Polycystic Ovarian Syndrome (PCOS) is a condition in females that affects reproductive hormones and compromises ovarian function. Women with PCOS usually experience increased levels of male hormones (androgens), and low levels of progesterone. It’s common to experience acne, and excess facial & body hair, and can lead to long-term insulin resistance, miscarriage, and even infertility in women.
PCOS is a relatively common condition affecting females. According to the National Institutes of Health (NIH), PCOS affects one in every 15 women worldwide. According to the World Health Organization (WHO), PCOS is one of the most common causes of female infertility. It affects 6% to 12% (as many as 5 million) of US women of reproductive age. Up to 70% of affected women remain undiagnosed worldwide.
Scientists think obesity, the types of food people eat, and other lifestyle factors, like lack of exercise, are contributing to the incidence of PCOS. A combination of lifestyle changes and natural remedies, like herbal therapies and dietary supplementation have been shown to improve the causes of PCOS in women.
The most common symptom experienced by women with Polycystic Ovarian Syndrome is a lack of regular ovulation, causing irregular periods (short or long cycles) or none at all (amenorrhea). Other symptoms include:
Not all of these symptoms are present in every woman with PCOS. The CDC states that untreated PCOS can cause serious health problems. Women who are overweight or obese are especially vulnerable to the following health risks:
Studies show that women with PCOS are not able to metabolize certain amino acids. Markers for these could be used to show a woman’s risk for PCOS and undergo treatment sooner in order to prevent it.
Naturopathic medicine addresses the underlying cause of disease. Since many women cannot tolerate the side effects of the conventional treatment for Polycystic Ovarian Syndrome, a more holistic approach offers a much more viable solution.
A naturopathic approach to treating PCOS aims to:
These may include:
Dietary changes are an effective intervention for improving ovarian health, fertility, and metabolism. Therefore, nutrition should be part of first-line treatment for all women with Polycystic Ovarian Syndrome.
One study done by NIH showed that a diet low in sugary and starchy carbohydrates was the most effective at regulating hormone function for PCOS patients, including an increase in pregnancy rates, ovulation, and menstruation, reduced miscarriage, and improved symptoms associated with excess male hormones. The longer a person was on a low-carb diet, the greater improvement there was in patients’ health.
Another study showed that intermittent fasting (a cycle of meal patterning) significantly improved PCOS patient outcomes. A larger breakfast and a smaller dinner, compared to skipping or eating a low-calorie breakfast and a high-calorie dinner, helps in lowering insulin and improves insulin sensitivity and ovulation rates.
Another powerful tool for managing PCOS is seed cycling. Seed cycling is when you consume organic seeds with certain phases of your menstrual cycle to support hormone levels. Research shows seed cycling improves irregular hormone levels in women and promotes a healthy life.
Replacing processed foods for unprocessed, anti-inflammatory whole food options can set the stage for better long-term health for patients with Polycystic Ovarian Syndrome. A well-balanced, nutrient-dense diet is the best way to manage symptoms associated with PCOS. While there is no one-size-fits-all approach, the following dietary guidelines may help individuals with PCOS:
Recent research has shown a link between poor gut health and PCOS. In light of this news, supplementing with probiotics has emerged as a potential intervention for managing PCOS. Studies have confirmed that probiotic supplementation had a potentially beneficial effect on some PCOS-related parameters, like body mass index (BMI), blood sugar levels, and blood lipid profiles.
Probiotics are friendly bacteria that help reestablish the balance and composition of the healthy bacteria (gut flora) in your gut. When gut flora is depleted, it’s a good idea to restore balance by adding good bacteria into your microbiome (gut system). You can restore gut health with the use of probiotics. Fermented foods like sauerkraut, kimchi, or kombucha are naturally high in probiotics.
You can also buy probiotic supplements in capsule or liquid form. Taking care to learn about how each supplement is prepared, the strains present, and even how they are stored is important when choosing a probiotic.
Weight management in PCOS is well documented. Research suggests that weight loss improves metabolic and reproductive outcomes in PCOS. When it comes to Polycystic Ovarian Syndrome, the best way to manage excess body weight includes:
Women find their insulin levels begin to drop by implementing the above strategies. As a result, they are able to reduce stubborn body fat and lose weight. When a woman with PCOS is at a healthy weight, her ovaries will function better, which results in regular ovulation and menstrual cycles.
A literature review shows that sleep disorders are very common in patients with PCOS and have negative effects on quality of life. Hormonal balance depends on good, recuperative sleep. During sleep, our bodies repair, restore, and regulate the healthy bodily function, including hormone production. Hormones in someone with Polycystic Ovarian Syndrome are already out of balance. Adding poor sleep to the mix will only make things worse for them.
