Understanding PCOS
Polycystic ovary syndrome (PCOS) is the most common disorder
in women and a major cause of anovulatory infertility. PCOS is a complex
heterogeneous disorder that has several aspects in terms of pathology such as
metabolic, endocrine, reproductive, and psychological. It is the most common
endocrine disease that affect 5 to 10% of women of adolescent and reproductive
age.
It is defined and diagnosed by a combination of signs and
symptoms of androgen excess, ovarian dysfunction, and polycystic ovarian
morphology on ultrasound. There is increasing evidence to suggest that PCOS
affects the whole life of women. The causes of PCOS are not fully understood.
Several factors such as genetics, diet, lifestyle, underlying neuroendocrine
disorders contributes to multiple pathological mechanisms that lead to hormonal
imbalance resulting in PCOS.
PCOS happens when there is an increase in levels of
androgen, insulin and an increased levels of Luteinizing hormone (LH) and
decreased levels of Follicle Stimulating Hormone (FSH). This varying imbalance
in the hormones causes the ovaries to produce more testosterone leading to
hirsutism, acne, multiple ovarian follicles (cysts), and menstural
irregularities because eggs don’t ovulate or ovulate only occasionally.
Key characteristics of PCOS are:
1. Excess production of androgen male hormones.
(increase in male type hormones - hyperandrogenism)
2. Increase in insulin resistance.
(increased insulin levels - hyperinsulinemia)
3. Increase in Lutenizing hormone (LH) & Follicle
Stimulating Hormone (FSH) ratio.
Signs or symptoms of PCOS:
- Irregular periods (more or less often or no periods).
- Polycystic ovaries.
- Absence of ovulation (anovulation).
- Hair growing on the face, stomach, and back (hirsutism).
- Loss of scalp hair.
- Acne.
- Delay in getting pregnant or infertility
- Weight gain or trouble losing weight.
- Depression.
- Risk of developing type 2 diabetes.
Menstural cycle and PCOS:
The menstrual cycle is 24 to 35 days cycle and it refers to
the maturing and release of an egg from an ovary and the preparation of the
uterus to receive and nurture an embryo. The menstrual cycle is governed by
fluctuations in hormone levels in the body, which rise and fall in a monthly
pattern. When the cycle is running smoothly, the pituitary gland in the base of
the brain produces a hormone called follicle-stimulating hormone (FSH) to
prepare an egg for release. The menstrual cycle starts two weeks before your
period when the egg is ready and this is when the brain sends signals to
release LH and FSH hormones to the ovaries. A large surge of LH stimulates
follicles in the ovaries to release an egg (ovulation). While this is
happening, the ovaries are secreting other hormones such as estrogen and
progesterone to thicken the lining (endometrium) of the uterus and prepare it
for pregnancy. The ovaries also produce small amounts of androgens (male
hormones), such as testosterone, which is converted into estrogen. If the egg
meets the sperm in the fallopian tube, fertilization, and conception may occur.
If fertilization does not occur, the endometrium lining sheds and results in
menstrual bleeding.
With PCOS, LH levels are often high when the menstrual cycle
starts and the levels of LH are also higher than FSH. Because the LH levels are
already quite high, there is no LH surge, without this surge, ovulation does
not occur and periods are irregular Women with PCOS may ovulate occasionally or
not at all, so periods may be too close together, or more commonly, too far
apart. Some women may not get a period at all.
PCOS is not a disease!
PCOS is not a disease that can be cured, it is a syndrome
that required supplemental, dietary and lifestyle modification and support.
Unived’s PCOS Management plus helps deal with the symptoms to normalize the
regular menstrual cycle through the use of inositols.
Unived’s PCOS Management Plus is formulated with clinically
proven ingredients to help normalize the menstrual cycle, help reduce
hyperinsulinemia, hyperandrogenism, and LH levels, help achieve the right
hormonal balance, help reduce symptoms of PCOS like facial hair (hirsutism),
acne, and insulin resistance through the use of inositols in a standard ratio
and supporting ingredients which reduce the symptoms associated with PCOS.
Our Formulation
Unived’s PCOS Management Plus delivers a 40:1 ratio of
Myo-Inositol (4000mg): D-Chiro-Inositol (Caronositol®-100mg).
We deliver the formula in a sachet and capsule. The sachet
contains Myo-Inositol,-4000mg Caronositol® (Natural D-Chiro-Inositol 97% from
Carob Pods)-100mg, Vitashine™ Vitamin D3 as Cholecalciferol from
Lichen-600I.U., L-5-Methyltetrahydrofolate -232mcg and Chromium
Picolinate-200mcg.
The Capsule contains Alpha Lipoic Acid-300mg, Algas
calcareas-116mg, Zinc citrate-44mg.
Mode of Action:
Two inositol isomers, Myo-Inositol (MI) and D-Chiro-Inositol
(DCI) are clinically proven to be effective in PCOS treatment, by improving
insulin resistance, serum androgen levels, and many features of the metabolic
syndrome.
