30A. Polycystic Ovarian Syndrome—An Integrative Approach to a Complex Epidemic

Focus Areas: Integrative Approaches to Care, Pediatrics, Alleviating Pain Polycystic ovarian syndrome (PCOS) is the most common endocrine dysfunction of reproductive-aged women, devastating the lives of those afflicted. Many factors contribute to this, including toxic environmental exposures, changing diets, gastrointestinal alterations, epigenetic modifications, and epidemic physical inactivity. The health consequences for women are enormous—PCOS now affects upwards of 15% of young women—with adverse effects persisting far into the menopause years. The official diagnosis of PCOS currently requires a woman to have only 2 of the following 3 problems: menstrual dysfunction, excessive hair or acne (signs of increased androgens), or polycystic ovaries on ultrasound. As PCOS is an indistinct syndrome with great variation in severity of symptomatology, the name for this condition and its diagnostic prerequisites will most likely be modified in the future. Regardless of the precise name and definition for this condition, understanding and properly treating this large cohort of women is imperative. PCOS should be of great interest to all specialties of medicine that deal with women, as those affected can present with a great array of problems. The most common symptoms are menstrual dysfunction and infertility, obesity, and insulin resistance. Many, though not all, have polycystic ovaries on ultrasound. More than half of the afflicted have hirsuitism and acne (often severe and cystic), and about a quarter have acanthosis nigricans and alopecia. Other symptoms include joint pain, autoimmune disease (particularly thyroid), mood disorders, fatigue and sleep problems, and gastrointestinal issues. Women with PCOS have a dramatically higher risk of developing cardiovascular disease and cancer. This session is devoted to presenting the latest research on PCOS, a comprehensive and integrative approach to treatment, and some novel theories on new ways to treat this devastating condition.