What is PCOS?
Finding an effective treatment for Polycycstic ovarian syndrome (PCOS) is important to me for two distinct reasons. 5-10% of woman are impacted by PCOS in their lifetime making PCOS a common and treatable condition in my Naturopathic practice. The second reason is that it is a condition that my wife has struggled with for many years therefore making it a syndrome that hits close to home.
PCOS is a bit of a misnomer as it is a continuum of symptoms and doesn’t necessarily have to include ovarian cysts. It is however characterized by several common objective findings including irregular periods, infertility, shifts in hormone balance (DHEA, Testosterone, LH, FSH), hirsutism (hair growth on the lip, chin and abdomen), Hair loss (Male pattern head hair loss), acne (typically on the lower jaw), high levels of insulin due to insulin resistance, and unexplained weight gain (especially around the abdomen).
Although we still do not know all the mechanisms involved as to why some women develop PCOS, there does seem to be a genetic component. Environmental toxins such as BPA seem to play a role, and gastrointestinal dysbiosis (unfriendly bacteria in the gut) plays a role as well.
Conventional Treatment for PCOS
Some of the more common conventional treatments of PCOS include birth control pill (to regulate irregular periods and hormone levels), metformin (a insulin sensitizing drug that helps to control blood sugar levels commonly used in diabetes), and spironolactone (a diuretic that also has the ability to block a type of testosterone formation called DHT). While these treatments can be helpful in the short-term they do not always address the root cause of PCOS and therefore ultimately fail in the long term. Some of these causes include hormone disrupters in the environment and diet, and gastrointestinal dysbiosis (leading to the production of inflammatory compounds that compromise insulin function).
Holistic Treatment for PCOS
Luckily there are relatively easy and low cost solutions to many of the fundamental causes of PCOS. As a Naturopathic Doctor I have the privilege and ability to take a detailed medical history. Doing so can point me in the direction(s) as to where these foundational imbalances are occurring. For instance if the patient has a history of gastrointestinal concerns, (constipation, diarrhea, gastritis, colitis) that informs me to focus investigation on the gastrointestinal tract. If a patients main concern is infertility and irregular periods I will shift focus into hormone balance. It may also be the case that a patient has several concern at the same time, which is not uncommon in PCOS. Once I know where to focus we can run specialized tests such as comprehensive stool analysis, female hormone panels, nutrient level panels, food sensitivity testing and environmental toxins. This aids in narrowing down where to implement the bulk of the treatment protocol. There are some general recommendations that are sure to aid all women with PCOS such as exercise, reduced carbohydrate diets and lowering exposure to petrochemicals. However, the medical history and specialized testing can be a guide for more specific recommendations.
Functional Testing for PCOS
A nutrients panel test can help determine if there are specific nutritional deficiencies such as low levels of vitamin D, vitamin A and omega-3 fatty acids, which tend to be common in PCOS. A female hormone panel can determine if there are specific imbalances with sex hormones. These imbalances can potentially be corrected with dietary recommendations, bio-identical hormone replacement, and nutraceutical supplements. Evidence of dysbiosis in gut from a stool analysis can be reversed with dietary recommendations that promote colonization of helpful butyrate producing bacteria. Nutraceuticals containing antibiotic herbs can preferentially kill harmful bacteria while protecting good bacteria. Probiotic supplements containing specific strains of bacteria and prebiotic fibre can be very effective. Food sensitivity testing can help confirm if there are specific foods in the diet that are activating an immune response, causing further inflammation in the gut. Environmental toxin analysis would shed light on high levels of exposure to particular toxins, most of which are known hormone disruptors. Even the simple testing of insulin levels and blood sugar can lead to recommendations for easily accessible compounds like inositol, L-carnitine and chromium which can effectively increase insulin sensitivity.
The take home message is that PCOS is an extremely common and often disruptive condition for a significant amount of women worldwide. The conventional treatment of PCOS often does not provide long term solutions and can have significant side effects. Simple and inexpensive solutions through dietary, supplement and lifestyle recommendations can address the root causes of PCOS and bring about significant symptom relief with long-term sustainability. I therefore encourage anyone suffering from PCOS who hasn’t found an effective solution to contact a local Naturopathic Doctor or Functional Medicine Doctor for an assessment. If you would like to contact me, you can do so through the appointment page by clicking the link in the menu bar. The sooner you start to address the root causes the easier and quicker long lasting symptom relief can be achieved. That being said, implementation of a functional medicine approach to PCOS will undoubtably be helpful at any stage and at any age.