In honor of Women’s Health Month, I felt it important to discuses a syndrome – that  like women, is elusive, complex and foolish to ignore – Polycystic Ovary Syndrome. PCOS appears in between 4 and 12% of women seen in American clinics (1,2) and in 20% of obese women. (3) A concern is that these numbers may be inaccurate because of the variety and inconsistency of criteria for diagnosis in the past and the myriad of subtle symptoms that go unreported and/or are overlooked.

Symptoms individually may seem unremarkable or easily treatable, but collectively, they point to a very important diagnosis.

  • Acne
  • Mild facial hair or nipple hair
  • Irregular periods
  • Heavy periods
  • Difficulty conceiving
  • Intermittent pelvic pain

Women are at risk for missing the mark on the accuracy of prevalence as well as missing the diagnosis all together. The possibility of miss diagnosing or ignoring PCOS has significant implications including the possibility of; increased risk for Type 2 diabetes, increase thickening of the endometrial lining and hyper-estrogen related cancers and cardiovascular disease.

Treatments typically include pharmaceutical hormone regulators such as oral contraceptive and metformin as well as a recommendation for weight loss in the over weight or obese PCOS patient.  (Please note, that only some of the women with PCOS are overweight or obese. In fact, many women that have PCOS are of a normal healthy weight). Regardless, these medications have been beneficial for some but many women are opposed to the use of prescriptions medication unless absolutely necessary and /or often do not like the side effects associated with these treatments.

More and more, women are asking the question, “Are there any alternative therapies?” The good news is that for many women the answer is yes.

Many woman are  in fact seeing changes when they implement one or more of the following; lifestyle changes, nutritional therapy, herbs, Chinese medicine, hydrotherapy, and homeopathy. In some instances, patients choose to integrate both natural and conventional therapies to get the best possible out come.

Regardless of the approach, the goals for treatment are:

  • Decrease circulating insulin and androgens,
  • Restore ovulation and menstrual regularity
  • Optimizing ad maintaining a healthy weight
  • Improve cardiovascular profiles
  • Support liver function
  • Improve hypothalamic-pituitary-adrenal (HPA) axis

Diagnostic criteria do indeed vary, however, several professional groups now agree that ovulatory dysfunction, hyperandrogenism, polycystic ovaries, and exclusion of other disorders in varying combinations are the criteria. (4) Only 2 of the above criteria need be present to be diagnosed with PCOS.

Under the care of a physician well versed in the recognition and treatment of PCOS, a woman should expect to report a thorough medical history, she may be asked to have a pelvic ultrasound to rule out a classic ovarian morphology, and have her blood drawn for certain hormones, such as thyroid function tests, testosterone, LH and FSH, insulin and blood sugar levels, lipid panel, prolactin levels. Some of these tests are for a PCOS diagnosis while others are intended to rule out other possible diagnoses.

Once she learns that she has PCOS, as frightening as it may seem, a woman is empowered.

Discovered sooner than later, there are many health benefits; she will be able to increase her chances for conception, regulate her cycles (whether painful, infrequent, extremely light, or excessively heavy), decrease acne and hair growth, loose weight, and most importantly, help her to improve her longevity and quality of life in regards to successful aging (a term that reefers to entering ones 60s and 70s without cardiovascular disease, diabetes, or cancer, among other things).

While there are many medications and even natural remedies, life style changes most likely will have the most profound impact and for many can reverse the presentation. In fact, for overweight and obese women with PCOS, weight loss alone is often associated with a reduction in serum testosterone concentration, resumption of ovulation, and pregnancy. (5,6,7)

If she implements the following changes she will not only improve metabolism but will likely also improve hormone regulation and longevity.

  • Decrease calories
  • Increase both cardiovascular and weight bearing exercise and
  • Choose whole foods rich in fruits and veggies, and whole grains over processed foods high in fat, sugar, and chemicals.

Specifically, increasing muscle mass improves glucose regulation, which increases her likeliness to ovulate and can improve cardiovascular function by lowering high LDL and triglycerides, raising protective HDL. Further, any treatment focused on reducing insulin levels in both lean and obese women with PCOS, may be beneficial. Women may see a fall in ovarian androgen secretion and an improvement in cyclic pituitary-ovarian function, which may reduce hair growth and restore menstrual regularity and presumably fertility. (4)

Comprehensive treatment plan will aim to regulate menses, reduce pelvic pain, improve fertility, reduce male pattern hair growth and/or loss and weight loss well as require that she incorporate exercise and nutrition to prevent heart disease, diabetes and cancer.

Naturopathic medicines may include but are not limited to:

  • Fiber for improved elimination of wastes including hormonal metabolites and reduction in chronic disease
  • Flax seed for its lignans, which may reduce hyperestrogen states and reduce in SHBG
  • Fish oils, specifically EPA and DHA, to improve glucose uptake by the cell, improve insulin sensitivity, and more specifically, to increase thermogenesis, decrease body fat deposition, and improve glucose clearance, (8)
  • Chromium for blood sugar regulation
  • D chiro – inositol to increase ovulation, lower insulin, improve triglycerides and blood pressure
  • Vitex for its long time use among midwifes and herbalist for cycle regulation
  • Nettles which may increase SHBG which is elevated in response to the high insulin and high androgen states seen in some women.

Most of these remedies have some research to draw on, are relatively inexpensive, easy to take, and for most are very safe and have no side effects.

Chinese herbs are very important to a holistic protocol geared towards treating PCOS.

Many women report normalization of menses, improved weigh loss and quality of life with the use of acupuncture in their treatment plans. An acupuncturist may aim to support kidney deficiency, which is related to adrenal function in the western diagnosis, spleen deficiency to support blood sugar regulation, and liver dysfunction to improve blood flow and address hormone imbalances.

When dealing with PCOS, a condition that is often addressed by treating a symptom rather than the whole person, possibly under diagnosed and reported, and often misdiagnosed, it is critical that women speak up and seek out an understanding of what is going with their bodies.  Further, I find it tragic that most treatment plans for PCOS are based entirely on pharmaceuticals when there are many known benefits – specifically for PCOS – of lifestyle counseling, increased activity, improved nutrition, and the implementation of even one of the many naturopathic and Traditional Chinese remedies.

Chuckling, I realize that both of those statements are actually incredibly true for so many conditions that Americans are experiencing today, the lesson…RESET NATURALLY!

Peace and health,

Dr. Rose

References available upon request