Do you experience hair loss, acne, hirsutism and or irregular periods and not sure why? Well it may due to having excess/ elevated androgens (such as testosterone) which can also be one of the three possible defining signs of Polycystic Ovarian Syndrome or PCOS.
According to the Rotterdam criteria , it states for a woman to be diagnosed with PCOS she must must have two out of the following three criteria:
1. Irregular or absent menstrual cycles 2. Polycystic ovaries (as seen on an ultrasound) 3. Evidence of hyperandrogenism (elevated androgens) The first two are quite self explanatory, but the third gets a little more complicated.
So what are androgens?
Androgens are often referred to as the “male” hormones, but are actually present and essential in both men and women. They are vital to normal reproductive function, emotional well-being, cognitive function, lean muscle function and growth, and bone strength.
In women, androgen hormones are created in the adrenal glands, the ovaries, and in fat cells and include the following hormones:
DHEA sulfate (DHEA-S)
Hyperandrogenism is when your androgen levels are higher than they should be.
Generally speaking most women with hyperandrogenism almost always have PCOS. (however there are other causes of hyperandrogenism that must be ruled out before a diagnosis of PCOS can be made.)
There are two “kinds” of hyperandrogenism: Clinical and biochemical, and having either kind may qualify you as having PCOS.
1.Clinical hyperandrogenism is when there are visible signs or symptoms that indicate elevated androgen production. These are things that can be seen or experienced without medical testing such as: acne, hair loss and hirsutism.
2. Biochemical hyperandrogenism is when your blood tests shows abnormally high levels of androgen hormones in the bloodstream.
What are the signs of having high levels of androgens such as testosterone?
Hirsutism (excess facial or body hair)
- Acne and/or oily skin
- Alopecia (thinning hair on the head)
- Acanthosis nigricans (rough, darkly pigmented areas of skin)
- High blood pressure
- Insulin resistance
- Fat storage around the mid-abdomen
- Irregular or absent periods or frequent skipped cycles
- Enlargement of the clitoris
- Deep or hoarse voice
However it is important to not that not all symptoms, (if any!) are always seen in all cases of hyperandrogenism, so the best way to confirm is via a blood test.
So what are some of causes of high androgen levels? Insulin resistance : some consider this a cause, other consider it symptom but either way we know there is a link between insulin resistance and high levels of androgens. Excess weight: several studies suggest that an increase in androgen levels can also affect metabolism and food intake in women, resulting in metabolic imbalances and weight gain.
hypersensitivity to androgens (which means there are symptoms of high androgens despite normal levels on a blood test and is thought to be genetic but that is still unclear. Physical inactivity and overactivity: We all know that too little exercise can have a negative effect on our weight and hormones, but many people don't realise that over exercising can actually cause your cortisol to rise and increase your circulating androgens – including testosterone. Coming off the contraceptive pill: The contraceptive pill suppresses many of our hormones including testosterone, so coming off the pill will naturally cause your testosterone levels to spike and can take some time to rebalance. Stress: stress puts extra pressure on your adrenals which has a direct impact on how much DHEA-S, DHEA, androstenedione and testosterone is produced which are all types of androgens. Other hormone imbalances : Our hormones are all intertwined, and are very sensitive to the decrease or increase of other hormones. If one hormone is unbalanced quite often other hormones will also become unbalanced too. Chronic inflammation: Chronic inflammation can stimulate the ovaries to make too much testosterone Tumours (very rare cases) Sex-hormone producing adrenal tumors are rare tumors that make too much androgen(i.e. testosterone), estrogen, or both. (not PCOS related) Diet high in inflammatory foods If you’re insulin resistant, or eat foods high in carbs/ sugar your body may try to pump out high levels of insulin in an effort to keep your blood sugar levels normal. Too-high levels of insulin can cause your ovaries to produce more androgens, such as testosterone.
Congenital adrenal hyperplasia: Refers to enlarged adrenal glands. It is due to inherited enzyme deficiency and is the most common adrenal disorder of infancy and childhood. (not PCOS related)
How to treat high androgens (including high levels of testosterone)?
For me my having high levels or androgens, particularly testosterone has been the main factor contributing to my PCOS symptoms, and something I have had to learn how to decrease and then continue to manage everyday.
It might sound drastic to have to manage it 'every day', but it is just all about simple lifestyle changes that become your knew 'normal' very quickly.
FOOD I eat a well balanced mostly whole food plant based diet.
I also choose cut out inflammatory foods like caffeine, alcohol, refined sugars, processed food and gluten.
Over time I have slowly reintroduced small amount of alcohol (ie a glass of champagne at a wedding or a slice of sourdough bread) but mostly I try to stick to my low inflammatory diet as much as possible
It is also really important to include lots of healthy fats which help to keep hormones balanced and help you feel satiated.
HERBS AND SUPPLEMENTS
I try to get most of vitamins and nutrients from food nut occasionally when I need to I will take supplements like Zinc, pre+probitics. mongolian seabuckthorn, magnesium etc.
I also take detoxifying and testosterone reducing herbs (such as spearmint, alfala leaf, ladys mantle, nettle leaf etc) every single day! (all of those herbs plus more are in Cysterhood tea).
I can not even begin to tell you how much managing my stress has helped me to manage my PCOS.
Things like yoga, breathing techniques, getting out for a walk, cooking/ baking, unfollowing account on social media that don't bring me joy and being in nature have helped me immensely. Find what works for you and bring it into your daily routine!
I steer clear of all high intensity exercises that can spike my cortisol and stick to gentle exercises like walking, yoga, pilates, swimming. surfing, hiking and stretching. I know alot of people love those adrenal pumping HIIT type classes but if your hormones are a priority I would consider looking at if it is doing you more harm than good.
www.ncbi.nlm.nih.gov › pmc › articles › PMC4130703