Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. However, ask any PCOS sufferer, and you’ll soon find out that despite how often women get diagnosed with it, specialists are yet to find a way for women diagnosed with it to live a more comfortable life.
Medications are used to either balance hormones or reduce blood sugar levels, yet they can’t cure PCOS, and in some cases, the medications themselves raise the risk for other conditions.
For example, one of the medications commonly used for PCOS, Metformin, elevates liver enzymes and interferes with the absorption of B vitamins.
However, there is hope. Newer research suggests that although the name of the syndrome implies dysfunction of the ovaries, in some women, the problem may not be in the ovaries, or perhaps not entirely.
Studies show that about half of women suffering from PCOS have their adrenal glands producing the excess androgens.
In addition, the adrenals can also cause your body to release stored glucose (elevated blood sugar being another marker of PCOS) even when you aren’t eating. Elevated androgens and insulin resistance are at the root of all PCOS symptoms.
The adrenal glands are part of the hypothalamus-pituitary-adrenal (HPA) axis, the center for threat detection and the reason why your body can run faster when chased by a tiger and why you can focus better when under pressure.
Being stuck in the flight or fight state can cause the body to produce excess androgens and insulin in the adrenal glands. This means your day-to-day struggles have a tangible impact on your hormones.
When the Threat Detection System is Faulty
When your body detects a real or perceived threat, the sympathetic nervous system (SNS) via the hypothalamus-pituitary-adrenal (HPA) axis is activated.
Trauma, regardless of how old or new it is, has one single common thread: spending more time in fight or flight mode as opposed to resting and digesting.
On a physiological level, the nervous system makes several changes to prepare you for a stressful event (the brain can’t make out the difference between the two). These changes include:
- Increased blood flow to the vital organs
- Increased focus and better visual acuity
- Elevated blood glucose for more energy
- Altered production of sex hormones
- Slowed down digestion
- Impaired immunity
All the physiological changes serve one purpose: to prepare your body to fight or flee.
Non-essential functions such as digestion, reproduction, and even fighting viruses are diminished because, when a tiger is chasing you in the jungle, you have a higher chance of survival if your muscles are filled with energy instead of having blood redirected to your stomach to digest the food you ate.
As you relax, the body goes into rest and digestion, prioritizing functions that can happen in a safe environment.
Women who can’t move smoothly between states of stress and relaxation may get stuck in a place where many of their bodily functions, including their hormone production, are impaired. Even a history of trauma shows evidence of the impact of stress on hormone levels.
Several studies found associations between early life trauma and war trauma, even without a PTSD diagnosis. These patients experienced elevated levels of DHEA, a type of androgen secreted by the adrenal glands.
Why Does the Body Create Excess Androgens and Insulin During Periods of Prolonged Stress?
Aside from being a precursor to androgens, DHEA is an anabolic steroid that has the ability to regenerate the body after stress, and it often goes hand in hand with cortisol.
So each time your body undergoes periods of stress, your body needs the extra androgens to heal from the taxing experience. In addition, each time you feel threatened, your body responds by preparing itself to fight off predators, even if that is a tight deadline or rumination over past traumatic events.
This response also includes releasing glucose in your bloodstream for quick bursts of energy, which can explain why women with PCOS have a low tolerance for sugary foods.
If there is stress, your body already has more than enough glucose in the bloodstream, and eating more sugary foods will only worsen your blood sugar readings.
What Can Help and Hurt Your HPA Axis?
The threat detection and stress management response is an ancient one. Your body responds to unresolved trauma and day-to-day stressors as if it were to a saber-toothed tiger.
Your muscles may not need the extra energy to meet the deadline or deal with a toxic partner, but you’ll get the excess glucose in your bloodstream anyway.
In addition, your body doesn’t make the difference between what’s happening now and what happened in the past. As long as it’s on your mind, traumatic events can cause lingering effects, even years after the event.
Ruminating over a painful past and the pain associated with it feels very urgent to the nervous system, and it can activate as if the threat needs to be addressed here and now.
In other words, if you suspect stress could be causing your PCOS, the first step is to test your DHEAS and look for ways to promote safety in your body.
A sense of safety can be promoted by finding an empathetic therapist who makes you feel safe and seen and helps you make choices that perpetuate that sense of safety in your life.
Good sleep hygiene, a healthy diet, gentle exercise, yoga, and massages are other ways to promote a sense of safety in the body and allow your nervous system to heal.
Lastly, stimulants such as caffeine and nicotine can hurt your HPA axis, particularly if you are suffering from chronic stress.