Polycystic Ovarian Syndrome PART II : Natural Treatments
If you haven't had an opportunity to read Part I of this series, click here for more info about signs and symptoms of PCOS.
How We treat Polycystic Ovarian Syndrome With Natural Therapies
As Naturopathic Doctors, we work with women to help regulate hormones to promote regular ovulatory cycles. We also help promote egg quality and minimize the formation of new cysts in the ovaries. Herbal medicine, dietary counselling and clinical nutritional supplementation can have a profound effect on hormonal regulation.
If you experience any signs of hormonal imbalance such as menstrual irregularity, painful menstrual cycles, weight gain or inability to lose weight, fatigue and mood dysregulation we encourage you to book a consultation with one of our naturopathic doctors. Early diagnosis and treatment of PCOS (all hormone conditions) can help preserve fertility and prevent metabolic conditions (obesity and diabetes).
In women with PCOS, they have an excess of male reproductive sex hormones, referred to as androgens. They often have decreased estrogen, low progesterone and imbalances of FSH and LH, important signalling hormones for follicle development and ovulation. The aforementioned hormonal irregularities lead to dysfunction in the follicular development of eggs, subsequent release of follicle at ovulation and formation of the endometrial lining. All of which will impact fertility. The lack of ovulation and proper formation of the follicle leads to the development of cysts in the ovary. This increases the risk for a rupture of cysts, an extremely painful event. One or several ruptured cysts can increase the risk of permanent ovarian damage.
First Line Treatment:
Diet and Exercise
Diet and exercise goals vary with the patient, as the presence of metabolic disturbance may not be evident in all patients. However due to the risk of insulin resistance and high cholesterol developing, low sugar and whole foods diets are often recommended. Increasing consumption of healthy fats and vegetables is foundational. In terms of exercise, 120 minutes weekly is the minimum recommendation. We encourage patients to explore different types of physical activity that are enjoyable and sustainable.
A variety of herbs known as hormone modulators can help to regain balance of estrogen and progesterone and decrease testosterone. All of which can help to reduce symptoms such as hirsutism (hormone related hair growth), acne and trouble losing weight. The use of herbs can help to regulate and induce ovulation. Commonly used herbs would be Licorice Root, Peony, Chaste Tree and Black Cohosh. Herbal medicine allows for individualized selection of herbs most relevant to a patient’s symptom picture. They are nourishing and balancing and a great conjunctive treatment for resolution of hormonal imbalance. Herbal medicine can have a profound impact and although they are generally quite safe, they should not be taken without the guidance of a health care practitioner.
Myo-Inositol. This is one of our “go to” first line therapies for PCOS. This B-vitamin derivative is safe and effective. It has been shown to regulate ovulatory function and improve egg quality. It also plays an important role in decreasing insulin resistance. High insulin levels in the blood have been shown to contribute to miscarriage and poor egg quality.
*Myo inositol may exacerbate symptoms of schizophrenia and mania, and therefore should not be supplemented in those with a medical history or vulnerability to either. Consult your trusted health care practitioner before beginning to supplement.
Omega 3 Fatty Acid. This supplement is a staple for improving overall health. Omega 3 fatty acids are essential for the integrity of our cell walls. They have been shown to help regulate the metabolic dysfunction in those with PCOS. They help to reduce insulin resistance, regulate blood cholesterol levels and decrease hirsutism (hair growth) associated with hormone imbalance. Lastly, it has been shown to help improve weight loss outcomes and BMI, likely due to its effect on metabolic parameters.
Melatonin (specifically indicated for improving egg quality). Melatonin has been shown to help improve ovulatory function and regularity in women with PCOS. Research has also shown melatonin to help improve egg quality and minimize inflammation in the ovaries. Morning grogginess is a very common symptom associated with melatonin use. It often means the dose is too high. Many melatonin supplements are dosed at 5mg or 3mg, when 1.5 mg is generally sufficient for improving sleep. However, the dosage used in the studies was 3mg and therefore chatting with your health care provider is encouraged to see how to make it manageable for you.
Naturopathic medicine takes an individualized approach to care. Although the aforementioned treatments have been proven effective, we will often select a few of the above to customize a treatment approach. We generally like to do more specific testing to ensure we are treating the hormonal imbalance properly and effectively. We encourage you to speak to a health care practitioner before beginning supplementation.
EASTND Naturopathic Team
The American Association of Clinical Endocrinology, Disease State Clinical Review: http://journals.aace.com/doi/pdf/10.4158/EP15748.DSC?code=aace-site
Kelekci KH, et al. (2010). Ovarian morphology and prevalence of polycystic ovary syndrome in reproductive aged women with or without mild acne.
Poly Cystic Ovarian Syndrome and Metabolic Syndrome: https://www.ncbi.nlm.nih.gov/pubmed/26265416