Hair loss, excessive hair growth (hirsutism), and acne are three prevalent and distressing symptoms of Polycystic Ovary Syndrome (PCOS). To tackle these symptoms effectively, it's essential to understand their root cause: androgens. PCOS is characterized by an excess of androgens, often referred to as male hormones. Reducing androgen levels can significantly alleviate these symptoms. Even if your blood tests don't show high androgen levels, experiencing these symptoms likely indicates that your body is converting the androgens you have into a more potent form, causing these issues.

The Role of Androgens in PCOS

Androgens are primarily produced in the ovaries and adrenal glands. While they play various beneficial roles in the body, excessive production, as seen in PCOS, can cause significant problems. It's useful to identify whether the high androgen levels are originating from the ovaries, adrenal glands, or both.

Testosterone: Produced 25% by the ovaries, 25% by the adrenal glands, and 50% through conversion of androstenedione in the bloodstream.
DHEA: Mainly produced by the adrenal glands, with a small amount from the ovaries. DHEA levels fluctuate throughout the day and decrease with age.
DHEA-S: The most abundant androgen in women of reproductive age, primarily produced by the adrenal glands. Levels also decrease with age.
Androstenedione: Equally produced by the ovaries and adrenal glands.
Dihydrotestosterone (DHT): The most potent androgen, produced from testosterone in various tissues.

Challenges in Hormone Testing

When evaluating androgen levels through blood tests, it's important to note that these tests are not always accurate. Normal range values might still indicate problems in women sensitive to androgens. Additionally, hormone tests conducted while on hormonal birth control will not provide accurate readings.

Addressing the Root Causes of Excess Androgens

Treating the underlying causes of androgen excess is crucial for managing PCOS symptoms effectively.

Ovarian Androgen Production: Often driven by insulin resistance and inflammation. Improving these conditions can help lower androgen levels.
Adrenal Androgen Production (DHEA-S): Mainly influenced by stress. Reducing both physical and mental stress can decrease this androgen. Stress-induced cortisol production can also contribute to insulin resistance, exacerbating the problem.

The Impact of Dihydrotestosterone (DHT)

DHT is often the main androgen responsible for hair loss, hirsutism, and acne. Even if androgen levels appear normal, increased activity of the enzyme 5-alpha reductase in the skin and hair follicles can convert testosterone into DHT, leading to the following issues:

Hair Loss (Alopecia): DHT binds to androgen receptors in hair follicles, shortening the growth phase and prolonging the falling out phase. This results in hair thinning and a visibly wider parting.
Hirsutism: DHT causes hair follicles to produce darker, thicker hair in unwanted areas.
Acne: DHT increases sebum production in the skin, leading to abnormal skin cell changes and bacterial accumulation.

Factors such as insulin resistance, inflammation, and obesity can increase the activity of 5-alpha reductase, thereby enhancing DHT production. Nutrition treatment strategies for PCOS symptoms often focus on blocking this enzyme's activity. It's important to note that having one symptom doesn't necessarily mean you'll develop all three.

Understanding and managing androgen levels and their effects are key steps in alleviating the troublesome symptoms of PCOS. By addressing the root causes, such as insulin resistance, inflammation, and stress, individuals can achieve better control over these symptoms and improve their overall quality of life.

Ready to take control of your PCOS symptoms and feel like yourself again? Let's chat!  Click here to book a free discovery call with me, and together we'll create a personalised nutrition plan to tackle those stubborn symptoms like hair loss and acne. It's time to start feeling your best—let's get started!