Episode #66: Cracking the PCOS Code: Understanding the Why Behind Your Symptoms

PCOS is a unique combination of symptoms that leads to a picture that prompts the diagnosis of PCOS but what’s going on behind those symptoms? That’s the root cause that we want to get to, especially when we are wanting to heal our hormones naturally and create a lifestyle that supports our body to thrive and to function the way that we want. For this month September, I want to dive into a series where we really walk through from the ground up of noticing symptoms, getting diagnosed, discovering your root cause, learning to heal your PCOS, and ultimately creating a lifestyle that is sustainable and enjoyable as you allow your body to live in an environment in a bubble that works for you and allows you to thrive and live your life fully without restrictions that you can enjoy and move on from the frustrations and stress of PCOS. So I hope you join me this month for each week as we continue this series in PCOS Awareness Month of September. All right, let’s get started.

You’re listening to the PCOS Repair Podcast where we explore the ins and outs of PCOS and how to repair the imbalances in your hormones naturally with a little medical help sprinkled in. Hi, I’m Ashlene Korcek, and with many years of medical and personal experience with polycystic ovarian syndrome, it is my joy to watch women reverse their PCOS as they learn to nourish their body in a whole new way. With the power of our beliefs, our mindset, and our environment, and the understanding of our genetics, we can heal at the root cause.

Welcome back to the PCOS Repair Podcast, where today we’re starting a four-part series where we’re going to be talking about really all the stages of learning about PCOS and learning about your root cause, what’s going on with you specifically, all the way to creating a lifestyle that works for you and your body. So if you haven’t already, hit the subscribe button because you’re going to want to get notified each week when the next episode becomes available because we’re going to build off of each of these weeks that we are starting with today. Okay, so first of all, when you start having certain symptoms, whether you went to your doctor and got your diagnosis, or you’re considering making an appointment because you’re starting to wonder if you have PCOS, wherever you are in that beginning stages or wherever you were in those beginning stages, your body was giving you clues that something wasn’t working quite right. It may have been something as simple as acne early on in adolescence that wasn’t going away when you thought it should. Perhaps it was not having a regular cycle. Even if you weren’t trying to get pregnant, you knew that not having a regular cycle was a sign that maybe you should see your doctor.

Maybe they diagnosed you with PCOS, maybe they just gave you birth control, and that led to many years of suppressing the issue and then maybe further down the line, you were trying to get pregnant, or you were struggling with other symptoms, and you revisited the topic with your doctor of what is going on with my body, and then got a diagnosis of PCOS, or perhaps you’re being worked up for a diagnosis of PCOS. Let’s look at what exactly, again, creates the criteria for a diagnosis of PCOS. Basically, we have a slew of symptoms. It can be anything from irregular cycles to absent cycles, difficulty getting pregnant due to not ovulating. It can be really heavy or difficult periods may lead your doctor to start looking at this. It can be things like acne, hair loss, hair growth on the body. You can have further testing that shows abnormal lab values or an ultrasound with polycystic ovary appearance. Now, an ovarian cyst, and I’ve said this before on earlier episodes, but really important to distinguish an ovarian cyst is a single cyst. It’s more of a true cyst that can rupture and be painful, and that is very different than polycystic ovaries.

Polycystic ovaries are all of the little follicles that tried to become a full-grown egg that was ready to ovulate and be released but didn’t get there. So basically because you didn’t ovulate enough months, you’re creating a collection of half matured follicles, and they create a polycystic, a many cystic appearance but they’re not a true cyst. They’re actually a follicle that was trying to become a egg, but it didn’t mature all the way until it wasn’t released and it just hung out on your ovaries. That’s an important distinction because I think a lot of times when people hear they had a cyst on their ovaries, they think, Oh, I must have polycystic ovarian syndrome and having cyst on your ovaries or not having cyst on your ovaries, honestly, as we’ve learned more about PCOS, is relatively irrelevant. People can have and not have any cyst on their ovaries, and so their ultrasound may be normal and people who have cystic ovaries may not have any other symptoms of PCOS because there may be other reasons why. They’re not ovulating every month, and it doesn’t necessarily mean they have PCOS. It’s a little bit of a take it with a grain of salt a test, but the combination of your list of symptoms as well as your lab work that often will show things like an LH ratio that is greater than one to one.

