medium chain triglyceride) is a wonderful source of energy which is not converted to fat, but can be used directly by the cells for energy, take 5-60ml. Please note it does have a laxative affect at high doses.

The soluble fibres such as apple pectin, guar and ground linseed are beneficial too, add them to drinks or food.

Very important: As homocysteine could be a contributing factor, a blood test should be done to check. If higher than 6 then it is essential to take the following nutrients to bring it down: 150mg B2-riboflavin; 75mg B6-pyrodoxine; 1000mg B12-cyanocobalamin; 1200mcg folic acid; 3000mg TMG-tri-methyl glycine (anhydrous); 30mg zinc.

Diet

References
Eur Rev Med Pharmacol Sci 2007; 11 (5) : 347-354
Randomized, double blind placebo-controlled trial: effects of Myo-inositol on ovarian function and metabolic factors in women with PCOS

The Journal of Clinical Endocrinology & Metabolism 2007, Vol. 92, No. 7 2726-2733
Insulin and Insulin-Like Growth Factor Stimulation of Vascular Endothelial Growth Factor Production by Luteinized Granulosa Cells: Comparison between Polycystic Ovarian Syndrome (PCOS) and Non-PCOS Women

European Journal of Endocrinology, 2006 Vol 154, Issue 1, 141-145
Metabolic syndrome in polycystic ovary syndrome (PCOS): lower prevalence in southern Italy than in the USA and the influence of criteria for the diagnosis of PCOS

The Anatomical Record 2005 Volume 231, Issue 2 , Pages 185 - 192
Changes in ovarian morphology and serum hormones in the rat after treatment with dehydroepiandrosterone

The Journal of Clinical Endocrinology & Metabolism 2004, Vol. 89, No. 5 2160-2165
Increased C-Reactive Protein Levels in the Polycystic Ovary Syndrome: A Marker of Cardiovascular Disease

Clin Endocrinol 60(5):560-567, 2004,
“Plasma Homocysteine in Polycystic Ovary Syndrome: Does it Correlate With Insulin Resistance and Ethnicity?”

INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE 14: 207-215, 2004
Induction of polycystic ovary by testosterone in immature female rats: Modulation of apoptosis and attenuation of glucose/insulin ratio
Pdf paper, no web address available

STEROIDS Volume 69, Issues 11-12 , October-November 2004, Pages 763-766
Licorice reduces serum testosterone in healthy women

J Intern Med. 2003 Nov;254(5):455-463.
“Effects of short-term treatment with metformin on serum concentrations of homocysteine, folate and vitamin B12 in type 2 diabetes mellitus: a randomized, placebo-controlled trial.”

J Clin Endocrinol Metab. 2003 Dec;88(12):5907-13.
'Altered cortisol metabolism in polycystic ovary syndrome: insulin enhances 5alpha-reduction but not the elevated adrenal steroid production rates.'

Human Reproduction, Vol. 17, No. 6, 1459-1463, June 2002
Luteal phase progesterone excretion in ovulatory women with polycystic ovaries

Human Reproduction, Vol. 16, No. 10, 2061-2065, October 2001
Effects of androstenedione, insulin and luteinizing hormone on steroidogenesis in human granulosa luteal cells.

Prim. Care Update Ob Gyns 2001 Jan;8(1):12-17
“The low-carbohydrate diet in primary care OB/GYN.”

The Journal of Clinical Endocrinology & Metabolism 2001, Vol. 86, No. 6 2453-2455
Low Grade Chronic Inflammation in Women with Polycystic Ovarian Syndrome

New England Journal of Medicine , 340(17), 1999, pages 1314-1320.
'Ovulatory and Metabolic Effects of D-Chiro-Inositol in the Polycystic Ovary Syndrome'

Gynecol Endocrinol. 1998 Feb;12(1):29-34.
Effects of estradiol and an aromatase inhibitor on progesterone production in human cultured luteal cells.

Archives of Environmental Contamination and Toxicology
Volume 3, Number 4 / December, 1975: 479-490
Prolonged ingestion of commercial DDT and PCB; effects on progesterone levels and reproduction in the mature female rat.

