What is PCOS?
Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that affects 6 to 12 percent of women of reproductive age. It is characterized by the presence of small cysts on the ovaries, irregular menstrual cycles, and high levels of androgens (male hormones) in the body. Women with PCOS are also more at risk for serious health problems such as obesity, diabetes, heart disease, hyperlipidemia, hypertension, fatty liver disease, sleep apnea, and stroke.
My PCOS Story
I was diagnosed with PCOS in 2015 during my first semester of nursing school. I knew little about the diagnosis and so I did what every 20-something would do – a quick google search. I saw symptoms like acne, excess body hair, weight gain, depression, anxiety, and even infertility. Already experiencing more stress than ever while in nursing school, I was completely overwhelmed with emotion and broke down in tears. My OBGYN told me that my ovaries “looked like chocolate chip cookies” and she promptly referred me to a reproductive endocrinologist to help with the management of my PCOS symptoms.
I went from being on zero medications to three medications for PCOS; birth control pills for my hormone imbalance, metformin for blood sugar regulation, and spironolactone for my cystic acne and hirsutism. As if I wasn’t overwhelmed enough, I was now taking several new medications with little support or guidance and no lifestyle recommendations were provided.
I began seeking out blogs, videos, and books to learn more about my new daunting PCOS diagnosis. I quickly learned that although the prescribed medications can be helpful in keeping symptoms at bay, they do not address the root cause of the disorder and can have unwanted side effects. I also learned that there were lifestyle changes, including diet and exercise, that I could make to manage my PCOS symptoms and even reverse the condition.
The Functional Medicine Approach to Treating PCOS
Conventional medicine typically treats PCOS with birth control pills, which can regulate menstrual cycles and reduce androgen levels, and medications to lower insulin levels. However, functional medicine takes a different approach to PCOS. Rather than treating symptoms, it aims to address the underlying imbalances in the body that are causing the disorder. Here are some strategies that I have used for myself and for my patients to help reverse PCOS and restore hormone balance:
- Address insulin resistance
Insulin resistance is a common underlying factor in PCOS. When the body becomes resistant to insulin, the pancreas produces more insulin to compensate. This can lead to high insulin levels in the blood, which can cause the ovaries to produce more androgens. Therefore, I recommend focusing on a diet that is both high in protein and healthy fats and low in refined carbohydrates/sugars – this can help improve insulin resistance, weight loss efforts, and decrease androgen levels.
Also, Exercise is crucial! Research suggests that aerobic exercise is effective in reducing inflammation and increasing insulin sensitivity in women with PCOS. Caveat: be careful not to over-exercise as this can contribute to increased cortisol production and hormone imbalances.
- Balance gut health
The gut microbiome plays an important role in hormone balance and PCOS. An imbalanced gut microbiome can lead to inflammation, which can disrupt hormone production and lead to insulin resistance. Supplements like L-glutamine and deglycyrrhizinated licorice root among others, can promote gut health by decreasing inflammation and repairing damaged gastrointestinal lining. Eating a diet that is rich in fiber, prebiotics/probiotics, and low in carbohydrates, sugars, and processed foods can help promote the growth of beneficial gut bacteria, increase microbial diversity, and restore microbial balance to gut microbiome.
- Manage stress
Stress can disrupt hormone balance and exacerbate symptoms of PCOS. Therefore, it is important for women with PCOS to engage in stress management techniques like meditation, yoga, or deep breathing exercises. Adaptogenic herbs like ashwagandha and maca, can also be helpful in supporting a healthy stress response and building resilience to facilitate hormone balance.
- Support liver function
The liver also plays an important role in hormone metabolism. Therefore, liver-supportive supplements like milk thistle or N-acetylcysteine (NAC) may be helpful for women with PCOS.
Although milk thistle and NAC are considered safe and are generally well tolerated, some groups of people should exercise caution or avoid taking them altogether. For example, individuals with allergies to milk thistle, ragweed, marigolds or daisies should avoid taking milk thistle. Also, women who are pregnant or breastfeeding, people with liver disease, asthma, bleeding disorders or recent surgery and children should avoid taking milk thistle and NAC or consult a healthcare practitioner prior to taking them.
Other ways to support liver function include eating a healthy diet; focus on eating foods that support liver detox including leafy greens, cruciferous vegetables, and beets. Also, maintaining a healthy weight, exercising regularly, staying hydrated, limiting alcohol intake, avoiding smoking and environmental toxins, and engaging in weekly saunas/steam can support detoxification pathways and optimize liver function.
- Consider Supplementation
There are several natural remedies that may help improve hormone balance in women with PCOS. For example, supplements like inositol and berberine (my personal favorites) have been shown to improve insulin sensitivity and reduce androgen levels in women with PCOS. Saw palmetto has also been shown to reduce androgen levels, while chasteberry (vitex) can help regulate menstrual cycles in women with PCOS. Supplements when used in combination with adequate diet, exercise, sleep, and stress management may just be the perfect PCOS prescription you didn’t know you needed! Work with a functional medicine provider like myself or Dr. Lipman to get started on creating a protocol that best suits your individual needs.
PCOS can be a challenging syndrome to manage, but functional medicine offers a holistic approach that addresses the root causes in a sustainable and realistic manner. At Eleven Eleven Wellness Center we aim to address gut health, insulin resistance, stress management, liver function, and other imbalances in the body to help you achieve hormonal balance and improve your overall health and well-being.