Typically, we see a one to one ratio. You may have low digestion, you may have high testosterone and then there are a whole list of other symptoms that you may also be dealing with that are less classic for PCOS, you may have increased anxiety, you may have poor sleep, you may have poor energy, weight problems are often associated with PCOS they are a complicated issue when it comes to PCOS and we’re going to talk about that as we get into the root cause hormones. Some of the root cause hormones make gaining weight extremely easy, and it can create a really poor cycle where you’re downward cycling to where you’re gaining weight easier and easier, and that’s making your PCOS symptoms worse and worse but PCOS is not caused by weight gain. It’s also not cured by weight loss, but they do play a very hand-in-hand role together that we will talk about more as we continue this series. Okay, so you go to your doctor, you have these symptoms, they diagnose you with PCOS. They basically tell you you could take the birth control pill. You can come back when you want assistance getting pregnant, maybe give you an acne medication if acne is your problem.

Not a lot of other assistance other than recommending weight loss. So where do you go from there? What is actually going on? You have this list of symptoms, now you have a name for them but what are those symptoms telling us about our body? So PCOS is one of those chronic disorders, chronic, meaning ongoing, not going away disorders, that medicine doesn’t really have a great way of dealing with. The best way to approach PCOS, if you want to improve your symptoms, if you want to improve your quality of life and how you feel in your body, have better energy, easier weight loss, better fertility, all the things, really it comes down to creating a lifestyle that supports your body because the medications available for us for PCOS are, at best, band-aids. There’s a couple that may have some helpful benefits, but they’re going to be minimally beneficial if we don’t create a lifestyle that really supports our hormones overall. The unique part about this is that while all of these collective symptoms at the tip of the iceberg, like what we see at the surface, look really similar, which is good because it paints the picture of PCOS, which allows our doctor to give us that diagnosis, so at least we have an idea of what we’re dealing with.

But what we’re looking at is the tipy, tipy, tipy, tip of the iceberg. There is so much more going underneath, and this is where the true variability comes in. A couple of years back, there were some research articles published about finding some genes that were associated with PCOS. This gave some really great insights into what is going on beneath the surface. How come each person has a very unique picture of how their PCOS plays out as well as a very unique experience with what works for them as they heal their PCOS. What did these genes tell us about PCOS? Basically, there is not one gene that’s really important to understand. There is not one gene for PCOS. There are many genes and they affect how our body deals with inflammation, how our body deals with blood sugar and insulin regulation but there wasn’t just one of each of those. There was many, many genes that we saw, but we saw those commonalities in the research that was done. So what does that mean? And does that mean that we can’t do anything about it? We are just stuck with it? Well, a couple of things here that we want to keep in mind.

One is that our genetics have many different types of genes. We have genes that say the color of our hair, that’s not going to change. We also have genes that can be turned off and turned on. I can’t just turn off the color of my hair, it is what it is. It’s going to be dark. I can’t change my eye color. Now, my eye color tends to look a little different depending on what I’m wearing, but my eye color is my eye color. My skin tone is my skin tone. Those are things that I can’t change. Genes that come in when it comes to our longevity, our risk of getting certain diseases. So when your doctor takes your family history, they’re trying to assess your risk of developing heart disease, diabetes, certain cancers, so that they can continually monitor you in an appropriate way. Some people with really strong certain histories weren’t more close monitoring of certain health issues to make sure that you’re not developing something that is very prevalent in your family history. However, does it mean that you will for sure get those things? No, it doesn’t and the reason is that your lifestyle, your other genes, so many other factors come in, and they determine whether or not you get that or not.

So just because a relative had heart disease and diabetes, depending on how you eat, how you exercise, how you create a lifestyle free of stress, or getting enough sleep and all the things that support health, you may not ever have any of those problems. You may be able to go many, many, many years past when your relative developed that disorder. This is where genes have tendencies. PCOS genes put us at a higher tendency to react to our environment in a way where we start to see symptoms of PCOS. Can we cure PCOS? No, we can’t go in there and change our genetics, we have the body that we have. However, we can change our environment to create a bubble, so to speak, where those genes don’t turn on, or if they’ve already turned on, they turn off and our symptoms go away. Of course, there’s variations to the degree that we can turn them off. Some people have a lot easier time turning them off, some people have a harder time, it depends to where our starting point is, where our health is currently, what our current habits are, and time frame. Some people it twitches around really quickly.

