Healing the Menstrual Cycle in PCOS

It is difficult living with PCOS or Anovulatory Androgen Excess (AAE)

• Never knowing when or if your period will start
• Having trouble losing weight or gaining weight despite trying hard to eat right
• Wondering if you’ll ever be able to have children (if you want them)
• Having to remove embarrassing facial and body hair and cope with painful pimples
• Feeling bad about yourself as a woman, depressed and sometimes anxious
• Having to always see doctors, take medicines and not feel well
• Facing risks for heavy flow and often hysterectomy in perimenopause
• Being at increased risk for blood clots, heart attacks, four times higher than usual risk for endometrial cancer (of the uterine lining), and also an increased risk for breast cancer

Current understanding – PCOS is difficult to treat and can never be cured

“The Pill”, combined hormonal contraceptives (CHC) of high estrogen/progestin is our best currently available and scientifically proven PCOS therapy

• The Pill (CHC) is beneficial only while it is being taken; benefits last a further 6 months
• The Pill (CHC) gives a regular flow – but it is a “pill-period”, not a natural one
• The Pill (CHC) helps women with PCOS feel better about themselves
• The Pill (CHC) slightly decreases facial hair and pimples
• The Pill (CHC) provides high levels of estrogen – but PCOS already has high or normal levels
• The Pill (CHC) increases risks for blood clots and heart disease/breast cancer
• Progestins in CHC are often testosterone-based – PCOS already has too high testosterone levels

Metformin is an important and safe medicine that acts to make insulin work better and decrease insulin resistance and diabetes; it also decreases the too-high insulin levels of PCOS

• Metformin slightly decreases testosterone; since insulin levels help make testosterone
• Metformin can help with infertility (but almost always is given with other medicines)
• Metformin can help with weight loss; works with diet and exercise to prevent diabetes
• Metformin can be taken with The Pill (CHC) if it is needed

New understanding – PCOS or Anovulatory Androgen Excess (AAE) is highly treatable – it can be cured if its root cause, rapid brain stimulated bursts of luteinizing hormone (LH), is treated. Progesterone slows rapid brain bursts of LH. The high LH levels created by those bursts causes PCOS's increased testosterone, that prevents normal cycles and ovulation from developing, and also produces high, steady estrogen levels.
Here's what you can do:

• Believe that you are basically a healthy person with life and love to offer
• Agree to learn about and work to solve the root causes of AAE
• Agree to start regular physical activity and work up to walking fast for 30 minutes a day
• Commit to eating three meals a day full of vegetables, fruit, adequate protein and whole grains
• Take Cyclic Progesterone (300 mg at bedtime) for 2 weeks a month or cycle days 14-27
• Take Spironolactone daily (100 mg at bedtime), a safe, inexpensive, older medicine that directly blocks the actions of testosterone) and makes progesterone more effective in slowing LH bursts
• Take Metformin if needed to prevent weight gain, help weight loss and/or prevent diabetes
• Track your self-discoveries and recovery with the Menstrual Cycle Diary©

See Frequently Asked Questions about PCOS/AAE here and a popular Clue article about the New PCOS Therapy here

- Jerilynn C. Prior MD Professor of Endocrinology, University of British Columbia