What does PCOS have to do with your adrenals?
A lot! This post explains the connections between your adrenal glands, your brain, and the hormone imbalances that show up in PCOS. The PCOS-adrenal relationship.
If you’re not clear what PCOS is, please read What is PCOS?.
Get to know your adrenal glands
Your adrenal glands are two tiny glands that sit on top of your kidneys. They have an inside part called the medulla, which produces your stress “fight or flight” hormones like adrenaline, and a bit of dopamine.
The outer part is called the cortex, which secretes important steroid hormones. The ones that pertain to PCOS include cortisol, DHEA, and testosterone. This is the case for women and men.
Your adrenal glands aren’t intelligent
Many of us have heard the term “adrenal fatigue,” which has no actual meaning physiologically. Your adrenal glands don’t just get tired and weary. They don’t decide to stop working.
It’s your very intelligent brain that directs and orchestrates what your adrenals do. Specifically, your hypothalamus is the control center and sends signaling hormones to your pituitary, which secretes hormonal directions straight to your adrenals. Feedback goes back to your hypothalamus to “decide” how to respond. This loop is called your hypothalamus-pituitary-adrenal axis, or HPA.
Instead of adrenal fatigue, there is a real condition involving a disruption of the HPA axis. We call this HPA-D, for HPA Dysregulation or Dysfunction. Many different patterns can show up with HPA-D, and we measure this by evaluating your adrenal hormones, your history, your current lifestyle, and your symptoms.
To test for HPA-D, our favorite is the Dutch Adrenal Hormone test. You can also take this self-assessment quiz.
What does HPA-D have to do with PCOS?
We’ve identified a subtype of PCOS that is highly correlated with HPA-D. In fact, it may be HPA-D that triggers the hormonal imbalance of polycystic ovarian syndrome in this type.
The incidence of PCOS is growing in numbers, as is the incidence of HPA-D. This is not surprising because HPA-D is typically caused by stress. And while we humans have always had stress, because it’s a natural part of life, these days we have a great deal more of chronic stress.
Chronic stress can be emotional or mental, and affect us around the clock, even disrupting our sleep. It can also be due to internal stressors in your body. Examples include:
- Foods that don’t agree with you that cause immune reactions and inflammation.
- Infections, which can be as simple as an overgrowth of undesirable bacteria in your gut, chronic sinus infections, or complex chronic infections such as Epstein-Barr virus.
- Inflammation, which is rampant these days, and a factor in most chronic illness.
- Exposure to the thousands of chemicals in our environment, which can cause endocrine (hormone) disruption.
- Heavy metals stored in your body, such as mercury.
- Biotoxins such as mold in your environment that can take up residence in your body.
Regardless of the source, chronic stress is like an internal fire, and your adrenals respond by constantly secreting cortisol in order to put out that fire.
chronically high cortisol
When your cortisol is chronically elevated, it causes disruption in your HPA axis. High cortisol can also cause:
- Weight gain in your abdomen and excess weight causes inflammation. (PCOS cases often have this type of weight gain, and PCOS is always related to inflammation).
- Chronically high insulin, which leads to insulin resistance (70% of PCOS cases have insulin resistance).
- Eventually, the progression of HPA-D leads to low overall cortisol, which causes fatigue, inability to fight infections, and immune dysregulation. (PCOS is correlated with immune dysregulation and autoimmunity).
Most of us are aware that stress causes a variety of physical ailments. At the very least, we may be aware of stress-related headaches or muscle tension. But we don’t realize that stressors can include internal metabolic processes that we are not aware of.
How to fix HPA-D
Lifestyle changes, such as sleep habits, modification of stressors and stress management tools, are key to healing from HPA-D.
In our program The PCOS SOLUTION, we guide you through our simple easy-to-do steps to make the right kind of lifestyle modifications. If you self-identify as an “HPA driven” type of PCOS within the program, you go on a specific path that adds supportive herbs, nutrients, diet and lifestyle changes. You can read more about the PCOS types we have identified.
Beyond The PCOS SOLUTION, we have an advanced program coming soon. In this program, you take the Dutch Adrenal test to nail down your specific nuances of HPA-D. We also identify other sources of stress such as internal infections or inflammation that can be resolved. It’s a deeper and more personalized way to heal from HPA-D.
The DHEA and testosterone connection to PCOS
One of the diagnostic criteria for PCOS is elevated DHEA and/or testosterone. These are considered androgen or male hormones, and we all produce them from our adrenal glands. We need these hormones, in the right amounts.
When one or both is elevated, that’s when we see high androgen symptoms such as:
- Boils on your butt, armpit or groin area
- Darkened skin in your armpit, groin or neck area
- Skin tags
- Adult acne
- Dark or thick hair growth on your chest, face or chin, abdomen or groin area
- Thinning hair, or balding near your temples or crown of your head
These are often the most annoying symptom in PCOS! Elevated DHEA and testosterone can also interfere with your ovulation and menstrual cycles.
How to lower high androgens naturally without medications
This takes time, and like HPA-D, diet and lifestyle factors are key. In The PCOS SOLUTION program, you learn the steps to change your diet and lifestyle to best support hormone balance. Then you can choose the high androgen subtype of PCOS, and get more specific guidance as to how to lower testosterone and DHEA, including the supplements that work at the right dosages.
In our advanced program, you do the Dutch Hormone Comprehensive test. This tests your adrenal hormones plus all your sex hormones and how they metabolize. We can identify whether DHEA is high, testosterone is high, or both. We also look at estrogen and progesterone. Progesterone is often low. Estrogen can be low as well, although it can also be high, or not metabolizing properly.
Estrogen dysregulation is really common because we are exposed to so much estrogen from our environment, which upsets our bodies production and metabolism of estrogen. So with PCOS androgen dominant types, you can be high-estrogen in a negative way.
We identify these imbalances and target methods to balance all of your sex hormones, including DHEA and testosterone. You can see results fairly soon, in terms of reducing acne slowing hair loss. However, it does take up to 12 months to really change unwanted hair growth and to grow thicker scalp hair.
Start with The PCOS Solution!