I am blessed to have now worked with thousands of women all over the world in their health, wellness and weight loss goals. One group of women who are near and dear to my heart are those who come to me with PCOS.

These women often come to me near hopeless and with the idea that no matter what they do they will never feel “normal” or be able to lose weight again. This truly breaks my heart.

In my experience the biggest problem with this diagnosis is the misinformation that if you have PCOS you are doomed. The reality is in my experience working with these women that once they get on a healthy lifestyle, eating and self-love program they see fantastic results.

For some reason me explaining this to those who have been diagnosed doesn’t come across as clear as what I would like and I am in no way blaming those who have been diagnosed. I fully understand that PCOS brings a lot of physical and emotional turmoil to a women’s life.

What I do want to clearly state is that you can get better. You can feel good again. You can lose weight.

This week our question for Dr. David Duizer is – How is PCOS treated? and how can you feel good again?

*If you live in the Vancouver, British Columbia area and would like to book an appointment with Dr. David Duizer ND to discuss his natural modalities and healing methods go here.
 

 

Ask Dr. Duizer – How to Treat PCOS Naturally

One of the main reasons we wanted to do an #AskDrDuizer about PCOS is because of the frustration this syndrome can cause so many women. With its undesirable symptoms, poor outlook and lack of conventional treatment options feeling ‘stuck’ or ‘hopeless’ is a theme amongst those who have been diagnosed.

The goal of today’s Q & A is to lift some of these concerns and give a few options for integrative treatments to look to when women find themselves frustrated with conventional medicine or for those who just do not wish to take hormones, drugs or pharmaceutical creams.
 

What is PCOS?

PCOS or Polycystic Ovarian Syndrome (Stein-Leventhal Syndrome/Hyperandrogenic Chronic Anovulation) is a common hormonal disorder among women with 5-10% of the population being affected.

It is defined as a syndrome where two of the following three are present:

1. Ovulatory dysfunction – usually noticed as irregularities in the menstrual cycle
2. Hyperandrogenism – excess androgens (hormones including testosterone)
3. Greater than 10 Follicles per ovary – diagnosed via pelvic ultrasound

This means that women do not have to have cysts on their ovaries to clinically suffer from PCOS. Only the symptoms need to be present in combination with a lab test showing increased testosterone.

In Naturopathic Medicine one of our healing principles is to ’treat the cause’ but in the case of PCOS this can be quite difficult as the cause is still unknown.

Different causative theories that we can work from include:

• Genetics – It may be a hereditary condition indicating that certain genes may be linked to the condition
• Low-grade Inflammation – Causing the ovaries to release excess hormones
• Insulin Resistance – Excess insulin may be the causing excess hormone release

 

What are the symptoms of PCOS?

The symptoms of PCOS vary from woman to woman but the most common include:

• Obesity (weight gain)
• Hirsuitism (male pattern hair growth or excess hair growth)
• Anovulation (no monthly ovulation)
• Irregular bleeding (irregular cycles)
• Acne
• Infertility
• Hypertension
• Diabetes
• Thickened darkened skin (underarms, nape of the neck and skin folds)
• Temporal balding

 

How is PCOS diagnosed?

When assessing for PCOS women can expect a clinical exam looking for excess hair growth, acne, weight gain, a pregnancy test to rule out pregnancy, hormone testing for testosterone and other hormones and a pelvic ultrasound to look for present ovarian cysts.

After the diagnosis is made more testing may be required to assess other conditions that may be associated with PCOS such as hypertension and diabetes.
 

What are the conventional medications for PCOS?

PCOS is traditionally managed by oral contraceptives. Obviously this isn’t idea for women trying to conceive and the risk of long term side effects of birth control pills doesn’t outweigh the benefits of their usage if other options for reducing estrogen levels or raising progesterone levels can be used.

Medical creams can be used to reduce unwanted hair growth and drugs commonly used in diabetes can be used to reduce insulin resistance.
 

What are the most concerning consequences of PCOS?

Aside from the frustrating symptoms of this condition it causes excess estrogen in the body. This can increase the risk of endometriosis and cancer.

The increase in testosterone can lead to an increase risk of cardiovascular disease.

The insulin resistance can lead to an increased risk of diabetes and all of the complications that go along with it.
 

What are the natural treatments options for PCOS?

In Naturopathic Medicine we look to a balanced approach to treating conditions such as PCOS which includes lifestyle changes, diet changes, herbal medicine and vitamin and mineral therapy. Below I have outlined a few of the different things that can be prescribed before trying hormone therapy.

Lifestyle and Diet Changes:

Even though weight loss can be difficult with PCOS exercise on its own can help to reduce insulin resistance and in turn reduce testosterone levels.

A low glycemic diet has the same effect and should be combined with small meals containing high fibre, lots of fruits and veggies and good fats.

Reduced alcohol consumption.

