Polycystic Ovarian Syndrom( PCOS ), is common and can affect as many as 12 - 15% of teenaged girls. Obesity is a pivotal feature, yet 10-12% patients will have normal and even very slim body, so called "lean PCOS" which indicates wide range of hormonal distubances that can lead to PCOS. Heredity and exposure of the female fetus during the pregnancy to elevated levels of androgens and blood sugar, most common trigerring factors. Elevated level of insulin (insulin resistance) among teens and adult women is a major factor in developmant of PCOS, it eventually leads to excessive production of male hormons by polycystic ovaries creating a vicious cycle of obesity and excessive male hormon production. That is why, GYN can only diagnose already obvious PCOS and prescribe hormonal contraceptives, which can mitigate , but not address underlying issue of insulin resistance and obesity. For the vast majority of PCOS women, with exception of "lean PCOS" bringing BMI closer to 25 or below can lead to reduction or complete resolution of PCOS signs and normalisation of menstrual pattern. One common sense approach is a combination of Ketogenic diet and intermittent fasting, which make perfect Physiologic sense and probably the only biologically reasonable way out. Combining prescribed Hormonal contraceptives, which are shielding womans body from negatives of Male hormons, with diet and life-style modifications is a perfact match.
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