September is PCOS Awareness Month and our Naturopath Evie is here to talk about all things PCOS. What is it? What happens to our body with PCOS and what can be done to help manage a PCOS diagnosis?
What is PCOS?
PCOS stands for Polycystic Ovarian Syndrome.
Polycystic ovaries are enlarged, with cysts on the outer edge. But, did you know that you can have polycystic ovaries and not have PCOS? It is actually quite common and normal for many women to have polycystic ovaries on ultrasound, especially young women.
So what makes PCOS different?
Two of the following three criteria are required for an official PCOS diagnosis:
- Loss of period/no ovulation/irregular periods
- High androgen levels (male hormones)
- Polycystic ovaries on ultrasound
So what if you have these three symptoms, does this mean you have PCOS? Not necessarily, there are actually many causes for these symptoms that first need to be ruled out.
Other causes for loss of period must be excluded, such as congenital adrenal hyperplasia, androgen secreting tumors, cushing syndrome, thyroid dysfunction and high prolactin levels.
Hypothalamic amenorrhea (when your hypothalamus causes your period to stop) can sometimes be misdiagnosed as PCOS and both are from very different causes and have different treatment protocols. Hypothalamic amenorrhea is commonly caused from malnutrition (eating disorder, plant-based diets, excessive exercise, underweight).
This is why it is so important to have clinical testing and receive a diagnosis from a medical professional.
Other Signs & Symptoms of PCOS
Other Signs & Symptoms of PCOS may include:
- Hair loss from the head
- Excessive body hair growth such as facial hair
- Subfertility/difficulty conceiving
- Mood symptoms – anxiety, depression, poor sleep
- Weight gain
- Insulin resistance – sugar cravings, fatigue, excessive thirst
- Acne – jawline and cheeks especially
- Irregular cycles or loss of period
Contributing Factors for PCOS
Stress disrupts our hypothalamic-pituitary-ovarian axis (HPO axis) which regulates our hormone production. It also increases androgen production (male hormone) which is commonly raised in people with PCOS.
2. Insulin resistance/blood sugar dysregulation
Stress and nutrient deficiencies can worsen our insulin regulation alongside a diet high that is high GI/high sugar. Insulin resistance increases androgen production in PCOS – it is thought almost 70% of PCOS has a component of insulin resistance.
3. Nutrient deficiencies
Nutrients such as magnesium, zinc, B vitamins, to name a few are crucial for our reproductive system function and regulation, maintaining low inflammation levels and having adequate nutrients such as magnesium are important for blood sugar regulation.
Inflammation can be caused by various factors such as gut microbiome imbalances, autoimmune diseases, infections, toxin exposure, endocrine (hormone) disrupting chemicals found in perfume etc. and mould exposure in the environment. Chronic inflammation can increase androgen production in PCOS. – yep them male hormones again.
5. OCP use
The oral contraceptive pill can increase androgen production and androgens can remain high after stopping the pill, so some women experience ‘post-pill PCOS’ after coming off the pill. This can cause a loss of period and acne, though this is usually temporary and after a few months’ things should regulate (but this isn’t always the case).
Treatment of PCOS
PCOS treatment will be different depending on the underlying contributing factors and causes. For some women, their PCOS is stress related, so managing and addressing their emotions and causes of stress may be their main treatment. Naturopathically treatment may involve referral to a supportive psychologist to unpack stressors at a deeper level, alongside providing herbal medicines and nutritional support to reduce stress levels and cortisol.
Insulin resistance and optimizing blood sugar regulation will be a common treatment for most women with PCOS. Naturopathically we would optimize insulin sensitivity through dietary and lifestyle changes/plans and through nutrients and herbs that help to regulate insulin and blood glucose levels.
If PCOS seems to be driven by inflammation, then treatment would involve investigating the underlying cause for inflammation in the body (perhaps doing further testing for other conditions) and then addressing the underlying cause of inflammation.
Addressing any nutrient deficiencies will be an important part of nourishing and regulating the reproductive system.
For post-pill PCOS, treatment will often involve a mixture of the above and using herbs and nutrients to regulate the menstrual cycle after OCP use. The pill can deplete the body’s stores of certain nutrients and also can directly impact the gut microbiome so sometimes these factors are addressed as well.
Getting a PCOS diagnosis can be disheartening to experience, but it is good to know that it doesn’t have to be a lifelong diagnosis, PCOS is a syndrome and can be reversed in some cases. There are many things that you can address in your diet and lifestyle as well as using nutritional and herbal medicine as supportive therapies.
Do You Have PCOS Symptoms?
If you think you may have PCOS or any of the mentioned conditions, or would like help managing your PCOS symptoms our Naturopath Evie is very passionate about women’s health and would love to help you manage your symptoms.
Contact us to schedule a Consultation, we also offer Telehealth appointments!