Archive for ovulation
Prevalence and Features of the Polycystic Ovary Syndrome
This article suggests a prevalence as high as 8% of PCOS which puts it as the most common endocrine abnormality of reproductive aged women in the US. PCOS has been linked very strongly to insulin resistance.
This link seems to come from elevated insulin affecting 15,20 lyase, the enzyme that converts testosterone to estrogen. So, elevated insulin slows conversion to estrogen, essentially rising levels of testosterone which messes up the ovulation process. The problem is that PCOS has traditionally been treated with oral contraception, which is know to worsen insulin resistance. Another perfect example of how we can actually screw the body up worse if we try to override human physiology instead of balance it.
JCEM — Abstracts: Azziz et al. 89 (6): 2745 -
Does Metformin Improve Clinical Features of Polycystic Ovary Syndrome?
This is a Cochrane Collaboration review of the medical literature and the bottom line is that metformin (a drug that increases insulin resistance) is an effective first line approach to anovulation in PCOS. I’m not entirely convinced that managing insulin resistance is being used clinically, however, and the birth control pill is still a common treatment (which, ironically, worsens insulin resistance…). As for these findings, I of course would advocate first using lifestyle changes and functional medicine approaches such as dietary changes, exercise and supplementation such as chromium or CLA.
Cochrane for Clinicains: Putting Evidence into Practice – December 1, 2003 – American Family Physician.
Clomid vs Metformin as the First-Line Treatment for Ovulation Induction in Nonobese Anovulatory Women with Polycystic Ovary Syndrome
Here’s the deal. I personally think most, if not all, cases of PCOS are related to insulin resistance. Most likely via high insulin levels inhibiting 15,20 lyase, the enzyme that converts testosterone to estrogen, so testosterone levels rise and inhibit ovulation. So, really, the PCOS is just one other symptoms of a time bomb ticking in your body.
What do we do in mainstream medicine? Diffuse the time bomb? Of course not. We ignore it and look at the more important issue–what to due with all that pesky smoke coming off the fuse. So ob/gyns ignore the insulin resistance and try to force ovulation with Clomid. Should be malpractice, but unfortunately is the standard of care.
So this study looks at using Metformin (not at all my preferred method for insulin resistance treatment) vs Clomid and finds that actually treating the underlying problem (what an innovative approach!!!) results in much better results. Don’t expect change anytime soon though…
Relationship between follicle size at insemination and pregnancy success
I continue to have a problem with fertility “specialists” that force a woman to ovulate when her body is not ready. Given that our number one absolute priority as a species is to procreate, if a woman’s body is NOT ovulating, there is a damn good reason. The imbalance in physiology that is occurring is what needs to get fixed and rarely is recognized by the “specialist.”
This article, while relating to cows, would strongly support the idea that forced ovulation is not good. Basically, if the egg is released at gunpoint (artificially with a compound like Clomid) it will be smaller and is much less healthy and more likely to produce a miscarriage. However, in a spontaneously released egg size does not matter and is not related to the likelihood of a successful pregnancy.
Clomiphene, Metformin, or Both for Infertility in the Polycystic Ovary Syndrome
Jese o’ Pete–How about NEITHER!! PCOS is a lifestyle condition that needs to be managed from a lifestyle standpoint. You force ovulation on a body that is saying it doesn’t want to get pregnant and you grow a fetus in an unhealthy system and then mom raises that child in the same poor lifestyle she had. This is a deadly combination as it pertains to chronic disease.
Although we are seeing the onset of chronic disease in younger and younger patients each generation, I firmly believe that we have only seen the tip of the iceberg as it relates to chronic disease.
The Neurosteroid Allopregnanolone is Reduced in Prefrontal Cortex in Alzheimer’s Disease
Allopregnanolone is considered one of the most potent GABA agonist on the planet, natural or synthetic. This means it has a potent ability to calm the brain cells down. Allopregnanolone is derived from progesterone. So how would what is thought of as a reproductive-age hormone affect the brain later in life? Actually the potential for interactions are great.
First, we know that the damage with Alzheimer’s and Parkinson’s start decades before symptoms, putting the time frames for beginning damage well into the reproductive years.In addition, Alzheimer’s is very strongly associated with insulin resistance, and IR is well known to inhibit ovulation and lower levels of progesterone. The bottom line, however, is the same as always–prevention of these age related chronic diseases begins decades earlier, and the approach to lowering risk is multifactorial.
