This hormone regulator isn't working quite right
GnRH (AKA luteinizing gonadotropin-releasing hormone) is a crucial hormone for regulating our reproduction, in both men and women. As women with PCOS, this is something that we deeply struggle with, particularly with our ability to ovulate. Whether or not we are trying to have a family right now, or ever want to have one, it’s a huge part of being a woman and being hormonally regular.
Let’s talk a little about what’s happening in our bodies.
There is just too much GnRH stimulation!
GnRH is produced in the hypothalamus in our brain and its main responsibility is to stimulate the release of LH (luteinizing hormone) and FSH (follicle stimulating hormone) in the anterior pituitary (Utiger, 2016). GnRH stimulates the LH and FSH to be released in a pulsatile fashion. What this means is that both of these hormones are released in intervals and at very particular doses throughout the day/month and the function of our reproductive abilities (i.e. menstrual cycle) are highly dependent on these exact pulses of release (Utiger, 2016). Depending on where we are at within our menstrual cycle, these hormones will be released at corresponding pulses. For example, in a normal woman’s body, when FSH is released at a large dose in conjunction with LH at a large dose, a woman will ovulate. FSH is higher during the follicular phase when a follicle is developing in our ovary, and LH is highest during the luteal phase, which matures a follicle and releases it (ovulation).
Many women with PCOS, however, have a serious disruption in this pulsatile function; as a matter of fact, there is too much GnRH that is being released and according to Bienkiwicz and her team, they concluded that the increase in GnRH pulses leads to an increase particularly in LH secretion.
Insulin & LH
As I've already discussed in the Carbohydrate Education section, women with PCOS tend to be insulin resistant. This suggests that we not only have too much glucose, testosterone and estrogen in our blood stream, but we also commonly have too much insulin, also known as hyperinsulinemia. It has been shown that women that have hyperinsulinemia actually have an increase amount of pulses of GnRH, therefore higher secretions of GnRH lead to inaccurate secretions of LH (Bienkiewicz, 2011). With inaccurate secretions, this causes very obvious issues in our menstrual cycle and our bodies aren’t being triggered properly to move through a successful menstrual cycle. This is another reason we don’t ovulate properly! According to a great study, Cherrington and his team stated that an increase in IGF-1 (Insulin-like Growth Factor-1 such as that found in dairy), insulin or both, stimulates an increase in GnRH leading to abnormal secretions of LH at inaccurate times.
What this means for PCOS
The balance of GnRH, LH and FSH is crucial for maintaining reproductive functioning. As women with PCOS, we have too much GnRH being released due to excess stimulation from IGF-1 and insulin leading to an increase and inaccurate secretion of LH. This throws off our entire ability to have a successful menstrual cycle and will go long periods of time without ovulation which is exhibited by amenorrhea/oligomenorrhea, in other words, lack of a period.
Take home message-Knowledge IS Power
There are many reasons we don’t ovulate properly. This is just 1 of them! As you’ve learned, our bodies don’t function normally on a biological level, but knowing what is going on gives us the power to help ourselves. To attempt to keep GnRH pulsing at more regular intervals, it’s particularly crucial to be careful about your carbohydrate consumption and your dairy consumption to reduce excessive insulin and excessive IGF-1. As you’ve learned here, both of these can help dramatically with keeping GnRH in check which keeps LH in check and pulsing at more regular intervals.
Cheers to working hard at getting your menstrual cycle back!!
Bieńkiewicz M., Cajdler-Łuba A., Lewandowski KC., Lewiński A. & Salata I . (2011). National Centers of Biotechnology Institute: The utility of the gonadotropin releasing hormone (GnRH) test in the diagnosis of polycystic ovary syndrome (PCOS). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21528473
Cherrington, B. D., Do, M. T., Hernandez, J. B., Lawson, M. A., Low, J. M., Navratil, A. M., Santos, S. J., & Song, H. (2009). National Centers of Biotechnology Institute: Insulin Augments Gonadotropin-Relasing Hormone Induction of Translation in LbetaT2 Cells. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2739255/
Utiger, R. A. (2016). GnRH. Retrieved from http://www.britannica.com/science/gonadotropin-releasing-hormone