Kandace Cahill: Follow-up Questions from recent PCOS seminar

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rutherowe
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Joined: 12/29/2014
Kandace Cahill: Follow-up Questions from recent PCOS seminar

Thanks for the wonderful and information-rich seminar earlier this month, Kandace. A few questions I had from the seminar:

You mentioned in your talk that insulin overstimulates the ovarian thecal cells, which in turn up-secrete androgens... And it also causes aromatase to convert these androgens peripherally (rather than centrally) to estrogen, leading to estrogen dominance. Do you often observe estrogen dominance as a co-morbidity with PCOS and/or IR? What are common things to look for? Are there also different phenotypes?

Also, do you have any online or book resources for better understanding the endocrinology and immunology of IR and inflammation? (E.g., insulin's effects on HPO axis, etc., as with my question above.) Similarly, do you have any recommended resources for interpreting BBT charts, beyond the "sawtooth" look you've observed in liver qi stagnant PCOS patients? In fact, any "further reading" recommendations would be great!

Thanks again for sharing your extensive understanding of this aspect of women's health. :)

Kind regards,
Ruth

kkcahill
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Joined: 04/17/2013

Hi Ruth,

Thanks for posting these questions!

I do often see estrogen dominance in my PCOS and IR patients. I don't personally see different phenotypic presentations related to estrogen dominance specifically, though I can certainly say that estrogen dominance is more common & more pronounced/severe in the Classic PCOS phenotype. Common symptoms to look for are: headaches, breast distention, fibrocystic breasts, weight gain, irritability, depression/anxiety, hair loss, constipation, fatigue, heavy menstruation, brain fog, insomnia, PMS, bloating, edema...the list goes on and on. There is much written on this topic these days. I don't have one recommended text that discusses it, but there is a wealth of reliable info found online.

There are some great resources for studying IR and inflammation, and how they affect endocrinology. I broke these processes down in my doctoral dissertation (which may be digitally available at OCOM??) and it is something I am including in my book, as I find their inter-relationships fascinating. I do have a very comprehensive reference list for all citations from the lecture. Unfortunately, it was too long to include in the slides. Would you like me to email it to you? If so, please send me an email with your contact info.

As for further TCM reading for BBT evaluation, I really love Jane Lyttleton's book, The Treatment of Infertility with Chinese Medicine. I also really like Acupuncture for IVF and Assisted Reproduction: An integrated approach to treatment and management, by Irina Szmelskyj & Lianne Aquilina.

Let me know if you have any other questions or thoughts you'd like to share.

Best,
Kandace

rutherowe
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Joined: 12/29/2014

Thanks for these explanations and suggestions, Kandace! Jane Lyttleton's book has been on my wish list for a while... It might be time to treat myself. And I look forward to your book coming out, as well. I'll send you an email re: the citations. I'd love to have them as a reference in my notes.

I don't have any more questions at the moment, but will post here if they arise. :)

Thank you again!

Kind regards,
Ruth

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