Pay Attention: Ritalin Acts Much Like Cocaine
Geez..do I really need to comment on this one? Just to reiterate…the numbers of kids diagnosed with ADD or ADHD has skyrocketed, and the quick answer to these cases has been the use of psychoactive substances such as Ritalin. There are no long term studies to verify the safety of long term use. NONE. Myself and many others out there are not entirely convinced that this is even a problem. Sure, I would agree that many of the diagnosis given are accurate, but I would have to guess they are a minority. Programs such as the Feingold diet, which removes all added chemicals such as food additives, colorings and preservatives, have had good results in bringing the focus back in these children. And, as with many other natural therapies, there are no side effects, unless you consider overall improved health as a side effect… Pay Attention: Ritalin Acts Much Like Cocaine http://jama.ama-assn.org/content/286/8/905.extract
Molecular Mechanisms Underlying Energy Regulation
This article touches on all the new potential targets for the drug companies’ quest for the ultimate obesity drug. You will have to register with this website to access the article, but it really is a good, in depth article. ENDO 2001: 83rd Annual Meeting of The Endocrine Society – Molecular Mechanisms Underlying Energy Regulation http://edrv.endojournals.org/content/27/3/260.short
The acute effects of calcium on calcium and bone metabolism
There has always been much controversy on the type, dosage and timing of calcium supplementation. I am not a firm believer in calcium carbonate due to the need for stomach acid for absorption (and almost all of us become deficient as we get older) and support the use of calcium citrate, malate or MCHC more strongly. This article finds that the timing of intake (morning or evening) does not affect the absorption (based on calcium’s effect on PTH secretion). AJCN — Abstracts: Kärkkäinen et al. 74 (3): 335 http://www.ajcn.org/cgi/content/abstract/74/3/335
PPAR Ligands Increase Concentrations of Adiponectin
The new diabetes drugs in the thiazolidinediones family are PPAR ligands (mimic the action), but researchers have been unaware as to how this action effected the body. This article sheds some light on this process. Authors found that the PPAR ligands stimulate an increase in the hormone adiponectin; a hormone that has multiple affects on insulin sensitivity and damages caused by increased insulin resistance. Diabetes — Abstracts: Maeda et al. 50 (9): 2094 http://diabetes.diabetesjournals.org/cgi/content/abstract/50/9/2094
Elderly show severe impairment of DHEA-S
Given the number of articles appearing related to the topic of adrenal function, a quick review is in order. The medulla (inside) of the adrenals produce epinephrine and norepinephrine…key players in the adrenaline response. The cortex (outside) produce three hormones from cholesterol…aldosterone (regulates blood pressure), cortisol (the body’s stress hormone) and DHEA (which goes on to ultimately become estrogen and testosterone). In the body’s initial response to stress, the body will produce more cortisol at the expense of DHEA (a phenomena known as pregnonolone steal…). Chronic stress will result in both lowered cortisol and DHEA…basically the adrenals “poop out.” All these levels are easily, safely and accurately measured with salivary testing. Synergy : Clinical Endocrinology 55 (2), 259-265 http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2265.2001.01317.x/abstract?systemMessage=Wiley+Online+Library+will+be+disrupted+6+Aug+from+10-12+BST+for+monthly+maintenance
Risk of Knee Ligament Injury Tied to Ovulation
I thought this article was interesting in that it related hormonal fluctuations with risk of ligamentous injuries. The idea that hormones change ligaments is by no means new–relaxin is secreted during pregnancy to allow the pubic symphysis to stretch and allow passage of the newborn through the birth canal. This article, however, suggests that other hormones may have similar characteristics. Consider this…hormones are readily modified by environment. It would be not great stretch to consider environmental impacts on hormonal regulation and subsequent alterations in ligament strength and flexibility. Might this lead to increased aches and pains seen in some chronic diseases such as fibromyalgia and rheumatoid arthritis?
Meeting of the American Orthopaedic Society for Sports Medicine Ovulation, and possibly oral contraceptive use, may play important roles in women’s risk of anterior cruciate ligament (ACL) injury, according to study findings presented at a recent meeting of the American Orthopaedic Society for Sports Medicine in Keystone, Colorado. Principal investigator Dr. Edward M. Wojtys of the University of Michigan in Ann Arbor and colleagues evaluated 65 women with ACL injuries and collected urine samples within a day of each woman’s injury to establish the phase of her menstrual cycle. They found that more than 2.5 times the expected number of injuries occurred during ovulation than during other points of the menstrual cycle. Because this pattern emerged only among women who were not on birth control pills, the findings also suggest that oral contraceptive use may provide some measure of protection from the injury, the researchers note. However, lead study author Dr. Wojtys stressed that the findings do not suggest birth control pills offer a way to prevent ACL injuries. “This research does not justify pulling young ladies out of sports or putting young women on oral contraceptives in order to prevent ligament injuries,” Dr. Wojtys, the director of sports medicine at the University of Michigan, said in a statement. “There is some evidence that ACL injuries are tied to the menstrual cycle and probably to hormones,” he added, “but we don’t have enough information yet to justify the use of oral contraceptives in order to prevent ligament injuries.” Studies indicate that female athletes rupture their ACLs up to eight times more often than male athletes do. A number of factors — from differences in musculature and training methods to women’s wider hips — are believed to account for the higher rate of ACL injuries among females. Previous research has also pointed to the role of the menstrual cycle, showing that ACL injuries are more common during ovulation. Estrogen levels are increased during ovulation and some researchers have speculated that hormone fluctuations factor into women’s ACL injury risk. But Dr. Wojtys said this relationship remains unproven. “Even if it is the menstrual cycle that is having some effect on the susceptibility of soft tissue…the susceptibility is not clear,” he said in the statement. “People are jumping to the conclusion that it is estrogen and it is acting at the anterior cruciate ligament, when in fact, there are multiple places where any hormone could act, including muscles, the central nervous system and the peripheral nervous system,” Dr. Wojtys added. He suggests further research is needed on how hormones affect ligaments and other soft tissue, as well as how hormones might alter the function of muscles and nerves.