PCOS Review Newsletter #19
Natural Health Ideas for Polycystic Ovary Syndrome
A free monthly newsletter for women with ovarian cysts or PCOS.
Issue #019 January 5, 2005 Bill Slater, Research Associate
1) Depression and PCOS
Depression is a prominent characteristic of women who have polycystic ovary syndrome. Part of the depression stems from the emotional difficulty of being infertile, overweight, too hairy, or having acne, hair loss or some other disturbing symptom.
However, the primary cause of depression in PCOS appears to be hormonal in nature. A number of studies have shown a connection between a negative mood and elevated androgens, which are male hormones such as testosterone. In one interesting study, there was a correlation between the most intense depression and testosterone levels slightly above normal, but not when testosterone was low or extremely high.
Of course, depression is not limited to elevated testosterone. Depression has also been associated with insulin resistance and depressed thyroid function. Disturbed LH (luteinizing hormone) levels and rhythms have been found in depressed women compared to women who are not depressed. Disturbed LH is a primary reason why you don't ovulate. Abnormal estrogen and cortisol are additional hormonal factors connected to depression.
Women with mixed anxiety-depression disorder have high levels of homocysteine in the follicular and luteal phase of the menstrual cycle, and they have higher blood homocysteine levels as compared to healthy women. Women with PCOS commonly have elevated homocysteine, which is a byproduct of metabolic activity. Normally, homocysteine is broken down and made harmless. However, a poor diet that is deficient in calcium and B vitamins, and drugs such as metformin (Glucophage) help to elevate homocysteine.
All of the above factors for depression are common in PCOS women. There are additional factors that we won't go into here. But you can see that if you have PCOS and depression, you have a complex situation on your hands, a situation that does not have a simple solution.
The good news is that you can favorably alter your hormones and thus lift your depression at least to some extent with a healthy diet, regular exercise, stress management, selected nutritional supplements, and possibly medications. The diet would include plenty of whole, fresh vegetables, fresh fruit in moderation, fish, poultry, some other meats, nuts and seeds in moderation, greatly reduced consumption of grain products, and possible reduction of some legumes. (We go into much greater detail in our PCOS Diet book). As for nutritional supplements, a high quality multi-vitamin/mineral would be a good place to start.
Weiner CL, et al, Androgens and mood dysfunction in women: comparison of women with polycystic ovarian syndrome to healthy controls, Psychosom Med. 2004 May-Jun;66(3):356-62
Rasgon NL et al, Depression in women with polycystic ovary syndrome: clinical and biochemical correlates, J Affect Disord. 2003 May;74(3):299-304
Tallova J, et al, Homocysteine During the Menstrual Cycle in Depressive Women, Eur J Clin Invest, 2003;33(3):268-273
Grambsch, P et al, Pulsatile luteinizing hormone disruption in depression. Psychoneuroendocrinology. 2004 Aug;29(7):825-9
2) Exercise Necessary for Loss of Belly Fat
Exercise is necessary for the loss of belly fat in diabetic women according to a new study. Thirty-three women were divided into "diet only" and "diet plus exercise" groups. Since diabetic women have metabolic problems similar to PCOS women, the study results are relevant.
Either diet alone, or diet plus exercise, caused an average weight loss of 9.9 lbs in three months. However, only the diet plus exercise group had a loss of visceral fat, which is the belly fat that surrounds internal organs.
In other words, weight loss per se is not your only goal. If you're overweight, your most important goal is to lose fat weight while retaining muscle weight. What you are losing (muscle, fat or water) is as important as how much you are losing.
3) Weight Lifting for Weight Loss
According to the National Institute for Health's Obesity Guidelines report, people who engage in weight lifting + aerobic exercise + diet will lose about 2 pounds more than those who use aerobic exercise + diet in order to lose weight. Those who do weight lifting + aerobic exercise + diet lose 5-11 lbs. more weight than those people who diet but don't exercise at all.
You know this, but it bears repeating: Regular exercise is an essential element of successful weight loss, and it helps to reduce insulin resistance if that is a problem for you. Resistance exercises, such as weight lifting, are an especially effective form of exercise.
Source: National Institutes of Health, National Heart, Lung, and Blood Institute, Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults : the evidence report, 1998, NIH publication No. 98-4083
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