Some people it takes a lot longer, some people it’s a several-year process where they see significant improvement along the way, but they still have a lot of gains to make over time. Again, everyone’s situation is so unique. Then I want to talk about the fact that not only have we discovered this PCOS gene, but one of the reasons why PCOS may be really on the rise. When I was first diagnosed with it, this was nine-plus years ago, I think nine years ago now, they said 1 in 10 women. Now, I’m hearing statistics of almost 1 in 6 and this may have a lot more to do with the fact that overall, as a population, our health is declining. I think the foods, the lifestyle, the stress, the demands on ourselves are so different than they were one generation ago that we are creating a situation where we are moving towards inflammation and diabetes at a faster rate as a species, but at the same time that it has a lot to do with our environment. So the question from a epidemiology standpoint, not is individually relevant, but something that I wonder about is, do more of us have these gene tendencies than we realize or are more of us getting these symptoms of PCOS even without the genes because of the mainstream lifestyle that people are living? and what can we do to change this so that we can turn those genes off? We are going to be talking about exactly that a little bit in today’s episode, but even more in the following episodes of this four-part series. Again, make sure that you’ve hit the subscribe button. Make sure that you’re going to get the notifications when those additional episodes come out, because this is going to be a several-step process to first of all, understanding why PCOS happens, how to discover what’s going on in your body specifically, how to heal your specific situation with PCOS, and then ultimately how to create a sustainable lifestyle. Those are the four parts that we’re going to be going over.

Now that you understand that genetic aspect or that how our body is relating to our environment, that these genes can be turned on or turned off, now let’s talk about what those root causes are. From the tip of the iceberg, we are seeing those symptoms. Those symptoms are things like irregular periods, acne, hair loss, facial hair or body hair, anxiety or mood disorders, depression, poor sleep and fatigue, fertility problems, weight problems, to name a few. As we go further into the down underneath the surface of that iceberg, we start to see the medium root causes. The medium root causes are going to be those hormone imbalances, these are going to be a lot of our androgen hormones. These are things where we have to test for these, so they’re not super obvious. We don’t know exactly what’s going on when we start to have an irregular period. This is where we start to differentiate between, Is there another disorder going on? Something like a thyroid disorder, or are we dealing with more of a PCOS disorder? But we’re having to run some tests to determine why are you not ovulating? Why are we having these symptoms? Why is your cycle irregular? Here, we’re going to start seeing on lab work that you may have elevated testosterone, the LH ratio that’s not one to one. We’re testing to make sure that there isn’t something else going on, like your thyroid looks good and so forth. Now, we see that these hormones are imbalanced. You may have high testosterone, you may have low progesterone. Why? What is causing these hormones to be imbalanced? We’re going to go deeper into the root cause.

This is where we start to look at what is going on with your cortisol? What is going on with the insulin response, what is going on with inflammation, how is your body responding to its environment at a very deep metabolic level? This is something that most doctors don’t really get into, with the primary reason being women with PCOS are typically being diagnosed somewhere in their late teens to mid-30s. At this point in life, our body is really quite resilient, and most of us have not crossed over the threshold into what our lab work would consider actual disease. That mid-level one that we talked about with the hormones, the androgens, thyroid issues, those ones will maybe start to show up on labs but what we don’t see yet is an elevated hemoglobin A1C, indicating that your blood sugar is too high, that you’re prediabetic or that you’re diabetic. That may happen later, but in that frame of time that most women are being with PCOS, those labs are going to be normal because you’re young and your body is resilient. It is making up for the imbalances. Now, if we did an insulin tolerance test, we may start to see some indication of elevation but what we may be dealing with is simply that our body is being hyperresponsive to our insulin because our body is being sluggish about our glucose management. If this is the case, you may be dealing with what I call the insulin effect because technically you’re not insulin-resistant yet. You may be dealing with a early degree of insulin resistance, but you don’t meet the criteria by lab values to be unhealthy in regards to, We need to start working on this. However, those values of labs don’t equal healthy. They equal, this is the threshold that medicine has determined that we start taking it seriously. Our body starts to struggle long before that threshold. That’s where we start to see the symptoms of PCOS occur. Same thing with inflammation, same thing with poor absorption of nutrients because of gut issues, same thing with our bodies hanging on to too much glucose, storing things and not being able to burn fat regularly, leading to elevated insulin levels, cortisol elevates our insulin, insulin elevates our LH, all of these things mess with our androgens, messing our cycles up, messing up our ovulation, messing up our fertility, increasing acne, increasing hair growth, etc, etc, etc.

