Polycystic Ovarian Syndrome (PCOS):
Polycystic Ovarian Syndrome is one of the most common endocrine disorders in women. It affects 6-10% of reproductive aged women. It often develops around puberty it can persist for years. A classic case of PCOS presents with obesity, acne or facial hair growth, polycystic ovaries (cysts on the ovaries), elevated levels of androgens including testosterone and absent or irregular menstrual cycles; however, many women with PCOS have only a few of these symptoms.
What causes PCOS?
Genetics and hormonal imbalances contribute to the underlying cause of PCOS. If a family member has PCOS then you may be more likely to develop it. Hormonal imbalance in any of the following glands may indicate PCOS: the pituitary, the ovaries, the pancreas or the adrenal glands. Polycystic ovaries is often a result of chronic anovulation. Insulin resistance and the inability to regulate blood sugar levels is also an important factor in PCOS.
Hormone Testing for PCOS
Women who suspect they have PCOS should have their hormones tested including estradiol, progesterone, testosterone, DHEA, follicle stimulating hormone, luteinizing hormone, cortisol and insulin. Salivary hormone testing as compared to blood hormone testing is often more diagnostic of hormonal imbalances because salivary testing is highly sensitive and measures the free, unbound hormone levels. Free hormones (not bound to a protein) are the most bio-available to target tissues throughout the body. Standard blood hormone testing only measures hormones that are bound to proteins.
Do I have PCOS?
Women with PCOS may have several of the following signs and symptoms:
- Ovarian Cysts
- Irregular menstrual cycles or absent menstrual cycles
- Abnormal mid-cycle bleeding
- Heavy periods
- Hair growth on upper lip and/or chin
- Elevated testosterone levels
- Alopecia (hair loss)
- Body fat around waistline
- Dark skin under armpits, neck, groin or breasts
Hormone testing and an ultrasound of the ovaries to determine if ovarian cysts are present is recommended before making the diagnosis of PCOS.
When hormone levels are balanced, insulin resistance is corrected and weight issues (if present) are managed then PCOS symptoms can significantly improve if not completely resolve. Conventional medical treatment for PCOS is typically birth control pills to regulate hormone levels. Clomid is often prescribed to help women get pregnant and Metformin is given for stabilizing blood sugar. These medications may put a band-aid on the symptoms but they do not address the underlying cause of the hormonal dysfunction. Naturopathic doctors take a different approach to healing PCOS helping women address the root cause of the hormonal dysfunction. Naturopathic doctors work with patients to optimize their diet, exercise and make specific supplement recommendations to balance hormones, improve blood sugar levels and improve a woman's overall health.
PCOS Dietary Guidelines
Women with PCOS who have insulin sensitivity should eat a low carbohydrate, high protein diet. The types of carbohydrates consumed is important. Carbohydrates made with white flour such as breads, muffins, cookies, and pastas are the worst for insulin sensitivity. They lack fiber and nutrients and can quickly spike insulin levels. Instead choose more whole grains such as:
Eat foods that are low in glycemic index, meaning they break down more slowly in the body and do not spike your blood sugar or insulin levels. Low glycemic index foods include:
Daily exercise is extremely important for women with PCOS who have insulin sensitivity. Losing as little as 5% of your body weight can reverse insulin sensitivity and improve hormone levels. Cardiovascular exercise for 45 minutes 4-5 times per week along with a high protein, low carbohydrate diet can greatly improve blood sugar levels.
Herbs, Nutrients and Supplements
There are many natural herbs, nutrients and supplements recommended to help women with PCOS.
Saw Palmetto (Serenoa repens)
An herbal supplement called Saw Palmetto has been shown to decrease the conversion of testosterone to its more biologically active form DHT. This can improve symptoms of acne, hair loss and facial hair growth in women with PCOS.
Chasteberry (Vitex agnus-castus)
Another herbal supplement called Chasteberry can help women with PCOS by inhibiting prolactin and raising progesterone levels. Often women with PCOS have low levels of progesterone due to the lack of ovulation. Chasteberry can help re-establish regular menstrual cycles.
There are many other natural supplements that can be used to help address symptoms of PCOS including DIM, chromium, cinnamon, gymnema, omega 3 fatty acids, flaxseeds, UNDA homeopathic compounds and gemmotherapies.
Natural treatment of PCOS can take a minimum of three months to balance hormone levels, stabilize blood sugar levels, improve insulin sensitivity and establish normal menses. Depending on your specific symptoms an individualized treatment plan can be tailored to your specific health needs. Talk to your Naturopathic Doctor about which specific supplements are right for you.