Finally, women should avoid refined sugar from white bread products, candy and packaged foods. Carbohydrate intake should be kept to 80g/day or lower and protein should be above 60g/day.

These options will help to keep blood sugar stable, reduce excess hormone synthesis and prevent weight gain.

Herbal Medicine Options:

This is where Naturopathic Medicine shines in the treatment of PCOS. The following is a rough guide and an ND should be consulted for proper dosages before starting any of these therapies.

• Vitex – uterine stimulant, helps naturally balance female hormones
• Rhodiola – adrenal gland adaptogen to help increase physical and mental endurance, improve energy and has been shown to stimulate ovulation
• Green Tea – increase sex-hormone-binding-globulin to bind excess testosterone
• Nettles – increase sex-hormone-binding-globulin to bind excess testosterone
• Saw Palmetto – inhibits the conversion of testosterone to its stronger form
• Licorice – shown to lower serum testosterone in women
• Soy – phytoestrogen – increase sex-hormone-binding-globulin to bind excess testosterone
• Flax Seeds – increase sex-hormone-binding-globulin to bind excess testosterone
• Fenugreek – progesterone precursor to help restore balance

Vitamin, Mineral and other Natural Therapies:

Certain deficiencies have been loosely linked to PCOS and supplementation may be helpful in reducing symptoms.

• Vitamin D – has been shown to be deficient in 75% of PCOS patients
• DIM – helps to reduce excess estrogen via liver metabolism
• Inositol – reduces insulin resistance
• Chromium – improves glycemic control (blood sugar regulation)
• NAC – has been shown to improves insulin sensitivity and reduce androgen levels

Acupuncture:

Personally I have had success as a clinician with a select few of the above mentioned herbs and vitamins in combination with an 8 week acupuncture protocol. This protocol is unique to each person and usually involves balancing the Kidney and Liver meridians (but this will be different from person to person).
 

What are the goals of treatment for PCOS?

1) Increase Sex Hormone Binding Globulin– This is so that the body can naturally reduces the amount of excess estrogen and testosterone. Some therapies that have been shown to do this include nettles, green tea, soy and flaxseed.

2) Improve insulin sensitivity or reduce insulin resistance – This is really to say improve glucose levels (regulate blood sugar) and reduce the amount of excess insulin released in PCOS. Examples of therapies that can achieve this include chromium, fenugreek, cinnamon, vitamin C and bitter melon.

3) Lower testosterone levels using herbs – Reducing testosterone will reduce most of the symptoms of PCOS including excess hair growth and acne. Some therapies we use to accomplish this include licorice and saw palmetto (which can prevent the conversion of testosterone into DHT – the stronger form of the hormone).

4) Prevent endometriosis and cancer – The goal here is to oppose the excess estrogen present in this syndrome by either increasing progesterone levels (as best we can without having to use bio-identical hormones) or by reducing estrogen levels.

5) Weight loss – A 10% weight loss can improve insulin sensitivity and reduce excess hormone levels. Exercise is key in this syndrome and should be a top priority.

One thing I haven’t mentioned about PCOS that I want to cover is the difference between external and internal sources of hormones and/or changes in hormones.

Externally exposures to exogenous estrogen from our food and chemicals in the environment can have an effect on estrogen levels and should also be considered as a factor in PCOS.

Internally stress has an effect on hormones and hormones themselves can alter stress levels. The extra estrogen present in PCOS can make the mind more sensitive to stress making situations more difficult to deal with. In addition excess stress can cause adrenal fatigue/burnout (more info here) which can tax progesterone levels and create an estrogen dominance picture (as seen in PCOS).
 

What is the outlook for PCOS?

Although PCOS often begins at puberty and the cause is still unknown it does not have to be a lifelong ailment.

The frustration of its symptoms and the risk of infertility weigh on the minds of women who have been diagnosed but in many cases synthetic hormones and pharmaceutical prescriptions are not necessary.

Through balancing the body and mind using herbs, vitamins, minerals, nutrition, exercise and acupuncture symptoms can be reduced, hormone levels can be restored to normal, ovulation can reoccur, women can become fertile again and weight can be lost.

Stress reduction techniques, excess hormone detoxification, balancing the body through vitamins and minerals are all essential components to a PCOS natural treatment plan.

*If you live in the Vancouver, British Columbia area and would like to book an appointment with Dr. David Duizer ND to discuss his natural modalities and healing methods go here.

References:
Merck Manual
Women’s Encyclopedia of Natural Medicine – Tori Hudson ND
Nutritional Medicine – Alan Gaby MD
 

Dr. David Duizer is a co-founder of DAMYHealth.com and a Naturopathic Physician practicing in Vancouver, British Columbia. He is a passionate, driven, motivated leader in integrative medicine focused on optimal wellbeing, holistic healing and natural health.

To learn more about Dr. David Duizer Click Here. Connect with David on Twitter @davidduizer, Facebook, and Google+.