A treatment plan for women with PCOS should include a focus on sleep hygiene. Research suggests making changes to lifestyle factors, such as nutrition and exercise as a first-line therapy for addressing sleep disorders in PCOS patients.
To promote recuperative sleep and make the most of sleep hygiene to optimize hormonal balance, women with PCOS can make the following changes to their sleep habits:
Creating a bedtime routine may take time. Find a routine that you like. Make small changes each day to create your routine. The body will respond to consistency and will eventually adapt to the new routine. After a while, you should see an improvement in PCOS symptoms.
Exercise is an important component of managing symptoms of Polycystic Ovarian Syndrome. Exercise will help to regulate hormones and lower testosterone levels, which will ease PCOS symptoms such as excess hair growth and acne. In general, any type of movement can help. A systematic review shows that women with PCOS tend to have better results with some combination of low-impact exercises, like steady-state cardio, strength training, and mobility.
Low-impact exercises can be particularly beneficial for individuals with PCOS because it’s less stressful on the central nervous system and will help promote hormone balance, including reduced stress hormones and enhanced insulin sensitivity. Exercise improves psychological well-being in all humans. It’s a first-line therapy for women with PCOS and will help ease the chances of depression and anxiety.
The benefits of exercise for PCOS sufferers include:
NIH Guidelines suggest at least 150 min of physical activity per week – that’s about 20 minutes a day.
The research shows that the vast majority of women with Polycystic Ovarian Syndrome consume an improperly balanced diet and have nutritional deficiencies. Diet and lifestyle changes are a first-line therapy for treating the root cause of PCOS. However, the same research shows that natural remedies and targeted supplementation are supportive, and can help restore balance in women with PCOS.
The PCOS supplements that have been shown to be the most beneficial include:
It is very common for women with PCOS to also be low in Vitamin D. Insulin resistance and vitamin D deficiency are highly correlated. Although the cause of PCOS and vitamin D deficiency remains unknown, research suggests a link between vitamin D deficiency and PCOS.
Omega-3 fatty acids have been shown to relieve symptoms common with polycystic ovarian syndrome (PCOS). Fish oil is rich in Omega-3 fatty acids and is an optimal choice. Studies show that fish oil supplements can help ease PMS symptoms like period pain.
Chromium supplementation is essential to glucose and insulin balance. A systematic review and meta-analysis show that supplementing with chromium has beneficial effects on decreasing body mass index (BMI), fasting insulin, and free testosterone in PCOS patients.
The causes for PCOS can be varied based on the type of hormonal imbalance any one patient is experiencing. Different dietary supplements will address different hormonal imbalances. Talk with your naturopath or primary care provider before starting any supplementation for PCOS.
While Metformin is a medication, not a supplement, it is often recommended for women with Polycystic Ovarian Syndrome because it reduces your blood sugar, which can therefore have a positive impact on insulin response. In a randomized controlled trial, metformin was shown to improve excess male sex hormones, and body composition, and reduce inflammatory markers in women with PCOS. However, Metformin is not a first-line treatment for naturopathic doctors, but it could be used. It is used more regularly by conventional doctors for treating PCOS and should not be combined with certain PCOS supplements
Studies show that Metformin can lead to a B12 deficiency. Women taking Metformin for PCOS should keep track of their B12 levels and supplement if necessary. In addition, Metformin has a well-established side effect profile that includes gastrointestinal complaints (nausea, diarrhea, abdominal pain), which may make it less tolerable for some patients.
While Metformin can be very effective, achieving stable blood sugar can be done naturally. A first-line therapy for PCOS includes eating a protein-forward diet with healthy fats and fiber, all of which help to stabilize your blood sugar. Nutritional and herbal supplementation can be just as effective for treating PCOS without some of the side effects.
Chasteberry, or Vitex is a large shrub or small tree that produces berries. These berries have been used for thousands of years as herbal supplements to relieve symptoms related to hormonal imbalances, particularly in menstrual cycle irregularities. Placebo-controlled trials show that Vitex has outperformed placebo in numerous trials, and is known as nature’s hormonal balancer. Vitex helps regulate ovulation, increase fertility, and improve progesterone in women with Polycystic Ovarian Syndrome.
Researchers found that Vitex increases progesterone production, which helps normalize the luteal phase of the menstrual cycle. It also can increase the chances of getting pregnant. Research indicates that Vitex supplementation helps increase fertility in women with PCOS.
