Polycystic Ovarian Syndrome (PCOS) is a common problem for many women. About 6-10% of women in the U.S. suffer from it and many don’t even know it! Integrative Gynecologist Dr. Bronwyn Fitz discuss the symptoms and natural solutions to address them.
The hallmarks of the syndrome are:
- irregular or skipped periods
- androgen excess: acne, male pattern hair growth or loss
- multiple small underdeveloped cysts on the ovaries.
Although the entire mechanism of PCOS hasn’t been fully worked out yet, we do know that people can present with variations of the above symptoms. Not all women have polycystic ovaries, not all have elevated testosterone levels — that doesn’t mean that they don’t have PCOS. There is likely a genetic component to PCOS as well, though we need more research to figure it out.
Despite the variation in how PCOS looks from person to person, one of the underlying driving mechanisms for many women appears to be insulin resistance. It is important to find out if you have PCOS because in addition to irregular periods and annoying acne, women are at increased risk for some long-term problems that can be serious: diabetes, high cholesterol, uterine cancer to name a few. We also know that women with PCOS can suffer from anxiety and depression as well.
For women who are not trying to get pregnant, the standard way of treating women with PCOS involves prescribing birth control pills. For women who are trying to conceive, they are often prescribed medicines like clomiphene citrate, letrozole, metformin, or more advanced infertility protocols. In my Integrative Gynecology and Functional Medicine practice, many women come to me seeking help for PCOS because they want to explore other options than all of the medicines I just listed. They ask me, “isn’t there something else I can do?” They answer is yes!
There are many dietary strategies, lifestyle modifications, supplements, and herbs that can help. And while I do sometimes prescribe birth control pills and other medicines to help with symptom relief, I think there is real value in trying to address the drivers of PCOS through lifestyle changes first. Though going on “the pill” has some benefits: it regulates periods, improves acne, protects women from uterine cancer – it doesn’t address the metabolic component. It is a symptom band aid. Once the band aid is removed, the symptoms recur. That is not good news for someone who is trying to get pregnant.
Here is what I mean: consider the example of a young woman with PCOS- she gets put on the pill. Her symptoms improve greatly, so she stays on it for many years. Then once she decides to come off the pill to start her family, she has a hard time getting pregnant. Next thing you know, she is off to the infertility doctor fretting the future of her family. I would so much rather tackle PCOS head on when women first get the diagnosis. Once a woman has decided to try to start her family, the biological clock is ticking and she can get very stressed about her health – which only makes conceiving even more difficult.
In my practice, when a woman presents with PCOS, we have a conversation. I have to learn what her most worrisome symptoms are and what her goals are. Then we work together to address the underlying hormonal and metabolic pathways that need optimizing. No two treatment plans are the same. Some of the very important strategies for reversing PCOS are:
- Eating a low glycemic index diet
- Using food as medicine –therapeutic foods like flax seeds, soy, cinnamon, green tea
- Exercise – most insulin is used in the muscle, therefore exercising the muscles is key
- Weight loss if needed
- Supplements – Inositol, N Acetylcysteine, chromium, alpha lipoic acid
- Herbs – chaste tree, berberine, curcumin, peony, licorice, saw palmetto, stinging nettle
- Stress management
- Detoxing your environment from endocrine disruptors
- Optimizing estrogen metabolism
- Using medicines judiciously
The journey to wellness with PCOS can be a long one. Making lifestyle changes can be challenging. For this reason, I often refer patients to nutritionists, therapists, acupuncturists, health coaches, to help support them in this journey. I work with endocrinologists and infertility doctors along the way also. Usually it is a team effort. I encourage women to find the right healthcare providers to have on their team. Feeling supported on your journey is paramount.
There is hope for women with PCOS. To learn more, feel free to call me for a medical visit, or if you don’t live in NY or CT, we can set up an educational consultation.