Beyond Hormones: The Complex Web of PCOS

May 17 / Drs. Bryan & Julie Walsh
This video is a clip from May’s PracticeUP Episode, “A Functional Medicine Approach to PCOS”. You can watch the entire presentation as a PracticeUP member here before June 15th. After that, this content can be found in the Clinician’s Code program.
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Understanding PCOS

Polycystic Ovary Syndrome (PCOS) is a complex condition that affects many women, creating a vicious cycle of hormonal imbalances and metabolic issues. Let's break down this cycle to understand it better.

The Role of the Ovaries and Hormones

In a healthy ovary, the egg (or oocyte) matures and is released during ovulation. If ovulation doesn’t occur, the follicle that contains the egg stays within the ovary and can become a cyst. Normally, after the egg is released, the remaining follicle transforms into the corpus luteum, which produces progesterone. However, in PCOS, ovulation often doesn't occur. Without ovulation, the follicle doesn’t develop into the corpus luteum, and therefore, no progesterone is produced. This lack of progesterone is significant because it disrupts the hormonal feedback loop.

The Hormonal Feedback Loop

The pituitary gland, which monitors hormone levels, senses the lack of progesterone and responds by producing more luteinizing hormone (LH). High levels of LH stimulate the ovarian theca cells to produce more androgens, such as testosterone.

Androgens and Insulin Resistance

These excess androgens contribute to symptoms like hirsutism (excessive hair growth) and can also lead to insulin resistance. Insulin resistance means the body's cells become less responsive to insulin, leading to higher blood sugar levels. The body compensates by producing even more insulin, which can further exacerbate androgen production.
"Understanding PCOS requires acknowledging this multifaceted web of interactions, not just a straightforward case of hormone imbalance."
The Vicious Cycle

This cycle can start at any point: from excess androgens to insulin resistance or vice versa. It creates a self-perpetuating loop where hormonal and metabolic imbalances feed into each other. Conventional medicine typically recognizes PCOS as a combination of glucose dysregulation and excessive androgens, but this explanation might be oversimplified.

A More Complex Web

The reality is that PCOS involves a myriad of factors beyond just androgens and insulin resistance. Many individuals with PCOS experience a wide range of symptoms and underlying issues. This complexity suggests that the condition could be more intricate than traditionally thought, involving multiple interrelated systems.

In Summary, 

Understanding PCOS requires acknowledging this multifaceted web of interactions. It's not just a straightforward case of hormone imbalance but a dynamic interplay of various bodily functions. Recognizing this complexity can lead to better management and treatment strategies for those affected by PCOS.
The one-hour, "A Functional Medicine Approach to PCOS" episode delivers an honest and comprehensive overview of the diverse factors contributing to PCOS, and equips health professionals with the tools they need to critically evaluate and uncover the root cause in their PCOS Patients.  

You can watch the full episode here as a PracticeUP member until June 15th, 2024. 

Or, for content just like this and so much more, join Clinician's Code, where practitioners go to master functional medicine.


"I LOVE everything about these presentations. It makes me excited to practice. 😊"


"This is incredible information Dr Walsh."

Michael P. 

"OMG OFF THE CHART! Thank you Dr. Walsh!"