A Holistic Approach to Treating Poly Cystic Ovarian Syndrome (PCOS)
Diagnosed with PCOS?
What does it mean in simple terms and is there an option other than the Contraceptive pill and Metformin?
PCOS stands for Poly Cystic Ovarian Syndrome and is the most common endocrine disorder in women. It occurs in 5% to 15% of women (depending on the criteria used to make a diagnosis) and is the most common cause of menstrual disorders and infertility.
Young girls are getting diagnosed in their teenage years and treatment is often the Oral contraceptive pill (OCP). Whether it is a 14-year-old girl or a woman in her 20’s or 30’s, the concept of taking the OCP for PCOS may seem daunting. This is where a Naturopath may be able to help and offer another option through diet modification, herbal and nutritional medicine. In some cases, Naturopathy can be used in conjunction with Metformin and the OCP to further reduce symptoms and improve overall hormonal balance.
Firstly, how is PCOS diagnosed –
- Ultrasound – with the presence of a polycystic ovary. What this means is a ultrasound will visually detect the presence of many partially formed follicles on the ovaries (where the follicle has not released an egg). They can look like a string of pearls.
- Elevated androgens – obtained via blood testing.
- Inconsistent ovulation – as seen in case history.
Symptoms can range from –
- Irregular periods or loss of periods
- Acne
- Excessive unwanted hair growth (face, arms, pubic, chest)
- Scalp hair thinning
- Inconsistent ovulation – as seen in case history.
It is important to note that not all PCOS women present identically.
Not all PCOS patients are overweight and many have a lean body shape.
Not all PCOS patients have insulin resistance.
Not all PCOS patients have elevated androgens.
Why does PCOS occur?
PCOS develops due to androgen dysregulation and hyper responsiveness to gonadotropin (FSH and LH) stimulation. Recent research suggests that a combination of genetics as well as environmental factors also play a role in the development of PCOS and factors such as prenatal exposure to androgens, along with obesity postnatally also contribute. Naturopaths can support in the early stages to help correct androgen levels and initiate ovulation before the condition becomes a chronic syndrome.
What other factors are at play in PCOS?
We know that an active inflammatory process (which can be the result of a seemingly unrelated condition such as IBS) may promote the elevation of androgens and encourage insulin resistance.
We also know that auto immune thyroid conditions can impact the PCOS picture.
Chronic dysbiosis (ie unbalanced microbiome) can also occur in PCOS patient’s due to elevations in testosterone.
PCOS may also cause the dysregulation of inositol (a vitamin like substance that works with insulin).
It is important to note the complications of unchecked PCOS can be –
- Insulin resistance and type 2 Diabetes
- Increased risk of cardiovascular disease
- Fertility issues
- Increased risk of endometrial hyperplasia
- Sleep apnoea and fatigue
- Mood disorders
So, it is easy to see how PCOS can be a complex condition, involving multiple systems in the body. This is why natural medicine can be useful, as it works on a “whole body” approach.
Knowing that there are other options beyond the contraceptive pill and metformin can be reassuring in supporting women to work out what is best for their body and help regain a sense of control. A Naturopath will help you understand the best diet that suits your body and will work with you to identify natural medicines that may assist in achieving your hormonal state of balance.
Naturopaths use natural medicines such as –
D-chiro-inositol which supports the way insulin affects androgen synthesis in PCOS patients and myo-inositol which mediates Follicle stimulating hormone signalling and glucose metabolism. A German study of 3,602 PCOS patients found the combination of folic acid and myo-inositol for 2 to 3 months resulted in restoration of ovulation in 70 pct of patients and the pregnancy rate in this case was equivalent or superior to those on Metformin. The study also noted that egg quality was improved in the myo-inositol and folic acid group.
Other studies have shown a positive impact on irregular periods from herbal combinations of Cinnamomum verum, Glycyrrhiza glabra, Hypericum perforatum, Paeonia lactiflora as well as Tribulus terrestris. Other significant improvements noted were a decrease in body mass index, improvement in blood pressure as well as insulin and LH levels.
If you or your daughter have been diagnosed with PCOS or experience some of the symptoms mentioned and would like more information contact Kathleen Mcfarlane to discuss what natural medicine options may be right for you.
References
Arentz S, Smith CA, Abbott J, Fahey P, Cheema BS, Bensoussan A. Combined Lifestyle and Herbal Medicine in Overweight Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial.
Phytother Res. 2017 Sep;31(9):1330-1340.
Regidor PA, Schindler AE, Lesoine B, Druckman R. Management of women with PCOS using myo-inositol and folic acid. New clinical data and review of the literature.
Horm Mol Biol Clin Investig. 2018 Mar 2;34(2).
Robert L. Rosenfield and David A. Ehrmann The Pathogenesis of Polycystic Ovary Syndrome (PCOS): The Hypothesis of PCOS as Functional Ovarian Hyperandrogenism Revisited.
Endocr Rev. 2016 Oct; 37(5): 467–520.