Further information

PCOS is generally considered a syndrome rather than a disease, because it manifests through a group of signs and symptoms that can occur in any combination, rather than having one known cause.

Other names for Polycystic Ovary Syndrome are Stein-Leventhal Syndrome, hyperandrogenic chronic anovulation, functional ovarian hyperandrogenism, and Polycystic Ovary Disease.

The exact cause of PCOS is unknown, although some authorities believe insulin resistance to play a major role.

The medications used to treat PCO's include birth control pills, spironolactone, flutamide, and clomiphene citrate. Treatment with clomiphene induces the pituitary gland to produce more FSH, which in turn stimulates maturity and release of the eggs. Although one study found a high level of bioactive FSH in PCO granulosa cells which failed to effect maturity of an egg. If insulin resistance is present metformin or one of the thiazolidinedione medications is given.

Women with PCOS may have some of the following symptoms...

• Amenorrhea (no menstrual period)
• infrequent menses, and/or oligomenorrhea (irregular bleeding) - Cycles are often greater than six weeks in length, with eight or fewer periods in a year. Irregular bleeding may include lengthy bleeding episodes, scant or heavy periods, or frequent spotting
• Oligo or anovulation (infrequent or absent ovulation) - While women with PCOS produce follicles - which are fluid-filled sacs on the ovary that contain an egg - the follicles often do not mature. It is these immature follicles that create the cysts. With the absence of ovulation no progesterone is made
• Hyperandrogenism - Increased serum levels of male hormones. Specifically, testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS)
• Infertility - Infertility is the inability to get pregnant within six to 12 months of unprotected intercourse, depending on age. With PCOS, infertility is usually due to ovulatory dysfunction
• Cystic ovaries - Classic PCOS ovaries have a "string of pearls" or "pearl necklace" appearance with many cysts (fluid-filled sacs). It is difficult to diagnose PCOS without the presence of some cysts or ovarian enlargement, but sometimes more subtle alterations may not have been recorded, or are not recognized as abnormal by the ultrasonographer
• Enlarged ovaries - Polycystic ovaries are usually 1.5 to 3 times larger than normal
• Chronic pelvic pain - The exact cause of this pain isn't known, but it may be due to enlarged ovaries leading to pelvic crowding. It is considered chronic when it has been noted for greater than six months
• Obesity or weight gain - Commonly a woman with PCOS will have what is called an apple figure where excess weight is concentrated heavily in the abdomen, similar to the way men often gain weight, with comparatively narrower arms and legs. The hip:waist ratio is smaller than on a pear-shaped woman - meaning there is less difference between hip and waist measurements. It should be noted that most, but not all, women with PCOS are overweight
• Insulin resistance, hyperinsulinemia, and diabetes - Insulin resistance is a condition where the body's use of insulin is inefficient. It is usually accompanied by compensatory hyperinsulinemia - an over-production of insulin. Both conditions often occur with normal glucose levels, and may be a precursor to diabetes, in which glucose intolerance is further decreased and blood glucose levels may also be elevated
• Dyslipidemia (lipid abnormalities) - Some women with PCOS have elevated LDL and reduced HDL cholesterol levels, as well as high triglycerides.
• Hypertension (high blood pressure) - Blood pressure readings over 140/90.
  Hirsutism (excess hair) - Excess hair growth such as on the face, chest, abdomen, thumbs, or toes
• Alopecia (male-pattern baldness or thinning hair) - The balding is more common on the top of the head than at the temples
• Acne/Oily Skin/Seborrhea - Oil production is stimulated by overproduction of androgens. Seborrhea is dandruff - flaking skin on the scalp caused by excess oil
• Acanthosis nigricans (dark patches of skin, tan to dark brown/black) - Most commonly on the back of the neck, but also in skin creases under arms, breasts, and between thighs, occasionally on the hands, elbows and knees. The darkened skin is usually velvety or rough to the touch
• Acrochordons (skin tags) - Tiny flaps (tags) of skin that usually cause no symptoms unless irritated by rubbing
• FSH levels are either low or normal
• LH levels are generally high
• Androgen ( testosterone ) levels are high
• Estrogen (principally estrone and estradiol) levels can be high or low
• Progesterone levels are lower than normal

Medline information

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