When I first started practicing Naturopathy, I rarely saw a patient with Polycystic Ovarian Syndrome (PCOS). Today it is estimated up to 20% of women have PCOS, which is equal to one in five women and shockingly up to 70% of women remain undiagnosed.
So, what is PCOS?
Polycystic translates to many cysts – this means there are many partially formed follicles on the ovaries, each of which contain an egg. These follicles rarely mature or produce eggs that can be fertilised.
For many years people automatically assumed PCOS was a gynaecological problem targeting the ovaries, it is now recognized as a systemic endocrine and metabolic syndrome. This means there are multiple contributing factors that can cause someone to develop PCOS.
The exact cause of PCOS is unknown, however we do now that genetics, lifestyle and the environment all play a role in the development. It is estimated that the risk of PCOS is increased by 50% if you have you have an immediate female relative who already suffers from this condition. This means if your mum or sister have had PCOS, your chances of having it are greatly increased.
The main problem underlying PCOS is abnormal function of the hypothalamic pituitary ovarian axis (HPO axis), put simply a hormonal imbalance where the body has difficulty metabolising and controlling androgens (male hormones) and estrogens (female hormones). This disruption in hormone function can be cause by insulin resistance, inflammation and chronic stress (elevated cortisol).
What are the signs and symptoms of PCOS?
- You have stopped menstruating OR you routinely miss your period – a key sign of PCOS is the cessation of ovulation. If you aren’t ovulating you aren’t producing progesterone and if you aren’t producing progesterone, you won’t have a period.
- Weight gain – this weight can often feel unexpected, you feel as if you are maintaining a healthy lifestyle, eating a wholefoods diet and exercising daily and yet you still can’t seem to shed any extra weight
- Acne – acne is a common sign of hormonal imbalance, but PCOS acne is persistent and appears on the face, chest and upper back
- Unwarranted hair growth aka hirsutism – due to increased androgens excessive hair is a common sign in a male distribution pattern (ie: upper lip, chin, around nipples, etc.)
- Hair loss – again, high levels of androgens can cause male pattern baldness or a receding or thinning of scalp hair
- Infertility – if you have noticed irregularity in your period and you’re not on hormonal contraceptives, this is a red flag that you may not be ovulating
- Increased androgens (male hormones)
- Elevated insulin
- Anxiety and depression – the many unwanted physical symptoms, inability to conceive and a feeling of powerlessness at weight loss all attribute to psychological distress, which is a major concern for people with PCOS
Symptoms sound familiar? What next?
Your first port of call is to have some testing done. Your doctor or Naturopath will first test your pituitary and ovarian hormone levels and circulating androgens. I would then also recommend testing DHEA, fasting glucose and insulin, thyroid hormones, lipid panel and vitamin D. Remember PCOS is a systemic condition and to effectively treat it we need to look at the body as a whole.
The next step is to come and see your Naturopath, holistic case taking plus the results of your pathology testing will help to determine the underlying causes of your specific PCOS. I say specific because this condition can be caused by so many different variables, so it is important to sort out exactly what is going on for you. There are four types of PCOS – insulin resistant PCOS, post-pill PCOS, inflammatory PCOS and adrenal PCOS; all of which are treated slightly different.
A conventional form of treatment that doctors routinely prescribe for PCOS is the oral contraceptive pill – which suppresses ovulation by switching off the ovaries. Of course, this will reduce the body’s production of testosterone and excess androgens and you will notice a reduction in symptoms – but it won’t solve the problem. It will simply mask the underlying cause and can lead to greater problems down the track once you come off the pill, especially if you are trying to conceive.
Treatment should always be managed with a qualified health care professional. Your Naturopath can utilise herbal medicines to manage symptoms of hormonal imbalance (estrogen and androgen dominance and progesterone deficiency) and to encourage healthy ovulation. Herbal medicine can also help with elevated cortisol levels, as well as increased insulin and blood glucose levels. My favourite herbs for treating PCOS include Chaste Tree, Licorice, Peony, Withania, Berberine, Gymnema and cinnamon. Nutrients such as zinc, magnesium, lipoic acid and inositol are also hugely helpful in treatment but again, be mindful that all of these natural treatments will be dependent on your own individual cause of PCOS, that is why it is essential to discuss your case with an experienced practitioner.
There are a few things you can do today to begin your healing journey. These steps will be included in your PCOS prescription from your Naturopath as diet and lifestyle are the foundation of treatment. They include:
- Quitting sugar, wheat, dairy and coffee – all are inflammatory and all drive endocrine dysfunction
- Eating a wholefoods diet – avoid processed or packaged foods and opt for natural ingredients chock full of fruits and vegetables
- Minimise your toxic load – swap to natural personal care and cleaning products, invest in a water filter, shop organic, swap your plastic food storage containers to glass, stainless steel or ceramic, avoid cooking with PFOA’s (this includes non-stick surfaces like Teflon) and instead opt for cast iron or stainless steel – these sound like huge changes, but your environmental toxic load is a major silent source of PCOS
- Minimise your stress – elevated cortisol is a symptom and driver of PCOS. Any activity that reduces your stress levels should now be a priority. Our favourites include spending time with people who make you laugh, getting out into nature, in the sunshine, breathing fresh air, exercising daily and implementing mindful practices such as yoga, meditation or journaling
- Exercise daily – move your body as much as you can and opt for activities you enjoy, there is no point in exercising if you don’t enjoy the activity you are doing. Think out of the box and go swimming or bushwalking or take a dance class. Exercise doesn’t always mean going to the gym and lifting weights, although if that’s what you enjoy, great!
PCOS doesn’t have to be a life sentence, given time and with the right guidance it can be treated effectively with the right interventions. Why not call the clinic on 02 4961 4075 and chat to one of our experienced Herb Bar Naturopaths, they can assist you with free advice, practitioner grade natural supplements and herbal medicines and get you back on your path to great health!
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