Polycystic Ovarian Syndrome, or PCOS, affects nearly 1 in 10 women of child-bearing age. And, despite its name, PCOS affects much more than just the ovaries themselves. This is an autoimmune disease that I have struggled with and led me to my career in integrative and holistic medicine.
PCOS is an increasingly common cause of infertility, and if left untreated, can increase risk for developing metabolic syndrome and Type 2 Diabetes (1)
Hormonal birth control is often the first choice for managing PCOS symptoms, but for women trying to become pregnant–this isn’t a viable solution. And while there isn’t a cure for PCOS–it’s symptoms are completely treatable, which means those with PCOS can have beautiful hair, glowing skin, and healthy pregnancies.
For root cause treatment of hormonal imbalances, getting insulin levels healthy, and inflammation down, the right diet, supplement, and lifestyle routine will provide relief and help to reduce the lifetime risk of chronic metabolic conditions like heart disease and diabetes, along with mental health conditions (2).
I often refer to PCOS management, as the PCOS triangle- where there is a gut issue, a methylation issue, along with the hormone issue. All three corners of this triangle have to be addressed to see symptoms and infertility resolve.
Signs & Symptoms of PCOS
Contrary to popular belief, you DON’T have to have cysts on your ovaries to have PCOS. The name itself creates confusion for many women, but cysts aren’t always present.
The primary symptoms of PCOS are:
- Body hair (called hirsutism)
- Weight gain or obesity, despite a healthy and active lifestyle
- Not ovulating
- Acne, especially on the back and chest
- Hair loss, or thinning hair on the head
- Irregular periods or no period (dysmenorrhea, or amenorrhea)
- Ovarian cysts
- Estrogen dominance signs (like worsening PMS, painful periods)
- Anxiety and depression
Pain from PCOS tends to be due to the imbalance between progesterone and estrogen. Because PCOS can cause symptoms of estrogen dominance, you may experience worse cramps, tender breasts, and more painful periods and PMS.
That said, though a ruptured cyst on the ovary is rare, it can still happen. There may be pain, inflammation, or bleeding involved if a cyst does rupture.
This is why it’s important to develop a relationship with a practitioner you trust, so they can evaluate your symptoms if you do ever have a cyst rupture and it causes pain.
What Is PCOS
Symptoms of polycystic ovarian syndrome are caused by an imbalance in the hormones estrogen and progesterone, and the excess production of androgens, or male hormones like testosterone.
High levels of insulin are also a root cause of PCOS, and cause the ovaries to make excess testosterone, which interferes with ovulation and causes some of the symptoms of PCOS like excess hair growth, thinning of hair on the head, and acne.
Excess weight is due in part to aspects of insulin resistance which, although not present in every single case of PCOS, is very common (1).
Long term, PCOS left untreated can lead to metabolic syndrome, Type 2 diabetes, and cardiovascular disease due to chronic inflammation and blood sugar imbalance, so there’s much incentive to address the lifestyle, diet, and hormonal factors that play a part in PCOS.
At your doctor’s office, PCOS is diagnosed by having one of two of the following: excess androgens (testosterone), polycystic ovaries, and dysfunction ovulating.
What causes the cysts in polycystic ovaries
During a regular cycle, your ovaries produce little fluid-filled sacs called a follicle that hold a growing egg. When ovulation happens, luteinizing hormone (LH) causes the follicle to break open, release the egg, and the egg travels down the fallopian tube to the uterus where it either becomes a pregnancy, or not–and then you get your period.
In women with PCOS, though, high levels of testosterone can prevent the egg from being released from the follicle, and then prevent it from traveling down the fallopian tube. The unreleased follicle becomes a cyst on the ovary, and is usually reabsorbed by the body.
In addition, more than one follicle can turn into a cyst on the ovary, which can cause enlarged ovaries, and some pain.
What This Means for Fertility
PCOS affects healthy ovulation. If an egg isn’t released from the ovary to be fertilized, pregnancy doesn’t occur.
To complicate matters, and imbalance in estrogen and progesterone makes it hormonally difficult for the body to have a successful implantation of an egg into the uterus. If the uterine lining isn’t sufficient to receive a fertilized egg, the body can’t sustain the pregnancy.
Solutions for Treating PCOS Naturally
If you’re living with PCOS, it’s absolutely essential that you focus closely on diet, lifestyle, and the right supplements. We may not have a cure for PCOS, but it’s symptoms can absolutely be well-managed AND you can still get pregnant
If you’re beginning your journey:
- It’s important to get your hormones tested. Working with a practitioner who understands the intricacies of women’s hormones is a must because there are several complex factors at play. Integrative practitioners will be able to interpret your relative estrogen levels, hormone fluctuations, and lifestyle factors that influence hormone levels.
