Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal imbalances that affects women. It is estimated that 8-13% of women worldwide experience PCOS. Up to 70% of women remain undiagnosed. The journey to understanding and healing from PCOS can be long and confusing. As a naturopathic doctor, I believe in taking a holistic, individualized approach to addressing PCOS—not just managing symptoms, but also understanding and supporting the root causes of the condition. In this post, I’ll explore what PCOS is, its underlying causes, and how you can approach treatment from a natural, whole-body perspective.
What Is PCOS?
PCOS is a hormonal disorder characterized by an imbalance of androgens (often referred to as “male hormones,” though they are present in everyone) and insulin. This imbalance can interfere with the normal ovulation cycle, making it difficult for individuals to conceive. Additionally, it can lead to a host of symptoms that affect both physical and emotional well-being, including irregular periods, weight gain, acne, and excess hair growth.
In the naturopathic philosophy, we view the body as an interconnected system, and PCOS is often seen as a result of multiple contributing factors rather than a singular issue. Insulin resistance, chronic inflammation, and adrenal imbalances can all play a significant role in the development and progression of PCOS.
The name of the condition can be misleading because not all women will have ovarian cysts, but all will have elevated androgens, such as testosterone or DHEA-S.
Key Symptoms of PCOS
PCOS symptoms can vary widely from person to person, but some of the most common signs include:
- Irregular Menstrual Cycles: PCOS often disrupts ovulation, resulting in infrequent, irregular, or absent periods. This can also affect fertility, which is a significant concern for many individuals.
- Excess Hair Growth (Hirsutism): Elevated levels of androgens in PCOS can lead to unwanted hair growth on the face, chest, abdomen, and back. This can be distressing for those affected.
- Acne and Oily Skin: Hormonal imbalances associated with PCOS may trigger acne, especially on the face, chest, and back. Excess oil production can worsen breakouts.
- Hair Thinning or Loss: Some individuals may experience thinning hair on the scalp due to high androgen levels, which can affect self-esteem.
- Weight Gain or Difficulty Losing Weight: Insulin resistance is a common factor in PCOS and can make it harder for the body to regulate blood sugar, leading to weight gain, especially around the abdomen.
- Cysts on the Ovaries: Many individuals with PCOS develop small cysts on the ovaries, which are often visible on ultrasound. These cysts are not harmful in themselves but can affect normal ovulation.
- Infertility: The hormonal imbalance in PCOS often prevents ovulation, leading to challenges with fertility. However, with the right natural therapies, many individuals with PCOS can successfully conceive.
- Other symptoms: Women with PCOS are at a greater risk of insomnia, sleep issues, fatigue, brain fog, anxiety, depression, and eating disorders because of the way reproductive hormones effect neurotransmitters and other metabolic hormones.
Naturopathic Diagnosis: A Holistic Approach
In naturopathic medicine, the goal is to look beyond the symptoms and address the root causes of PCOS. While many women remain undiagnosed, some women who don’t really have true PCOS may often by given that label. PCOS is a diagnosis of exclusion, meaning we must rule out many other issues that can cause irregular cycles and high androgens.
PCOS is somewhat of a “lazy diagnosis”, as there are many root causes that should be addressed and managed to help reverse symptoms.
There are typically four types of PCOS: insulin-resistance, inflammatory, adrenal, and post-pill.
Other conditions that mimic PCOS include:
- high prolactin
- hypothyroidism
- insulin resistance
- vitamin D deficiency
- cortisol dysregulation
- melatonin dysfunction
- undereating
- hypothalamic amenorrhea
- nonclassic congenital adrenal hyperplasia.
- Additionally, some psychiatric medications can cause hyperandrogenism.
Diagnosis typically involves:
- Comprehensive Health History: We dive deep into your personal and family health history, including menstrual history, dietary habits, lifestyle, and stress levels.
- Physical Examination: A thorough physical exam helps identify signs of hormone imbalance, including excess hair growth, acne, and weight distribution.
- Laboratory Testing: Blood tests to assess hormone levels (such as FSH, LH, androgens, estrogen, and progesterone) and markers for insulin resistance can help pinpoint imbalances. Other tests, like thyroid, prolactin, and vitamin D levels should be evaluated.
- Ultrasound Imaging: An ultrasound may be used to assess the presence of ovarian cysts, though it’s important to note that the presence of cysts alone does not mean someone has PCOS.
Naturopathic Treatment for PCOS
As a naturopathic doctor, my approach to managing PCOS focuses on natural, individualized treatment strategies to address the underlying causes of hormonal imbalance, improve overall health, and support the body’s natural healing processes. While it may be a life-long, “lifestyle” approach to your health, reversing your symptoms and healing is certainly possible with the right support in place.
Supporting Insulin Sensitivity
PCOS is often accompanied by insulin resistance, which can contribute to weight gain and difficulty managing blood sugar levels. The ovaries respond to insulin differently than other cells in the body, so even women who don’t have insulin issues on blood work should focus on blood-sugar stabilizing nutrition that supports ovarian health. Naturopathic treatments that support healthy blood sugar metabolism include:
- Herbal Medicine: Herbs like berberine, cinnamon, and fenugreek can help improve insulin sensitivity.
- Dietary Changes: A low-glycemic, whole foods-based diet that minimizes refined sugars and processed foods is crucial. Focus on nutrient-dense vegetables, healthy fats (like avocados, nuts, and seeds), and lean proteins.
