Women with Polycystic Ovary Syndrome (PCOS) suffer from numerous potentially devastating signs and symptoms. And mainstream treatment is limited at best. Could this be because we are missing a vital key – a cornerstone – of how PCOS comes to be and continues to cycle through our lives by focusing on symptoms rather than causes? Could the answer be literally sitting in our brain rather than our pelvis? Growing research gives profound insight into the connection between PCOS and brain.
The Connections Between PCOS, Hormones and The Brain
PCOS is a complex syndrome with a multitude of hormonal irregularities. These hormonal changes do not occur in isolation, nor in one small body part alone. This requires a control system, like a flight deck dashboard. Ours sits in our head, in the hormonal master-switch of the brain.
For the most part, we have beautifully balanced and intricate feedback systems in health. This includes something called a negative feedback loop, which helps to maintain our homeostasis or biological stability. When levels of one hormone drop too low, a cascade of responses acts like dominos to raise the hormonal levels back to within normal limits.
An Example of a Negative Feedback Loop
Let’s look at lowered thyroid function, as a sluggish thyroid is more common in women with PCOS. Hypothyroidism can contribute to fatigue, depression, weight gain, irregular cycles, infertility. And I feel thyroid should be a standard test for all women suspected of, or diagnosed with, PCOS.
When the brain detects low levels of thyroid hormone:
- The hypothalamus gland in the brain responds by producing thyrotropin-releasing hormone (TRH)
- “The nerve fibres that come out of the gland carry the (TRH) and release it into the blood surrounding the pituitary gland,” a gland also found in the brain
- TRH acts to stimulate the production and release of Thyroid Stimulating Hormone (TSH) (which is the most commonly tested thyroid hormone clinically)
- Which then up-regulates the production of the thyroid hormones
- Which, on release, increases the thyroid hormones in our blood and available for use.
In short, when the brain detects low levels of thyroid hormone, it performs a series of actions to increase the levels of thyroid hormones and make them available for use.
The Brain-Androgen Link Explained
Now, that we’ve taken a look at a better-understood aspect of PCOS in the thyroid, let’s look at interesting recent research into the brain-androgen link.
First, a few terms that will help us to negotiate this complicated landscape.
Androgens: These are steroid hormones that promote male sex characteristics, such as testosterone.
Cell receptors: They can be thought of as a lock, which allows the cell door to open on the introduction of a specific key. Our function is dependent on the right materials being allowed to enter and leave our cells. So our incredible body created a complex array of receptors, to allow the right substance in at the right time.
Let’s look at an analogy to understand cell receptors. Think of a carpark (this is equivalent to your cell.) It is filled with different makes and models of cars, each one different (a specific type of cell receptor.) You own one key. Your key will fit only one car, but when it does you can open its doors, jump in, start the engine and take control. However, this one key is very specific and does not allow you access to the other cars.
Neurons: These are critical cells that convey electrical impulses, like those of your brain and nervous system.
Extra-ovarian: This means simply, outside of the ovaries.
Neuroendocrine: It refers to “of or relating to the interactions between the nervous and endocrine systems, especially in relation to hormones.” In simpler terms, this means the way the nervous system and our hormones talk to and influence each other.
How does this link with PCOS? In PCOS, androgens, such as testosterone, are often found in higher levels. In fact, it is one of the three criteria in the diagnosis of this common syndrome. High androgen levels can cause increased body and facial hair growth, scalp hair loss, acne, infertility and irregular cycles.
Because this type of hormone is so intertwined in Polycystic Ovary Syndrome, Caldwell and her research team studied the “importance of extra-ovarian neuroendocrine androgen action in the origins of PCOS.” In other words, they studied the way that hormones and nerves outside of our ovaries impact on the development of PCOS.
They found “… direct androgen actions, particularly in neurons, are required for the development of key reproductive and metabolic PCOS features. These data highlight the previously overlooked importance of extra-ovarian neuroendocrine androgen action in the origins of PCOS…” In other words, the importance of the actions of outside-of-the-ovary neuroendocrine androgens in the development of Polycystic Ovary Syndrome.
This raises further questions about our previous assumptions about the causes of PCOS.
A review study by Corbould revealed that while it is generally accepted that insulin resistance can cause androgen excess, the reverse could also be true.
Insulin resistance is very common in this syndrome. And we need to assess this state because of its effects on weight, fertility, longevity and many of the signs and symptoms it may cause. However, maybe this isn’t a one-way street, or even the main highway. Maybe high androgen levels are the significant cause of insulin resistance?
Tips To Reduce The Adverse Effects of Androgens
Understanding how androgens work in the female brain, and that high levels can contribute to many of the issues experienced by those suffering from this illness, provides a new and important way to look at successfully approaching and tailoring PCOS treatments.
This study adds to the evidence that our ovaries are not the cause of this syndrome. Our brain and its sensitivity to androgens may be.
Saying that, and as important and exciting as our growing understanding of androgenic sources and impacts are, what can you do right now to reduce excessive androgen levels?
Plant-Based Anti-Androgenic Therapies
Plant-based therapies, such as consumption of red reishi mushroom (Ganoderma lucidum), licorice root (Glycyrrhiza glabra) and white peony (Paeonia lactiflora) have been shown to reduce androgen levels.
Improving Insulin Sensitivity For Potential Reduction In Androgenic Effects
As mentioned above, insulin resistance and androgens are able to affect each other. How can you use this relationship with our current state of knowledge to reduce androgenic levels and effect?
The Magic of Movement
Hit intensity interval training (HIIT) has been shown to improve insulin sensitivity, which may reduce androgen levels in women.
Long-term training may lead to a decrease of circulating androgens. Aviva method and yoga are both practices that incorporate movement and may reduce stress. These are both key in improving insulin resistance, and therefore have the potential to balance other hormone levels, including androgens.
Rest and Relax
Stress can cause insulin resistance, as can lack of sleep. Both of these stressors can also lead to weight gain and increase psychological strain, resulting in chronic stress exposure.
Powell and her team found “… that stressed women had higher testosterone (levels).” Reducing stress with holistic mind-body practices like Aviva and Yoga, regular Chiropractic adjustments, sufficient sleep, and a regular and copious sprinkling of fun are great advice!
The brain and our neuroendocrine systems are incredible and complex, and for all our intensive research, we have yet much to discover and understand. It is not a surprise then, that one study can redirect our attention to a possible new cause of PCOS; that outside-the-ovary neuroendocrine androgens may be critical in the origins of PCOS. As research continues to slowly lay a less murky path forward for women with PCOS, our evidence-based approaches return, still, to the importance of a natural and holistic approach in dealing with this complex hormonal disorder.