Are you a woman that has irregular heavy bleeding or even absent periods? One common cause of absent menstruation (amenorrhea) is polycystic ovarian syndrome (PCOS). PCOS impairs ovulation and causes infertility amongst a slew of other physical symptoms, which can affect how a woman looks and feels about herself. While there is no cure, the good news is that the symptoms are often treatable through lifestyle changes alone. Through a proper diet, regular moderate exercise, and the assistance of a few natural health products, many prescription medications (e.g., hormonal birth control, metformin, spironolactone, clomid, etc.) can be avoided.

Signs & Symptoms of PCOS
Abnormalities in the metabolism of sex hormones (androgens and estrogen) lead to menstrual irregularities (commonly anovulation and missed periods) and excess production of testosterone (hyperandrogenism), which can result in infertility, the development of cysts (small fluid-filled sacs), and abnormal growth of hair on a woman’s face and body (hirsuitism). Further, abnormalities in blood sugar regulation (insulin resistance) can cause weight gain or difficulty losing weight, diabetes, and even skin tags and darkening of skin around body folds: neck, groin, underneath the breasts, etc. Excess testosterone not only interferes with ovulation and causes unwanted hair growth but can also promote hair thinning and male-pattern hair loss in some, as well as oily skin and stubborn hormonal acne on the face, chest, and back.

Not all women with PCOS are overweight; up to 40% have a normal or low body mass index (BMI). What’s more, certain women will get their periods more frequently (polymenorrhea is when menstruation occurs every 21 days or less). The criteria for a diagnosis of PCOS only requires two of the aforementioned symptoms (in bold); cysts on one or both ovaries is not essential.

Complications of PCOS
Overtime, PCOS can result in another syndrome. Metabolic syndrome is a cluster of high blood pressure (hypertension), high blood sugar, high cholesterol / triglycerides, and excess body fat around your waist, which all increase the risk of cardiometabolic disease (heart disease, stroke, diabetes). Abdominal obesity and insulin resistance (what causes diabetes overtime) are also associated with non-alcoholic fatty liver disease (NAFLD)–as is excess androgens–along with sleep apnea. Depression rates are higher in those with PCOS. Further both metabolic syndrome and an irregular menses can cause more rapid growth and reproduction of cells in the uterine lining (hyperplasia); this process is involved in the development of uterine cancer. PCOS is also possibly linked to an increased risk of breast cancer.

Therefore, periodic monitoring of these parameters by a healthcare professional is strongly advised, irrespective of whether other symptoms are bothersome. Now that you know what’s at stake, I want to empower you with tips on how to address the several contributing factors and optimize the pathways to health when faced with PCOS.

Improving Ovulation
When ovulation does not occur, there is insufficient progesterone to maintain the lining of the uterus (endometrium). It sheds and heavy bleeding occurs, similarly to a real period. Nonetheless, it is a non-cyclical and abnormal form of uterine bleeding. An absence of ovulation makes conception impossible. Even a 5-10% weight loss can lead to more regular ovulation (and increase the chances of a healthy pregnancy) as well as decrease the prominence of insulin resistance, cholesterol, and hyperandrogenism. Expert recommendations range from 2.5 – 9 hours, 5 hours is a good compromise. Ovulation test strips are a simple way to assess the true nature of your menses at home. Women with PCOS who have some sort of natural cycle, whether long or short in length, have reduced rates of insulin resistance and metabolic complications.

Improving Insulin Sensitivity
Instead of metformin (a common drug used to manage blood sugar), try “Mel-fen-ium”: bitter melon (Momordica charantia), fenugreek seeds (Trigonella foenum-graecum), and chromium to maintain normal insulin levels. In my opinion, bitter melon is about the most bitter thing you can eat that’s not toxic! Thankfully, you can also take it in pill or tincture form to get its anti-diabetic and hypoglycemic effects. Chromium is an essential trace mineral that gets synthesized into glucose tolerance factor (GTF), which amplifies insulin’s activity three-fold. Kapow! Watch the video below to learn more about how you can incorporate more of these medicinal foods into your daily routine.

Regardless of weight, commitment to a diet that is lower in refined and starchy carbohydrates and higher in lean, healthy proteins is beneficial to anyone with PCOS. Whole unprocessed foods aid the body’s natural detoxification process. If you’re looking for more guidance on metabolic detoxification, consider joining us for our next 10-day Brio Virtual Group Detox. You can register here for the fast-approaching online info session.

Reducing Androgens (“male hormones”)
Insulin resistance reduces levels of sex hormone binding globulin (SHBG). As its name suggests, SHBG binds to testosterone and estrogen making them less active. Drinking green tea is a win-win because it elevates SHBG while reducing estrogen levels. Saw palmetto (Serenoa repens) stops the conversion of testosterone to a stronger form, dihydrotestosterone (DHT), while licorice (Glycyrrhiza glabra) is anti-inflammatory and acts as a great detoxifier and hormone balancer. Spearmint (Mentha spicata) tea is another great option for PCOS due to its significant anti-androgenic effects.

Takeaway Message
Natural treatment for current symptoms and active prevention of diseases associated with PCOS (hypertension, diabetes, fatty liver, heart disease, endometrial / breast cancer, etc.) is within reach. There is no “magic bullet” cure for this condition (pharmaceutical or nutraceutical), but tackling the main underlying factors can go a long way in reducing symptom severity and providing relief. Incorporating some of the aforementioned herbs can be as easy as “one, two, tea” for those who prefer not to take supplements but not all useful compounds are water-soluble. Speak to your naturopathic doctor about elevating your PCOS treatment plan with the most beneficial forms of vitamins, minerals, herbs, and other health products to maximize your efforts with diet and exercise and manage the bigger picture.

In health,
Dr. Vanessa