- Supplements: Magnesium, vitamin D, omega-3 fatty acids, and chromium are known to support insulin function and improve metabolic health.
Balancing Hormones Naturally
Since PCOS is a hormonal disorder, regulating hormone levels is a cornerstone of treatment. Here are some natural remedies to consider:
- Adaptogenic Herbs: Adaptogens like ashwagandha and rhodiola help balance stress hormones and support adrenal health, which is important for regulating overall hormone production.
- Chaste Tree (Vitex): This herb is known to support the pituitary gland and regulate the menstrual cycle, helping to restore balance between estrogen and progesterone.
- Maca Root: Known for its ability to support hormone balance, maca can be a valuable ally in managing symptoms of PCOS, including menstrual irregularities and low libido.
- Natural anti-androgen supplements and herbs: can lower testosterone levels and improve acne and hair growth patterns: Zinc, Saw palmetto, nettle, green tea, and spearmint tea are all natural anti-androgens
Detoxification and Reducing Inflammation: Inflammation plays a key role in the development of PCOS. Women with PCOS tend to have greater inflammation in the body. A gentle detoxification plan can help reduce systemic inflammation and improve overall hormonal health:
Liver Support: Herbs like milk thistle, burdock, yellow dock, red clover, nettle, and dandelion root support the liver in detoxifying excess hormones, including estrogen.
Anti-inflammatory Foods: Incorporating omega-3-rich foods, such as fatty fish, flaxseeds, and walnuts, can help reduce inflammation and support hormonal balance.
Higher Fat/Protein, Lower Carb Lifestyle:
Most women with PCOS can greatly benefit from emphasizing more high-quality (organic) fats and proteins. The ovaries respond to insulin differently than other body cells. Insulin triggers the theca cells in the ovaries to produce more androgens, like testosterone. So even women without insulin resistance on blood work will improve ovulation by eating a higher fat, higher protein diet. Some examples include:
- Grass-fed meats: beef, chicken, duck, lamb, rabbit, pork
- Organ meats such as beef liver
- Bone broths
- Wild-caught fatty fish: salmon, sardines, mackerel
- Eggs
- Shellfish: mussels, oysters, shrimp
- Healthy fats: ghee, grass-fed butter, coconut oil, avocados, heavy cream
Optimizing Gut Health: Gut health is closely tied to hormone regulation. Imbalances in gut bacteria can contribute to inflammation and insulin resistance. To support gut health:
- Probiotics: A high-quality probiotic can improve gut microbiome diversity, reduce inflammation, and support healthy digestion.
- Prebiotic Fiber: Foods like artichokes, garlic, and onions help feed beneficial gut bacteria, promoting balance and improved digestion.
Lifestyle Considerations
Lifestyle changes, such as stress management and regular physical activity, are essential for managing PCOS naturally:
- Exercise: Moderate exercise, including yoga, walking, or swimming, can help manage weight, balance blood sugar, and reduce stress.
- Mindfulness and Stress Reduction: Techniques like meditation, deep breathing exercises, or acupuncture can help manage stress, which in turn supports hormonal balance and overall well-being.
Fertility and PCOS
While PCOS is a common cause of infertility, natural approaches can improve fertility in many individuals. By addressing underlying issues such as insulin resistance, hormonal imbalances, and inflammation, many individuals with PCOS can restore regular ovulation and conceive naturally. PCOS is one of the most reversible causes of infertility. Women with PCOS tend to be more fertile as they age because the natural decline in androgens. Naturopathic treatment often combines diet, supplements, and lifestyle changes to optimize fertility.
Conclusion
PCOS is a complex condition, but it is entirely manageable with a comprehensive approach. As a naturopathic doctor, I believe that treating PCOS requires a combination of targeted interventions, personalized lifestyle changes, and natural therapies that support the body’s innate ability to heal. By addressing the root causes of PCOS rather than just masking symptoms, we can help restore hormonal balance, improve quality of life, and enhance fertility.
If you suspect you have PCOS or are currently struggling with its symptoms, working with a naturopathic doctor who can offer personalized care, and guidance may be the key to your healing journey.
Are you struggling with the symptoms associated with PCOS? Irregular cycles, mood swings, hair growth, acne, insomnia, fatigue, weight gain?? Would you like to discuss specific natural treatments for PCOS or have questions about your own health? I’d be happy to help you navigate this journey with care and support. Click here to complete the Healthy Hormone Program Application to get started.
About Dr. Whelan
Dr Whelan, a licensed naturopathic doctor in Vermont since 2019, is also an affiliated Medical Consultant with the FertilityCare Systems of America. She specializes in women’s hormonal health, helping her clients achieve optimal fertility, better moods, greater energy, deeper sleep, and easier, predictable, painfree periods. Dr Whelan treats teens and women of reproductive age throughout perimenopause and early post-menopause.
Dr. Whelan integrates centuries-old wisdom that regards nature as the most effective healer with contemporary health research. Her approach is rooted in enhancing the body’s innate (and extraordinary) healing capacities. She utilizes treatment modalities that include nutrition, lifestyle medicine, botanical medicines, and cooperative hormone replacement therapies.
Selecting Dr. Whelan as your women’s health expert ensures you receive a doctor who listens to your concerns, identifies the root causes of your health issues, and supports you with preventive care to help you achieve your best possible life.