Polycystic Ovarian Syndrome PCOS

Polycystic ovarian syndrome, or PCOS, is the most common endocrine disorder affecting women of reproductive age. Yet, it is often overlooked and may take a woman years to get a proper diagnosis and treatment.

The conventional approach addresses the signs and symptoms of PCOS with medication. Medical management may not adequately address the root causes and help women restore hormonal and metabolic balance.

At TārāMD, we take an integrative approach to PCOS, incorporating diet strategies, lifestyle changes, supplements, and other natural tools for our PCOS patients. Keep reading to learn more about PCOS, diagnosis, causes, and integrative solutions to consider.

What is PCOS?

PCOS is a collection of symptoms and may present differently for different women. It affects lean women and those who carry extra weight. For diagnosis of PCOS, two of the three following criteria need to be met, along with the exclusion of other conditions that could explain the symptoms:

1. Absence of ovulation or irregular ovulation (leading to irregular cycles or no periods)
2. Elevated androgens (including testosterone) or signs of high androgens, such as hair growth on the chin or chest, acne, and hair loss on the head
3. Polycystic ovaries – multiple fluid-filled cysts on the follicles of one or both ovaries that interfere with ovulation

The PCOS name is problematic as it’s possible to have PCOS without having polycystic ovaries.

PCOS impacts fertility, quality of life, mental health, and metabolic function. Women with PCOS are more likely to have challenges getting pregnant and develop gestational diabetes during pregnancy and type 2 diabetes later in life. They also have higher rates of depression and anxiety.

What Causes PCOS?

In integrative medicine, we peel back the layers to understand the root causes and drivers of PCOS. These include:

• Genetics - PCOS tends to cluster in families, suggesting a strong genetic component. Some evidence suggests that epigenetic changes that happen in utero may contribute.
• Insulin resistance – Insulin resistance is a metabolic state that occurs when cells become numb to insulin’s effect. The result is both high blood sugar and high blood insulin levels. Insulin resistance occurs in many (but not all) women with PCOS and is a driver of elevated testosterone.
• HPA-axis dysfunction – Sometimes referred to as “adrenal fatigue,” this issue in communication between the brain and adrenal glands can play a role in increased androgen production from the adrenal glands.
• Inflammation – Underlying causes of inflammation, including food sensitivities, infections, and environmental toxins, can trigger and progress PCOS.
• Low SHBG – Sex hormone binding globulin is a transport protein for estrogen and testosterone. When sex hormone binding globulin is low, testosterone levels can be higher. Low SHBG is related to hypothyroidism, the use of certain medications, and other factors.

Conventional Treatment

With a diagnosis of PCOS, many women find themselves taking several medications. These might include:

• Metformin – A diabetes medication that helps to lower blood sugar levels
• Birth control pill – suppresses natural hormone production and may reduce some symptoms of PCOS
• Anti-androgen medications – designed to block androgens to reduce symptoms of high androgens

It’s important to note that these medications have side effects, such as nutrient deficiencies, and may not adequately address the root cause of PCOS. For example, when a woman wants to get pregnant, she may discontinue taking birth control to find that her PCOS symptoms return.

Integrative Approaches To PCOS 

In some cases, medication may be necessary; however, there are many supportive integrative strategies, including:  

• Balance blood sugar. Changing the diet to manage carbohydrate (and sugar) intake and balance blood sugar supports and improves insulin resistance. I suggest using a continuous glucose monitor to learn more about how your current diet affects blood sugar and work to make targeted, personalized adjustments. Unfortunately it is not as simple as just cutting out carbs. Carbohydrates can actually be part of the healing diet for PCOS so be sure to work with a professional before radically changing your diet.

• Address other dietary factors. Since undereating affects ovulation, it’s important to eat enough food and get support for disordered eating if that applies to you. Identifying and avoiding foods you are sensitive to may be a strategy for lowering inflammation.

• Reduce exposure to toxins, including endocrine disruptors. Environmental toxins are all around us, and many drive metabolic and hormonal dysfunction. Learn more about endocrine disruptors and how to avoid them here.

BPA (bis-phenol A) exposure links to PCOS. Avoid BPA by reducing plastic use, choosing natural fiber clothing, and not touching printed receipts (decline receipts or ask for an email instead).

• Support the microbiome and gut function. Microbiome health is critical for hormonal health, metabolism, immunity, and overall health. Work with an integrative provider for comprehensive stool testing and personalized approaches to microbiome balance.
• Address stress. Reducing and managing stress isn’t easy, but a critical component of PCOS recovery. It will support hormone balance and put your nervous system in the ideal state for healing.
• Exercise. Movement is a wonderful tool for stress management, blood sugar balance, hormonal health, and much more.
• Personalize supplemental support. Dietary supplements can help address your unique PCOS root causes and symptoms. Supplements to discuss with your integrative provider include:

• Inositol
• NAC
• Alpha lipoic acid
• Berberine
• Vitamin D
• Vitex
• Saw palmetto
• Adaptogenic herbs
• B vitamins
• Magnesium
• And others

At TārāMD, we take a whole-body approach and personalize PCOS treatment for each woman. By addressing the drivers of PCOS, symptoms subside and fertility improves.

If you suspect PCOS, we can help you get a full evaluation and proper diagnosis. Or if you’ve been diagnosed, but still don’t feel well, we can help you understand your root causes and what treatments would serve you best. Get in touch today!