Inositol is a type of sugar that our bodies naturally produce. It is a form of sugar that helps give structure to cells. It also occurs naturally in certain foods, such as meat, fruits, corn, beans, grains, and legumes. Sometimes Inositol is referred to as vitamin B8. In reality, it is not an actual vitamin because your body makes it on its own.
Research suggests that supplementing with inositol may have many health benefits for women with Polycystic Ovarian Syndrome because of its effect on insulin. When Inositol supplements are given to women with PCOS, many of the symptoms of PCOS improve, including blood sugar, and blood pressure. Inositol supplementation has also been shown to have a positive effect on ovulation, which has helped PCOS patients with getting pregnant.
According to research, inositol is as effective as metformin in improving metabolic factors causing PCOS in women.
Saw palmetto is an herbal supplement made from the fruit of the Serenoa repens tree. It has been used as an herbal treatment for various health issues, including enlarged prostate, chronic pelvic pain, migraine, hair loss, and other conditions. Studies show that when palmetto is combined with zinc there has been marked improvement in PCOS symptoms. It decreases the enzyme that makes Dihydrotestosterone (DHT), a male hormone that enhances the effects of testosterone and causes symptoms like unwanted facial hair, acne, and irregular menstrual cycles. PCOS symptoms associated with male sex hormones can be improved by decreasing the conversion of testosterone.
Saw palmetto is a powerful adaptogenic herb that has been shown to stabilize women’s testosterone levels, a major cause of Polycystic Ovarian Syndrome. It is a good alternative therapy with little side effects, Using saw palmetto can help put PCOS into remission more effectively than medication.
Evening primrose oil (EPO) has traditionally been used to treat bruises, hemorrhoids, and sore throats, but it has been shown to help with painful and irregular periods, amongst other reproductive and hormonal issues in women.
EPO also has been shown to improve cholesterol levels and oxidative stress, both of which are linked to Polycystic Ovarian Syndrome.
Correcting diet and other lifestyle factors can be enough to treat Polycystic Ovarian Syndrome. However, herbal therapies and nutritional prescriptions can significantly help to manage PCOS and its symptoms. A literature review showed that the use of natural remedies, like herbs improves fertility as well as PCOS symptoms. Clinical evidence shows several herbal treatments that are effective for helping PCOS symptoms, like irregular periods and excess male sex hormones.
Herbs that have shown promise include:
Cinnamon has been proven to have a positive effect on blood sugar balance, cholesterol, and triglycerides. Recent research from the NIH shows that when women with PCOS supplemented with cinnamon extract, there was marked improvement in the balancing of hormones, including insulin. The same research also shows that cinnamon may help to regulate menstrual periods.
Conventional medications have been shown to be very effective in the treatment of PCOS. However, these medications may not be right for long-term use because of the side effects that occur with them. More and more, PCOS patients are relying on herbal medicine as an alternative to conventional drugs to keep their PCOS under control and in remission. Since everyone is different, talk with your naturopath or primary care provider before starting any herbal treatments for PCOS.
Shatavari (Asparagus racemosus), is an herb that has been used to treat a long list of health issues, including reproductive health. It is commonly used in Ayurvedic medicine to support healthy hormone levels and ovarian function. Some people with Polycystic Ovarian Syndrome use Shatavari as a natural remedy to help manage symptoms caused by hormonal imbalances, which are disrupted in women with PCOS.
Studies show that Shatavarti can improve fertility in women with PCOS because it is calming, thereby helping manage the stress response. It has profound effects on the health of the ovaries, helping to restore ovarian health and fertility. Shavatari has been shown to:
Ashwagandha (Withania somnifera) is an adaptogenic herb that is gaining popularity but has been commonly used in traditional Ayurvedic medicine. Adaptogens are believed to help the body cope with stress and maintain balance. Ashwagandha is effective in PCOS treatment to:
Maca (Lepidium meyenii) is a root vegetable native to the Andes region of Peru. It is commonly used in Peruvian cooking, and used in natural medicine for its various reproductive health benefits. Maca root helps to regulate the menstrual cycle, improve fertility, and reduce symptoms such as acne and unwanted hair growth when used in PCOS treatment. It has also been studied as a remedy for metabolic syndrome. It has been shown to improve insulin response for women with Polycystic Ovarian Syndrome.
Research shows that Maca root helps balance reproductive hormones and lowers levels of cortisol, a stress hormone. Its adaptogenic properties help balance cortisol levels which can help reduce anxiety, stress, and depression, all of which can exacerbate symptoms of PCOS.
