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  • To be diagnosed with PCOS, a woman must meet 2 of these 3 criteria:
    • Irregular periods, or periods that are more than 35 days apart. The medical term for this is oligomenorrhea.
    • Either elevated androgens (thats hormones like testosterone, DHEA, and androstenedione), or symptoms of high androgens
    • Ultrasound evidence of ovaries with cysts on them


  • The hormonal signature of PCOS is:
    • High luteinizing hormone (LH). LH is a brain hormone that tells the ovaries to make estrogen. When estrogen is low, LH is high, and vice versa. So low estrogen should trigger the release of LH, and in turn, LH should trigger a release of more estrogen. This cycle is broken in women with PCOS.
    • Decreased SHBG (sex hormone binding gobulin). In the blood, estrogen, testosterone and progesterone dont float around by themselves. They need a carrier to take them around. That carrier is a protein called SHBG. Its like a person in a taxi. The person is the hormone, and the taxi is SHBG. As a result of lower SHBG, it makes testosterone higher in women, because more of the testosterone is free.
    • Low progesterone. The hormone that is dominant in the second part of the menstrual cycle.
    • High cortisol. The stress hormone.
    • One study found that there is more subclinical hypothyroidism in women with PCOS compared to women with the same weight, but without PCOS.


  • Another study found that the fat cells of women with PCOS are 25% larger of women without PCOS, but of the same weight.


  • According to one study, obese women with PCOS are 400%-2900% more likely to have sleep apnea compared to women of the same weight and body fat percentage, but without PCOS.
    • This does not apply to lean women with PCOS.


  • Women with PCOS have a higher risk of heart disease, compared with women without PCOS, according to several studies (like this one, this one and this one).
  • More women with PCOS have depression, compared to women without PCOS, mostly due to the infertility (according to this study).
  • 34-57% of women with PCOS have anxiety (reference here).


  • Treatment:
    • The first order of business is the most obvious: diet and exercise.
    • One study analyzed different diets, and found that one that has 50% low-glycemic carbohydrates, 30% fat, and 20% protein seems to have the best effects on PCOS.
    • As far as drugs are concerned, the most frequently prescribed drugs for PCOS are metformin and thiazolidinediones.
    • As far as natural supplements are concerned, one of the most proven is myo-inositol, as well as glucomannan.

So now you just saw the clinical side of PCOS, but how does it affect them in real life? What we hear from our clients who have PCOS is that they:

  • Dont feel like going out, because they think they dont look good. They dont look feminine.
  • Feel like prisoners within their own body
  • Have poor body images.

Even a small amount of fresh herbs can double or even quadruple the antioxidant power of a meal. The ability of oregano to decrease chromosomal damage from radiation and marjoram to affect hormone levels in women with PCOS is put to the test.

Kegel exercises to strengthen the muscles of the pelvic floor. These exercises are recommended for women who have given birth, to firm up their stretched muscles and prevent or reduce incontinence. Doctors and nurses teach their patients how to do Kegel exercises, which can be done at home without special equipment. The only difficult part is learning to identify the muscle to be squeezed: you can do this by sitting on a toilet and trying to stop the flow of urine, or by inserting a finger into your vagina and squeezing down on it. If you can do either of these two things, you have found the right muscle to exercise. Your doctor or nurse will tell you how often and how long to practice Kegel exercises. A typical schedule may be to tighten the muscles for a count of ten, ten times a day. Biofeedback to help increase your awareness of and control over the appropriate muscles. Biofeedback can be combined with Kegel exercises.+++

+++Please visit for more information on the international biofeedback expert, Dr. George Grant, who is the founder of and whom one of the authors, Dibra, works with.
We would like to inform you that your eminent article ECGY-17-SC-125 entitled Management of PCOS Polycystic Ovary Syndrome has been completed with galley proof. Please find the attached PDF of your article.; file:///C:/Users/Dr.%20Grant/Downloads/ECGY-04-00087.pdf

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