This month SNJ health columnist Ruth Holmes discusses a problem affecting the ovaries

THE term ‘polycystic’ is actually a misnomer and refers to the ultrasound appearance of an ovary which appears to have many small cysts.

These "cysts" are in reality follicles that grow on the ovaries during the menstrual cycle. Eggs develop within these follicles, one of which will reach maturity faster than the others and be released into the fallopian tubes. The remaining follicles will then degenerate. This is what's known as ovulation.

In the case of Polycystic Ovary Syndrome (PCOS), the ovaries are much larger than normal,and there are a number of undeveloped follicles that appear in clumps.

This is a common condition in women, many of whom will be having regular menstrual cycles and ovulatory patterns, and normal hormone profiles.

This condition is usually diagnosed by ultrasound scan, hormone blood tests and sometimes a laparoscopic investigation. The blood test can help to determine the severity of the problem and rule out any other hormone abnormalities. PCOS can be an indication that some type of endocrine abnormality exists, but equally it could be a normal feature of the woman’s ovaries.

No definite cause has been established, but it has been suggested the problem is primarily a metabolic condition commonly associated with insulin resistance with a tendency to over-activity or over-production of androgens and erratic ovulation. Symptoms can range from difficulty in losing weight/weight gain, irregular periods or no bleeding, infertility, excessive hair growth due to higher than normal male hormones, acne and mood swings. As there is no cure for this condition the way forward is wanting to treat naturally or to 1. treat insulin resistance 2. ensure regular menstrual bleeding 3. reduce and treat any excess androgen levels and the effects of 4. improve ovulation and fertility for those women wanting to become pregnant.

These treatments need to be adapted for each individual.

Weight management is important. If there are additional symptoms such as excess body hair (hirsutism) alongside infertility, then losing a few kilograms can help the patient to reduce androgen levels and reinstate ovulation.

Adequate management of insulin resistance is vital and so changes to diet and lifestyle are strongly recommended. Carbohydrate foods with a low glycaemic index (slow release) should be selected as persistent sugar cravings are often a sign of insulin resistance. To avoid hyper-insulinaemia eat regular smaller meals that contain a higher protein to carbohydrate level. This will maintain better glycaemic control and reduce the sugar cravings.

Chromium and Magnesium are minerals that are vital to maintain adequate blood sugar level. These can be taken two to three times a day. Foods high in these are wheat bran and wheatgerm, oatmeal, rye, seafood, Brazil nuts, almonds and walnuts, soya flour, beet tops, spinach parsley, dried figs, apricots and avocados.

In addition to a wide range of wholefoods, vegetables, fish, seeds and seed oils are advised in order to obtain the trace nutrients and essential fatty acids which can help to improve insulin resistance. Fibre is also important as this improves impaired glucose intolerance as does decreasing any saturated fats.

Phytoestrogens are an important food group to include into the diet, such as soya, chickpeas, lentils etc. B vitamins are essential for weight loss as they are involved in the fat burning process to enable energy to be made.

There are various herbs that are traditionally used to help with insulin resistance such as Galega officinalis (Goats rue) the medication Metformin is a synthetic form of this herb which is often prescribed for this condition, Panax ginseng and Eleutherococcus senticosus (Siberian ginseng) have a role in normalising blood sugar levels whilst supporting the adrenal glands, as stress levels need to be monitored and altered if necessary by lifestyle changes where possible, ensuring the the liver is clearing any excess hormones is vital with good hydration and liver herbs such as Silybum marianum (Milk thistle) and Taraxacum officinalis (dandelion root), more specific hormone regulating herbs are best taken upon advice to be specific, one of the most important herbs for this use is Agnus castus (Vitex) and Paeonia lactiflora (white peony).