Polycystic Ovarian Syndrome (PCOS) is a leading cause of infertility in reproductive aged woman, affecting approximately 5 million in the US alone. In this article I am sharing natural solutions in the treatment of PCOS that I use in my medical practice.
PCOS–the name suggests that in order to have this diagnosis a woman should also have multiple cysts on her ovaries. This just isn't true for the majority of cases. And this name is so confusing that it even leads to under diagnosis by health care professionals— a much larger issue, especially when your fertility is at stake.
But PCOS is about a whole lot more than fertility alone. Having PCOS puts you are greater risk for developing diabetes, high cholesterol and heart disease. And while the cysts require an ultrasound to detect, the other, more common symptoms of PCOS are much more evident to women— acne, weight gain, male pattern hair growth and irregular periods.
The good news about PCOS is that it is both treatable and even reversible through simple, but impactful interventions.
The four areas I address when approaching a patient with PCOS include:
- Blood sugar regulation
- Gut function
- HPA axis/ adrenal health
- Liver detoxification
Blood Sugar Regulation:
Blood sugar dysregulation is one of the hallmarks of PCOS. Insulin, the hormone that regulates your blood sugar, has a large role to play in PCOS through it's ability to stimulate androgen production (think testosterone). In the ovary, insulin and lutenizing hormone work together to stimulate the production of androgrens. In addition, testosterone production is up-regulated in the adrenals by insulin.
This is why one of the keys to restoring fertility and your period is blood sugar control. Your doctor should monitor your blood sugar regularly, especially if you have been found to have pre-diabetes or diabetes.
Lab tests to monitor blood sugar:
Hemoglobin A1C
Fasting glucose
Insulin
Gut Function:
Your gut is one of your major organs of detoxification and aids the body in removing hormones from the body. In addition, it also is the home of a large percentage of your immune system, which means the gut must be considered in reducing inflammation.
Addressing inflammation is an important consideration in the treatment of PCOS for two reasons. Firstly, inflammatory cytokines (chemical messengers of the immune system) stimulate the production of androgens. The second is because of the toll chronic inflammation takes on the adrenals, it can lead to further adrenal dysregulation.
Lab test to monitor gut function:
Comprehensive stool analysis
Lactulose breath test
HPA Axis/ Adrenal Health:
The adrenal glands are often a source of androgen production in PCOS. Through their secretion of cortisol, they are able to modulate inflammation in the body. Their health and function are paramount in achieving hormonal balance.
Lab test to monitor adrenal function:
Adrenal Stress Index Test
DHEA-S
ACTH
Liver Detoxification:
Your liver works so hard at detoxing everything you put in your body, become exposed to and yes, even your hormones. Liver health is absolutely important in any hormonal condition, but especially PCOS. Why PCOS?
In a study published by the Journal of Human Reproductive Science, 67% of women were found to have fatty liver or Non-Alcoholic Fatty Liver Disease (NAFLD), compared to only 25% of the control group. In this condition, fat accumulates in the liver and impairs the liver cells function.
Lab testing to monitor liver:
AST
ALT
GGT
Alkaline phosphatase
Cholesterol
Lab testing to monitor sex hormones:
Free Testosterone
Estrogen
Progesterone
Sex hormone binding globulin
LH
FSH
DHEA-S
5 Natural Solutions in the Treatment of PCOS
Eat Well and Eat Enough
Since insulin dysregulation is at the heart of PCOS, it only makes sense that dietary interventions can make a big difference in your hormonal health. Yes, your diet can make a huge impact on your PCOS symptoms!
There's no one size fits all diet. But most of my patients are able to control their blood sugar and support their hormones by following a Paleo or a whole food diet. What's the key changes to make?
Reduce or eliminate grains (not carbohydrates)
Increase protein intake
Eat 7-9 servings (the more vegetables the better) of fruits and vegetables daily
Eat organic, high quality fats
Eliminate processed foods
Reduce or eliminate sugar
Making sure you are eating regularly and taking in enough calories helps your body maintain healthy blood sugar while also providing you with ample nutrients.
It may sound simple, but I understand that diet and lifestyle changes can be challenging. Go easy on your self and if you need help, well I'm always happy to help.
Exercise
Strength training, HIIT, Yoga, Pilates and body weight conditioning are all great forms of exercise for PCOS. They build muscle, reduce stress, sensitize your body to insulin and make you feel great.
On the other hand, forms of exercise like extended cardio training can actually create a stress response in the body and lead to more hormonal dysregulation.
If you have a pre-exisiting condition or adrenal fatigue, please check with your doctor before beginning an exercise routine.
Improve Your Gut Health
Eating probiotic rich foods and high fiber foods are one way to ensure you have healthy gut bugs. I also recommend people follow basic food hygiene— chew your food well, eat in a calm and relaxed environment, eat until you feel satisfied and avoid eating in front of your computer or television.
If you have an underlying gut issue, it is important to work with a qualified health care practitioner to resolve your condition.
Nourish Your Adrenals
Your adrenals love it when you take time to unwind. Yes, getting a massage or hanging out with people who you enjoy is medicine.
Doctors orders: Go Play!
And after all that play, get yourself into bed by 10 pm and sleep. Your adrenals love sleep.
In addition, your adrenals really thrive when you have adequate vitamin C, B vitamins, and magnesium. Yes, back to diet. But sometimes, your body needs a little more than diet and supplementation is necessary.
Supplement as Needed
When we are in a healing phase, we often need extra nutrition and other support to help us restore and heal our body. You can read my full article on supplements for PCOS here.
Some of the supplements I like to utilize in PCOS include:
- Vitex (Chaste tree berry): Promotes healthy progesterone levels. Balance by Dr. Brighten contains Vitex.
- Vitamin D3: Supports immune system, hormones and gut health. You can find Vitamin D3 here.
- Adaptogenic herbs: Supports adrenal health. You can find Adrenal Support here.
- Omega-3 Fish Oil: Reduces inflammation, supports hormones. You can find Omega Plus here.
- B Complex: Supports hormone production and nourishes the adrenals. You can find B-Active Plus here.
- Myo-inositol: Reduces androgens, restores ovary function and increases sensitivity to insulin. You can find Myoinositol Plus here.
- d-Chiro-Inositol: Reduces androgens.
References
- Rosenfield RL. Ovarian and adrenal function in polycystic ovary syndrome. Endocrinol Metab Clin North Am. 1999. 28(2). 265.
- González F. Inflammation in Polycystic Ovary Syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids. 2012. 77(4). 300-5.
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