Bloated stomach, periods all over the place, weight gain and acne, these are all symptoms of the little known Polycystic Ovarian Syndrome. PCOS is increasing in prevalence, but there are evidence based natural products that can help support the journey.

Polycystic ovarian syndrome was a condition that was hardly heard of until recently. According to the Journal of Human Reproductive Sciences, the prevalence of this chronic condition is increasing. This articles examines what PCOS is, and what natural treatments exist to help manage this chronic condition.

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What is Polycystic Ovarian Syndrome (PCOS)?

PCOS is a female hormonal condition affecting women through their reproductive age. It can start soon after a young woman starts to menstruate and last the entirety of her reproductive years. PCOS presents as a sex hormone imbalance typically where a woman has increased male hormones known as androgens. This imbalance effects the ability of a woman to ovulate, leading to irregular periods (generally long bleeds and further apart). For some women, symptoms move beyond periods including acne, male pattern hair loss and growth in areas typically found in men, and difficulties conceiving. Additionally, PCOS can affect blood sugars & insulin, leading to weight gain and other metabolic syndrome issues. Many women also experience digestive complaints with PCOS, and studies show that there is a less diverse microbiome in women with this condition. There also tends to be low grade inflammation across the body. Some women will also experience anxiety and depression, which may in fact be hormone driven.

The World Health Organisation reports that PCOS prevalence is between 8-13% of the population. The Healthline website (USA) reports the prevalence at up to 26% of women.

Because the hormones acting on the ovaries are disordered in PCOS, eggs which would normally be released during ovulation do not fully mature, and therefore are not expelled. This leads to fluid filled cysts developing where the egg should have matured inside the ovaries, hence the name poly meaning ‘many’ cysts. It is also important to be aware that progesterone, the female hormone that helps with sleep, fluid balance & mood is produced in the corpus luteum, which is fundamentally akin to the eggshell. No or limited ovulation, means the corpus luteum isn’t fully developed, therefore women with PCOS are often low in this key hormone, which can affect other areas like mood and sleep.

Dietary support

Polycystic ovarian syndrome is a chronic condition. This means it cannot be cured, but rather needs to be managed. Up to 90% of women with PCOS have Insulin Resistance, the inability to produce and process effective insulin leading to lowered energy production and burning of glucose, consequently accumulating body fat. Insulin resistance can be assisted with diet. Overall the dietary goal is reduced blood sugar dysregulation, weight loss, minimization of digestive issues such as bloating or constipation & loose stools, and to reduce inflammation in the body. This is definitely not a one-size-fits-all approach but there are a few general things that can be helpful.

Assuming the body can tolerate it, a Mediterranean diet is generally a good place to start. This diet is high in anti-inflammatory foods such as fish with its omega 3’s, phyto nutrient rich vegetables, unprocessed grains & legumes providing fibre plus plenty of good fats. Some PCOS people won’t tolerate all of these foods and should this be the case its worth checking out a low FODMAP strategy. FODMAPs information is beyond this article but feel free to contact us. Adding in anti-inflammatory herbs such as turmeric and rosemary on a daily basis can be helpful. Brassicas such as broccoli and cauliflower are particularly good for clearing hormones but some women will not tolerate these as they can lead to bloating & digestive discomfort. Legumes such as chickpeas and lentils can be very helpful, but again, some will have difficulties with these. Eliminating processed foods is really important as is the reduction and preferably elimination of alcohol. In general, processed carbohydrate foods cause glucose spikes when consumed and add to the insulin resistance issue. Meals that contain good fat and moderate protein tend to balance blood sugars and also the continual insulin and blood sugar spikes.

In general, lower carbohydrate, higher good fat, and medium amounts of protein tend to be best to manage blood sugars and weight gain. Fasting programs can also be helpful for some people. Seek advice from a health practitioner before making significant dietary changes to ensure you fully understand the details.

Acupuncture

There is some evidence that acupuncture can help with the management of PCOS. Please contact us if you would like a local referral.

Supplements

Inositol

Inositol falls into the family of B vitamins. There have been numerous studies which show Inositol may be useful in PCOS. It may assist in the reduction of androgens (testosterone) and help to manage blood sugars, therefore contributing to reduction of symptoms such as weight gain and acne. It also assists to regulate ovulation, which in turn helps for a more ‘normal’ period, and can also assist mood and sleep. Inositol comes in two forms, and both of these have evidence for supporting PCOS, tipping slightly towards Myo-inositol. Generally studies show that 1000mg daily is required . For Inositol supplements, click here

Berberine

Berberine comes from a number of herbs. It has anti-microbial action thereby may assist with gut symptoms that often accompany PCOS. Berberine has been shown to be effective in supporting healthy blood sugar regulation, and has been shown in at least one clinical trial to be as effective as Metformin, which is a significant medication for type 2 diabetes management in New Zealand. Berberine works by supporting metabolism via an enzyme system called AMPK, which works to reset the master switch, and thereby can support a better cholesterol profile, and blood sugar balance. A number of people lose considerable weight on berberine. If you would like more information on berberine supplements, click here.

Turmeric

Turmeric supports the reduction of inflammation. PCOS is often associated with low grade systemic inflammation. Turmeric also supports the liver and therefore can assist with hormone clearance and the distribution of fats around the body, both of which are very important in this context. For Turmeric supplement information, click here.

Probiotics

Many women with PCOS also have digestive issues. Probiotics can help with overall health, including digestive symptoms such as bloating. Spore based probiotics survive the stomach acid via the protection of their shell like spore, and therefore are preferred option. Some spore based probiotics also encourage the body to produce digestive enzymes, which again contributes to less bloating and better digestion of nutrients. Probiotics have also been shown to assist in weight loss. For spore based probiotics, click here.

References

A New Approach to Polycystic Ovary Syndrome: The Gut Microbiota, Gamze Yurtdaş ¹, Yasemin Akdevelioğlu ¹

World Health Organisation, viewed at

https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome#:~:text=Polycystic%20ovary%20syndrome%20(PCOS)%20affects,a%20leading%20cause%20of%20infertility.

Underlying mechanisms of acupuncture therapy on polycystic ovary syndrome: Evidences from animal and clinical studies, Yang Ye, ^{1 , †} Cong-Cong Zhou, ^{2 , †} Hang-Qi Hu, ¹ Ii Fukuzawa, ¹ and Hao-Lin Zhang ^{1 ,} https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9637827/

Study on the Effect of Berberine, Myoinositol, and Metformin in Women with Polycystic Ovary Syndrome: A Prospective Randomised Study, Monitoring Editor: Alexander Muacevic and John R Adler

Neha Mishra,¹ Ruchi Verma,¹ and Payal Jadaun²