Polycystic ovarian syndrome (PCOS) is a common reproductive issue in women that actually encompasses a wide variety of symptoms, with the most common being a failure to regularly ovulate and thus having irregular periods.
As ovulation is the key to producing oestrogen and progesterone, failure to ovulate can therefore actually lead to a higher level of androgens including testosterone (the male hormones).
During a normal cycle, usually around 6- 12 follicles develop, with about 1 becoming dominant and progressing to ovulation. However, with PCOS what can happen is that all follicles keep growing but don’t fully develop, creating what appear to be cysts. On the other hand, you don’t have to have visible cysts to be in the PCOS category (it can get a little complicated!).
Whilst it’s commonly believed that an ultrasound can diagnose PCOS, in actual fact, blood tests are required to assess hormones and determine a diagnosis.
Symptoms of PCOS include:
- Heavy or irregular periods
- Acne, oily skin or dandruff
- Excess body hair (hirsutism) usually on the chest, face, back or bottom
- Hair loss or thinning hair on the head
- Fertility issues
- Weight gain
- Pelvic pain
- Skin tags
- Mood imbalances
So, What Can Be Done?
Medically, there appears to be no cure for PCOS and so conventional treatment can involve either birth control, or metformin to balance blood sugar. Yet, with functional medicine, we really like to delve a little deeper and uncover what may be contributing to the issues on a wider level.
Balance Blood Sugar
In the majority of cases, blood sugar issues are definitely at the root of this condition, so it’s a great place to start. When blood sugar is high, insulin levels are raised, leading to higher unbound testosterone, disrupted ovulation, and greater level of androgens.
To help combat this issue, the diet needs to focus on whole, unprocessed carbohydrates, whilst removing sugar and refined foods like breads, pastas and cakes. Even too much fruit can sometimes be a bad thing, especially if it’s in the form of juices, so I usually tell people to stick to 1 cup of berries a day! Eating all meals with a form of protein and healthy fat is important too, as these macronutrients can help slow down the release of blood sugar.
Additionally, smoking, stress and lack of sleep can negatively affect blood sugar levels so this needs to be taken into account too!
In terms of supplements, my favourite for helping blood sugar are omega 3 and myo-inositol, but doses can vary depending on the individual.
Inflammation is at the heart of most hormonal issues as it can affect hormone receptors as well as ovulation. Insulin and inflammation are very closely linked, yet other factors involved in this process are an accumulation of toxins and heavy metals, poor dietary choices, food intolerances/ allergies, and digestive issues including a gut flora imbalance or presence of parasites.
Other symptoms of inflammation to be aware of come in the form of skin conditions, headaches, and joint pains. If you’re periods are all over the place and you’re aching a lot, this may be an area you want to strongly consider!
To help combat inflammation, it can be useful to pull out anything that could be causing an issue to the body, from synthetic home and skincare products (yes, these are a MASSIVE source of toxins), to potential food allergens like dairy and gluten. Look at supporting the main organ of detoxification with liver cleansing herbs like milk thistle and glutathione or NAC, and cut out high mercury fish like tuna or swordfish. Adding in smaller oily fish like wild salmon, sardines and mackerel are great though as they’re rich in the anti-inflammatory omega 3.
Balance your hormones
Whenever I see clients with PCOS or suspected PCOS I’ll nearly always run a hormone panel to see exactly what their hormones are doing, from oestrogen and progesterone, to the androgens and even stress hormones. Depending on what pathways are dominant and what the ratios of hormones are, we can then look at supplementing accordingly with herbs and nutrients to help get things back on track.
Interestingly, herbs that can help with androgen balance are the same that can help with prostate health. Things like nettle and saw palmetto can work wonders.
The great news is that PCOS doesn’t have to be a diagnosis for life, and the symptoms can definitely be supported and managed. Just with a few tweaks here and there and maybe some functional testing, you can get to the route of what’s going on and feel a million times better!