- Test for nutritional deficiencies. Especially if you’re coming off hormonal birth control, as it can deplete levels of crucial nutrients, and are connected to hormone imbalances. Methylation issues and fatty acid deficiencies are common in PCOS, which is why supplementing with active, fully-methylated B vitamins is a must.
- Identify and remove food allergies and intolerance. Because cutting down inflammation is so important with PCOS, it’s important to steer clear of the foods that cause you inflammation. Common culprits are grains, dairy, or soy, but YOU will have your own unique markers for foods that you may be sensitive to. In practice, I find that common patterns include gluten intolerance and yeast or candida overgrowth. Take a look at how to cure candida naturally.
Weight Loss and PCOS
Insulin resistance, one of the primary aspects of PCOS, can make achieving a healthy weight especially difficult if you’re eating the Standard American Diet. Fortunately, you have all the resources at your fingertips to maintain a healthy blood sugar balance, and keep insulin levels healthy to encourage your body to use fat for fuel, instead of storing it.
Insulin resistance happens when your pancreas needs to release extra insulin to decrease high blood sugar. In those with PCOS, cells are less responsive to the message insulin sends, requiring the pancreas to release more.
The problem with high insulin is that it’s a fat storage hormone. It makes our body less inclined to use it’s own fat for fuel, electing instead to store excess calories away as it tries to lower blood sugar levels.
To get to a healthy weight with PCOS we need to
- Keep insulin levels low, or in a healthy range
- Decrease inflammation with diet
- Manage stress
Read on for recommendations on how to do this! These are important for every woman with PCOS, not just for those trying to lose weight.
Lifestyle & Diet for Natural PCOS Treatment
Eat an anti-inflammatory diet.
Plenty of nutrient-dense veggies, healthy omega-3 fats, and quality protein will serve your blood sugar and hormone balance best. These basics are a great place to start.
Keep blood sugar balanced.
Since insulin dysregulation is at the heart of PCOS, get healthy carbohydrates from low starch plant foods (greens, broccoli, berries, etc.), and keep processed grains to an absolute minimum. You’ll want to omit added sugar, alcohol, and maybe even gluten, depending on your tolerance.
Hormone metabolizing greens
Speaking of veggies–cruciferous veggies like broccoli, cauliflower, leeks, and kale help the body metabolize excess hormones. Aiming for about 8 servings per week is a great goal for healthy hormones.
Daily! Thirty minutes of moderate cardio, strength training, or yoga is worth its weight in gold for decreasing inflammation, improving stress markers, and maintaining a healthy response to insulin.
Work on gut health
New studies are showing that our microbiome plays a role in hormone balance and PCOS symptoms.
Use the right supplements.
- Berberine supports a healthy response to insulin, keeping blood sugar balanced and healthy (3).
- Saw palmetto inhibits the enzyme that converts hormones to testosterone, which can alleviate unwanted body hair, and help with healthy hair growth on your head (4).
- Magnesium helps mediate metabolic syndrome, which is a collection of symptoms involving high blood pressure, blood sugar imbalance, body fat around the waist, and high triglycerides (5).
- Vitex, or chaste tree, helps shift the ratio of estrogen and progesterone in favor of progesterone, creating more comfortable periods and lessening symptoms of PMS like cramps and tender breasts (6). And, progesterone is an absolute necessity in the back half of your cycle (after ovulation) for pregnancy and easier periods.
- Myo-inositol reduces androgens, supports ovarian function, and insulin sensitivity (7)(8)(9).
- Maca helps to support estrogen production, energy, and vitality
- Omega-3 is powerful for reducing inflammation and promoting healthy cholesterol levels (10).
In my practice, Hormone Helper contains both maca and myo-inositol for comprehensive hormone support to balance estrogen and progesterone, and increase fertility.
PCOS, Fertility & Infertility
You can get pregnant if you have PCOS. Because even though we don’t have a cure for PCOS, it’s symptoms are absolutely treatable, and that means you can still get pregnant if you have polycystic ovaries.
By following the recommendation above, and being consistent, you can heal your hormones, balance your blood sugar, and restore ovulation for a healthy pregnancy.
If you know someone who’s been trying to conceive, forward this article on to her and help me share this valuable information that can be of crucial importance on someone’s #TTC journey!