Is Male PCOS Real?
Intro
Is Male PCOS real? The scientific & medical communities are still trying to figure this one out, but literature does reveal that men with male PCOS have similar hormonal changes as women with PCOS. Although, there are marked differences between the female picture and the male picture.
First off, what is PCOS? PCOS stands for polycystic ovarian syndrome. And, I’m now sure you’re now thinking how can males get PCOS if they do not have ovaries? PCOS can be thought of as a hormone imbalance condition with metabolic imbalance, and metabolic imbalance means imbalances with blood sugar, cholesterol, and more. With that, it has been shown that males with metabolic imbalance can experience some of the same hormone imbalance symptoms that females with PCOS experience. But, of course, there are differences in symptoms since there is difference between male and female anatomy and physiology.
In this blog you will learn:
The symptoms of “Male PCOS”
The causes of these symptoms
Integrative & holistic management options that address the root cause and symptoms
Symptoms of “Male PCOS”
Female and male PCOS can share similar symptoms, and it has been shown that PCOS traits can be shared amongst male and female relatives. The difference between female and male symptom picture is the difference in menstruation, as female with PCOS can experience irregular and/or absent menstrual cycles in addition to a variety of symptoms as per the Rotterdam Criteria for the diagnosis of female PCOS.
Symptoms of “Male PCOS”:
As more literature surfaces about the connection between metabolic imbalances, hormone imbalance, and symptoms, we could be able to add more to the list above.
Root causes
From what we understand about the symptoms of “Male PCOS” so far, literature has been able to connect certain hormone & metabolic imbalances with the development of symptoms. However, we are still yet to fully understand how these hormone imbalances can lead to the development of symptoms.
Here is what has been reported so far about hormone & metabolic imbalances with symptoms of “Male PCOS”:
Genetics: It has been seen that males with a female relatives who have PCOS are more likely to experience premature balding before the age of 35, suggesting that traits of female PCOS could be passed down to males.
Insulin resistance: Insulin is a pancreatic hormone responsible for balancing blood sugar levels by telling cells to absorb sugar from the blood. Insulin resistance takes place when people have had high blood sugar for a prolonged period of time, and is usually a sign of diabetes. There is also literature that reveals that insulin resistance is connected to lower sex hormone binding globulin, and therefore higher levels of free testosterone. From what we know about testosterone, it can lead to cystic acne, hair loss, and more. Science has also connected insulin resistance with premature balding, cystic acne, prostate issues, and erectile dysfunction in males, suggesting that there could be a connection between insulin, testosterone, and symptoms. Interestingly, however, excessively high levels of testosterone is not commonly found in those with “Male PCOS”. With that, we are yet to fully understand how insulin resistance can lead to some of these symptoms, but we do know that insulin resistance has been connected with microcirculation issues in males with erectile dysfunction.
Adrenal dysfunction: The adrenal glands are the glands responsible for the stress response when someone is stressed by sending out cortisol, and other stimulating neurotransmitters. It was seen that males who experience premature balding before the age of 35 experienced increased adrenal activity similar to females with PCOS
As we learn more about “Male PCOS”, we are able to identify more root causes of the condition. However, it should be noted that disease is bioindividual, and people can have different root causes for their disease state and for their symptoms. For personalized and more-targeted treatment, it would be helpful to work with a provider who will be able to truly look for risk factors and order the needed labs to identify root causes.
Integrative & Holistic Management of “Male PCOS”
Licensed NDs always try to find the root cause of a patient’s symptoms and address those symptoms with integrative medical treatments. Licensed NDs can identify root causes clinically and with lab work. And, in regards to lab work, licensed NDs can personalize lab orders to sieve out suspected root causes of their patient’s symptoms. Below are some integrative options that licensed NDs may recommend to their patients’ root causes of “Male PCOS”
Insulin resistance:
Diet & nutrition: A diet of low-glycemic foods may be recommended as a low-glycemic diet has been shown to be of benefit for those with blood sugar issues. Examples of low-glycemic foods are: green vegetables, some fruits, beans, lentils, whole grains (except for white rice). It has also been shown that regular consumption of high fiber foods supports healthy blood sugar balance. And, as insulin resistance is closely tied to obesity and metabolic disorder, literature hypothesizes that addressing weight loss with diet and more could be of benefit in those experiencing “Male PCOS”.
Lifestyle medicine: Science reveals that a combination of low-glycemic foods and exercise can increase insulin sensitivity.
