Polycystic ovarian syndrome or PCOS for short is a disorder that affects up to 20% of women of reproductive age. PCOS is a syndrome, which suggests there are a number of symptoms that are linked to this disorder and if you present with a handful of the symptoms, then you may have PCOS.

How do you know if you have PCOS?

Are you experiencing a number of these symptoms that may be linked to PCOS…

• Menstrual length abnormalities.
• Annovulation (no period).
• Hyperandrogenaemia: too many androgens e.g. testosterone – see below.
• Insulin resistance (see further information below).
• Infertility.
• Weight gain.
• Excess facial, arm, leg and nipple hair (Hirsutism).
• Male pattern hair loss.
• Acne or oily skin.
• Type 2 diabetes.
• High cholesterol.
• Anxiety and/or depression.

What causes PCOS?

Whilst the name ‘polycystic’ suggests that this syndrome is all about cysts on the ovaries, it is a little misleading. PCOS is often associated with metabolic and hormonal issues. Below are the main causes of polycystic ovarian syndrome.

1. 1. Insulin resistance. Insulin resistance is a metabolic issue that occurs when the body no longer reacts to the signal from insulin. Insulin normally helps transport glucose from the blood into all of your cells. Insulin resistance results in excessive production of androgens (sex hormones) in the ovaries and can result in infertility, acne, hair growth and irregular cycles.
   2. Androgen dominance. This can be an issue caused by insulin resistance. A large increase in androgen production in the ovaries can results in high testosterone levels – leading to acne, excess hair growth, male pattern hair loss and irregular cycles.
   3. Inflammation. High androgen levels can also create inflammation which in turn increases insulin resistance. So you can see how each symptom can feed into each other. Treating inflammation is a must in all cases of PCOS. If untreated, inflammation can lead to oxidative stress, which in the long term, can lead to heart disease, high blood pressure and diabetes.
   4. Detoxification: Increased androgen levels place a burden on detoxification pathways. You can read more about detoxification pathways in my blog “What is Causing your Acne?” If PCOS treatment dose not address the liver, the results can be ovarian dysfunction and further metabolic dysfunction.
   5. Diet: Your diet plays a big factor in PCOS and making changes to your diet can have a dramatic effect on decreasing symptoms. Increasing omega 3 fatty acids, such as ground flaxseed, chia seeds (soaked) and algal oil, will also help to reduce inflammation.
   6. Lifestyle: Exercise plays a big role in PCOS as a decrease in weight by as little as 5% can restore normal ovulation and fertility. Lifestyle factors can also affect inflammation and detoxification pathways, both through physical and mental behaviours.

 What you can do to treat PCOS?

1. Decrease your weight. Whilst this is not always so simply, decreasing your weight (if you are over a healthy level) can have huge benefits in treating PCOS. Weight loss improves androgen levels, insulin resistance and menstrual regularity.
2. Decrease saturated and trans fats in your diet. These fats increase insulin resistance and inflammation and can also lead to high cholesterol levels.
3. Decrease processed and refined carbohydrates in your diet. These foods tend to contain large amounts of sugars, fats and salt, which will exacerbate insulin resistance, inflammation and weight gain.
4. Increase the amount of fibre you are consuming. Fibre helps to decrease androgens and support healthy glucose metabolism
5. Reduce inflammation in your body. The simplest way to start doing this is to stop heating the following oils when cooking: safflower, corn, sunflower, canola, grapeseed, soybean and margarine. Heating these oils will increase oxidative stress and inflammation. Increasing omega 3 fatty acids will also help to reduce inflammation.
6. Increase exercise and movement. Exercise will help to reduce insulin resistance and reduce body weight – which we saw from point #1 can have huge benefits in treating PCOS.

As a Naturopath, what areas of natural medicine would I recommend when treating a client with PCOS?

Nutrients

• Chromium. This helps to regulate blood sugar levels, by increasing glucose uptake into your cells.
• Inositol. This is involved in the transduction signal of insulin. If your levels are low, there is a lack of response to insulin which results in insulin resistance.
• Magnesium. Magnesium assists with insulin resistance by increasing glucose uptake by the cells. Magnesium levels are often depleted by the oral female contraception pill, which is unfortunately a common medical treatment for PCOS.
• Zinc. Deficiencies of this essential nutrient are often associated with impaired hormone secretion. Zinc has androgen blocking effects and promotes ovulation. It also can be depleted by the use of oral contraceptive pill when treating PCOS.

Herbs

Two common herbs that are used effectively in the treatment of PCOS are Peony and Licorice.

• Peony. The natural medicine name for this is Paeonia lactiflora – but yes, this is a variety of the beautiful pink blossoming flowers! Peony is often used in the treatment of PCOS as it is a hormone modulator, helping to reduce androgens and balance oestrogen (estrogen). Because of this, it reduces excess hair growth, reduces male pattern hair loss, decreases acne, supports healthy hormone levels and can help reverse infertility.
• Licorice. Combined with other herbs such as Peony, licorice helps to reduce testosterone and improve ovulation. It has a synergistic affect that will naturally decrease PCOS symptoms.

Another herb that can be used in the treatment of PCOS is:

• Cinnamon – Cinnamomum Verum. This can also be called True Cinnamon or Ceylon Cinnamon and possesses higher health properties than Cassia Cinnamon (which is more common and mass produced). Cinnamon helps support glucose metabolism and activate insulin receptors, thus decreasing insulin resistance.