Under normal physiological conditions, the body maintains a
ratio of MI and DCI of 40:1. An enzyme called epimerase is responsible for
converting MI-to-DCI, maintaining the physiological ratio of 40:1. The
conversion rate of MI-to-DCI becomes less in women with PCOS due to impaired
epimerase activity. This results in an imbalanced MI-to-DCI ratio leading
to DCI deficiency which promotes insulin resistance in the
cells, thereby resulting in metabolic complications.
Maintaining the ratio of 40:1 restores the menstrual cycle,
and ovulation, increasing progesterone and decreasing LH, testosterone, and
insulin levels. To restore the disturbed inositol balance in women with PCOS
Unived’s PCOS Management has formulated with Myo-Inositol and Caroinositol®
(DCI) in their physiological ratio of 40:1 along with supporting ingredients.
This ensures better clinical results with improved ovarian function &
metabolism in PCOS.
Inositols - Myo-Inositol and D-Chiro Inositol along with
supporting ingredients plays a part in the process of normalizing one or all
hormones that are involved in PCOS and improving the symptoms of PCOS and
supporting fertility.
- Myo-Inositol: It is naturally converted to DCI in the body
but because of epimerase inactivity the ratio is imbalanced. Thus is important
to supplement with both the inositols to achieve balance. MI has shown to lower
LH, testosterone and insulin levels significantly, as well as LH/FSH ratio and
insulin resistance to some extent. - Caronositol® - Unived’s PCOS contains natural
D-Chiro-Inositol from carob extract which helps with ovulation by maintaining
serum progesterone levels, reducing LH/FSH ratio and LH levels also reducing
insulin resistance and hyperandrogenism (free testosterone). - Alpha-Lipoic Acid – is an absolute antioxidant that reduces
oxidative stress. It is reported to help with improving ovulation, number of
menses, serum progesterone levels, reduction of number of ovarian peripheral
cysts. Also helps reduce insulin resistance and insulin levels and increases
HDL-C. - Chromium Picolinate – works as an auto amplification system
for insulin signalling and helps reduce fasting blood glucose levels thus
aiding the enhancement pf insulin sensitivity. It also helps with reducing
testosterone levels. - Vitamin D3 – is natural and plant-based and helps with
reduction of insulin resistance and excessive androgen (male hormone) levels,
also helps deal with menstrual dysregulation and improves follicular responses
to FSH hormone and normalize AMH levels. - Calcium – it is very important for regular menstrual cycle
as it plays a role in activation of oocytes and improving follicular responses
also helps to lower LH levels and increase levels of FSH. - Zinc – Zinc supplementation has beneficial effect in
regulating hormonal balance, glucose metabolism, lipid metabolism, reducing
oxidative stress and inflammation.
Every ingredient plays a part in normalizing one or all
hormones that are involved in PCOS. The basic goal is to lower LH, insulin,
insulin resistance, androgens, and improve FSH responses. All this together
will promote ovulation and regulate menstrual cycles.
References:
1. De Leo, V., et al. "Genetic, hormonal and metabolic
aspects of PCOS: an update." Reproductive Biology and Endocrinology 14.1
(2016): 1-17.
2. Günalan, Elif, Aylin Yaba, and Bayram Yılmaz. "The
effect of nutrient supplementation in the management of polycystic ovary
syndrome-associated metabolic dysfunctions: A critical review." Journal of
the Turkish German Gynecological Association 19.4 (2018): 220.
3. Carmina, Enrico, and Rogerio A. Lobo. "Polycystic
ovary syndrome (PCOS): arguably the most common endocrinopathy is associated
with significant morbidity in women." The journal of clinical
endocrinology & metabolism 84.6 (1999): 1897-1899.
4. Cianci, Antonio, et al. "d-chiro-Inositol and alpha
lipoic acid treatment of metabolic and menses disorders in women with
PCOS." Gynecological Endocrinology 31.6 (2015): 483-486.
5. Kalra, Bharti, Sanjay Kalra, and J. B. Sharma. "The
inositols and polycystic ovary syndrome." Indian journal of endocrinology
and metabolism 20.5 (2016): 720.
6. Genazzani, Alessandro D., et al. "Myo-inositol
administration positively affects hyperinsulinemia and hormonal parameters in
overweight patients with polycystic ovary syndrome." Gynecological
Endocrinology 24.3 (2008): 139-144.
7. Genazzani, Alessandro D., et al. "Modulatory role of
D-chiro-inositol and alpha lipoic acid combination on hormonal and metabolic
parameters of overweight/obese PCOS patients." Eur Gynecol Obstet 1.1
(2019): 29-33.
8. Fazelian, Siavash, et al. "Chromium supplementation
and polycystic ovary syndrome: A systematic review and meta-analysis."
Journal of trace elements in medicine and biology 42 (2017): 92-96.
9. dehghani Firouzabadi, Raziah, et al. "Therapeutic
effects of calcium & vitamin D supplementation in women with PCOS."
Complementary therapies in clinical practice 18.2 (2012): 85-88.
10.Nasiadek, Marzenna, et al. "The role of zinc in
selected female reproductive system disorders." Nutrients 12.8 (2020):
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