Vitamins, herbs, and minerals: There is evidence that certain nutrients and herbs can promote healthy insulin sensitivity, such as:
Pharmaceuticals: The most commonly prescribed pharmaceutical for those with insulin resistance is metformin. This may be recommended by a licensed naturopathic doctor if labs indicate severe insulin resistance and/or the patient has not been responding to natural treatment. It has also been shown that those prescribed metformin experienced a reduction in erectile dysfunction when sildenafil (Viagra) was not helpful on its own.
Hypothalamic-pituitary-adrenal (HPA) axis function:
Diet & nutrition: Hypoglycemia is a common physical stressor, which could potentially activate the adrenal glands via the HPA axis. Some symptoms of hypoglycemia (aka low blood sugar) are shakiness, faintness, irritability, sweating, and more when one is hungry. To prevent hypoglycemia and achieve steady states of blood sugar, choosing low-glycemic carbohydrates, emphasizing optimal protein intake, having meals or snacks every 3-4 hours, and having healthy fats in each meal may help.
Lifestyle medicine: Extreme levels of exercise can also be a stressor to the body, and choosing more-gentle exercises, such as yoga and tai chi, may support optimal HPA axis function.
Herbs:
Nervine herbs are a class of herbs that soothe the nervous system, which can be over activated during states of stress and worry. Some nervine herbs are: chamomile, lavender, lemon balm, and passionflower.
Adaptogenic herbs are a class of herbs that help the body adapt to emotional and physical stressors. Some adaptogenic herbs are: ashwagandha, asian ginseng, rhodiola, and schisandra.
Symptom management
Licensed NDs may also recommend integrative options to address symptoms. Here are some options that a licensed ND may recommend:
Erectile Dysfunction (ED): L-arginine is an amino acid responsible for supporting the production of nitric oxide, which is necessary for supporting healthy blood vessels function. It has been seen that those with erectile dysfunction have lower levels of L-arginine, which may contribute to circulation issues leading to erectile dysfunction. Additionally, a study comparing the effectiveness of L-arginine alone, Tadalafil (a pharmaceutical for ED) alone, and the combination of both L-arginine + Tadalafil showed that L-arginine alone was more helpful for those with mild and moderate ED, and that combination L-arginine + Tadalafil was more helpful in those with mild and severe ED. Literature also reveals that daily supplementation of L-arginine with Tadalafil has been shown to be of benefit in diabetic patients with erectile dysfunction. In addition to this, science has seen that supplementation of L-arginine with pycnogenol (an antioxidant) significantly improved sexual function in males with erectile dysfunction, and that low levels of vitamin D with L-arginine deficiency could play a contributing to the development of ED. With all of this, a licensed ND may recommend combination therapies to symptomatically treat ED, which may include L-arginine, pycnogenol, vitamin D, and Tadalafil.
Benign prostatic hyperplasia (BPH): Literature reveals that the herb saw palmetto improved symptoms of BPH, with recent literature revealing that phytosterol-enriched saw palmetto extract possibly being more effective than regular saw palmetto oil preparations for BPH in animal models. Other herbs that could be recommended for BPH by a doctor include: Pygeum africanum, Nettle root, and more. In addition to natural options, a licensed ND may also recommend pharmaceutical therapies for BPH, such as Prasozin and Tamsulosin.
Acne: I wrote all about naturopathic treatment for acne in my blog where I compare regular acne with fungal acne. Click here to learn more and to read the blog
Summary & Takeaways
Would it be right to call this male syndrome “PCOS”?
My thoughts: No, and that this male syndrome deserves a different name.
The term “syndrome” indicates that there is a set of symptoms for a disease state, and they we just need a term to bring all of the symptoms together under one name for easier understanding. Right now, “Male PCOS” is the only thing we have. But, my hope is that we have different term for this set of symptoms in the future. Additionally, when something is considered a “syndrome”, it doesn’t really identify or explain what the cause of the disease state is. With that, I also hope that scientists are able to do more research to investigate the root cause of the symptoms and to better understand why metabolic imbalance and lead to hormone imbalance symptoms in those with “Male PCOS”.
In this blog post, you learned:
There is a connection between metabolic imbalance and hormone imbalance in males, and that males who experience “Male PCOS” have similar hormonal changes as females with PCOS.
Symptoms of metabolic imbalance in males with “Male PCOS” include: early hair loss, erectile issues, sexual dysfunction, prostate issues, and acne.
As “Male PCOS” is just a syndrome, people with symptoms should work with a provider for personalized & targeted treatment that addresses the root cause of their symptoms.
Some root causes of “Male PCOS” include: genetics, insulin resistance, and adrenal activity.
Disease is bioindividual, and that people can have difference root causes of their symptoms. There are several options that a licensed naturopathic doctor may recommend given a patient’s personal health picture and root cause(s).
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