Licorice root (Glycyrrhiza glabra) is an herb that has a long history of use as an herbal remedy in natural medicine for various purposes. In women’s health licorice root is used to manage symptoms in menopause and PCOS because of its effects on balancing reproductive hormones. It is also known for its powerful effects on stabilizing adrenal health, its anti-inflammatory properties, and its effect on metabolizing sugar.
Licorice root contains compounds that are believed to help balance estrogen and testosterone in women. It has been shown that licorice could help ease unusual fluctuations in these hormones.
Studies show Licorice root helps level out cortisol, the stress hormone. When cortisol is chronically high, it can compromise your adrenal glands and cause “adrenal fatigue”. Your adrenals are responsible for certain hormone production. When they are not functioning properly, it can cause a cascade of hormonal imbalances and can cause you to feel tired and fatigued, achy, sleep disruptions, and digestive issues.
Licorice root has also been studied for its anti-inflammatory properties. Because Polycystic Ovarian Syndrome is associated with chronic inflammation, licorice root is an intervention that has potential benefits in reducing inflammation.
One caution with licorice root is that it can affect blood pressure. One compound found in licorice, called glycyrrhizin, can affect blood pressure by increasing sodium retention and decreasing potassium levels. Excessive consumption of licorice root may lead to elevated blood pressure. Women with PCOS often have other risk factors for cardiovascular issues, so it’s important to work with a healthcare provider to mitigate the potential impact it has on blood pressure.
Holy basil, also known as Tulsi, is an herb that is known for its adaptogenic and anti-inflammatory properties. Holy basil has been shown to regulate insulin levels, lower inflammation, lower cholesterol and assist with liver detoxification in those with metabolic disease. All of which are relevant to managing certain symptoms associated with PCOS.
Punarnava (Boerhavia diffusa) is an herb used in traditional Ayurvedic medicine. Traditionally it is used as a diuretic, but is also known for its anti-inflammatory properties, which are useful in managing PCOS symptoms. Punarnava has been used to support liver health, which may also benefit certain women with PCOS because of the strong link between PCOS and fatty liver.
Obesity, systemic inflammation, metabolic syndrome, and insulin resistance are common in people with Polycystic Ovarian Syndrome. All of these conditions raise the risk of diabetes, heart disease, and other illnesses. Eating unhealthy foods that exacerbate these conditions should be avoided in patients with PCOS. To improve PCOS symptoms and risk for disease, eliminate the following types of foods:
Polycystic Ovarian Syndrome is a complex condition that doesn’t have distinct “stages” in the way some medical conditions do. Instead, PCOS is generally diagnosed based on a combination of signs, symptoms, and laboratory tests. PCOS particularly affects women at the early to late reproductive age (15–35 years). The severity and specific manifestations of PCOS can vary widely. One common way to categorize PCOS is based on its phenotypes (observable traits), which take into account a combination of symptoms and lab findings. The phenotypes are often described as follows:
According to the National Institutes for Health (NIH), Classic PCOS (phenotype A) is at a higher risk of metabolic and cardiovascular outcomes as compared with the other phenotypes. Those with mild PCOS (phenotype D) are the least severe phenotype. Assigning phenotype to women with PCOS-related infertility can help predict future health outcomes and therefore determine the types of treatments for each patient.
Polycystic Ovarian Syndrome can lead to serious health problems, such as:
While PCOS can’t be cured, it can be treated. A combination of lifestyle changes and naturopathic PCOS treatments can manage symptoms and patients can be put into remission. According to NIH, many women undergo complete remission as long as weight is under control
The exact cause of Polycystic Ovarian Syndrome is still being investigated, but heredity and environment are contributing factors to PCOS. The research so far shows that PCOS may be caused in the following ways:
Polycystic Ovarian Syndrome can be associated with weight gain and high visceral fat (belly fat). This is commonly referred to as a “PCOS belly.” Getting rid of a PCOS belly has positive benefits for symptom relief and improving health problems associated with PCOS. Managing PCOS-related weight gain and abdominal fat involves a combination of lifestyle changes, dietary adjustments, and treatment interventions. Strategies that may help reduce PCOS belly include:
Managing a healthy weight when you have PCOS is difficult because of the dysregulated hormones. Controlling your food choices, getting regular exercise, and managing your response to stress will help keep your hormones in check, which will help control symptoms of PCOS, including PCOS belly. Studies by NIH show that there can be a complete remission from PCOS by losing weight.
PCOS is complicated and complex and everybody is different in what they need. A treatment approach that addresses your individual needs and root causes of symptoms is the best way to manage this condition and is key to long-term health.
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