The tricky part comes into, this is happening in different ways, different reasons, and different quantities in every woman. Well, we have four main categories of PCOS root causes: inflammation, the insulin effect, my term, I don’t know that anyone else uses that one, a hormone imbalance may be caused by something like being on birth control or some even a nutritional deficiency where your body has just shut down its hormones because it doesn’t feel like it’s a safe time to get pregnant. So usually that’s oftentimes we see coming off of birth control, but it doesn’t have to be where our body has just deemed it not time to get pregnant and has actually shut down our fertility. Whether or not you’re trying to get pregnant or not, that may be why your cycle is missing. The fourth category is a stress response. We are dealing with a deep metabolic cortisol issue that’s leading to an insulin issue that’s leading up the cascade through a stressed response to something in our environment. Something in our environment, something in our life is causing our body stress, and it doesn’t necessarily correlate to you feeling stressed, but something is causing your body stress.

In those root causes, you can see how each person’s lifestyle is going to affect those and creates such a different picture of what’s going on. That’s where it’s really important to recognize that, sure, your doctor may have given you the diagnosis of PCOS, but that’s only step one. Now we need to figure out what is going on, what is your unique story of PCOS that your body is trying to tell you. As we learn to listen to your body, as we learn to understand what’s going on, then we can start to address your specific PCOS root causes and adjust your lifestyle to help your body be healthy, heal, and to thrive. The starting place for this is going to be to take the PCOS Root Cause quiz. The questions of this quiz are going to help you start to understand and learn how to listen to your body. What symptoms are you looking for? Because the symptoms of PCOS are the tip of the iceberg. What are the symptoms that indicate what’s going on deeper? They’re there, but they’re different. The questions of this quiz are going to help you to start getting in tune with other areas of your body and what your body is telling you that you want to pay attention to.

The answer to the quiz is going to give you a pretty good idea of where you’re at with your current PCOS root causes. These can change over time, and you can definitely have more than one but the cool thing when you take the quiz is it’s going to tell you the one that you are scoring the highest on so that you’re able to say, Okay, this is where my focus needs to be. In next week’s episode, we are going to get into the root causes a little bit further and talk about what’s going on in your body with each specific root cause. So after you’ve taken that quiz, you’re going to learn a little bit more about those root causes in our next episode. Again, hit that subscribe button and if you haven’t already, make sure you take the root cause. If it’s been a while, take it again. The link will be included in the show notes for this episode and if you have any questions until next time, you know where to find me. I’m over on Instagram @Nourishedtohealthy. I love to hear from you, so feel free to pop into my DMs anytime and we can continue the conversation about PCOS and starting to realize your unique picture of what’s going on with your body with PCOS, that is step one, very important step one, as you begin your healing journey to healthy hormones. All right, until next time. Bye for now.

Did you know that studies of PCOS epigenetics have shown that our environment can either worsen or completely reverse our PCOS symptoms? I believe that although PCOS makes us sensitive to our environment, it also makes us powerful. When we learn what our body needs and commit to providing those needs, not only do we gain back our health, but we grow in power just by showing up for ourselves this is why I’ve created a guide for you to get started my PCOS Fertility Meal Guide can be found in the show notes below. I want to show you how to create an environment that promotes healing while still being able to live a life that you enjoy. This guide is completely free, so go get your copy now so that you can step into the vision that you have for your life and for your health.