Polycystic ovarian syndrome (PCOS) is the most common hormonal disorder in females of reproductive age. This prevalent syndrome is in fact a diverse disorder with different underlying biological mechanisms and is characterised by androgen excess and anovulatory or irregular menstrual cycles. In simple terms, PCOS is an umbrella term which includes the most clinically recognised symptoms of irregular periods, acne, facial hair growth (hirsutism), insulin resistance and weight gain. Unfortunately, women with PCOS have an increased risk of developing conditions such as diabetes, heart disease and infertility, due to the lack of attention to the above underlying biological mechanisms. In fact, more than half of women with PCOS develop type II diabetes by the time they’re 40! It’s no wonder that the condition is associated with drastically reduced quality of life and patients are searching for relief.
Conventional treatment commonly involves prescription of the oral contraceptive pill or the biguanide metformin to treat insulin resistance. However, these medications unfortunately carry unwanted side effects. Fortunately, there are several natural treatments available, which can help to manage the symptoms of PCOS and improve overall health and wellness.
Lifestyle modification for PCOS
Lifestyle is a great place to start with patients and making certain lifestyle changes has been shown to effectively improve PCOS symptoms. This includes adopting a healthy diet, regular movement and stress management. A diet that is low in carbohydrates and high in protein and fibre can work to regulate blood sugar levels, which is important for women with PCOS. Exercise has also been shown to moderate insulin levels and is essential for managing PCOS symptoms. Additionally, mind-body techniques such as yoga, meditation or mindfulness reduce stress levels and enhance overall wellbeing.
Savvy supplements to reduce PCOS symptoms
Inositol has a huge amount of research behind it for the treatment of PCOS. Inositol occurs naturally in the body, and can be found in many foods, particularly grains, nuts and fruit. A 2018 review of research found that ovulation rates and menstrual cycles improved with inositol in women with PCOS. Inositol has additionally been clinically trialled for weight loss, anxiety, insomnia and premenstrual mood symptoms. Clinical recommendations of two to four grams per day of inositol have been linked with symptom improvement. The absorption of inositol can be impaired by sweeteners such as sorbitol, therefore it is best taken with a wholefood diet.
Chromium has been shown to improve insulin activity in the body. To date there are still only a small number of clinical trials into the effects of chromium in those with PCOS. One small study of five women diagnosed with PCOS found that two months of supplementing with chromium resulted in an enhanced glucose disposal rate, highlighting an improvement in insulin resistance.
The traditional Chinese medicine combination of liquorice and peony is often prescribed by natural healthcare Practitioners for the management of symptoms associated with PCOS. It is reasoned that this herbal combination helps to convert testosterone (which is increased in PCOS) to oestrogen, working to support hormonal regulation, in addition to moderating inflammation and reducing elevated blood glucose, insulin and blood lipids.
Enhance health outcomes with a multimodality team
As a Practitioner it is essential to understand the needs of the patient and work at alleviating the underlying driver/s of symptoms. This may include the collaboration of a multimodality team incorporating nutrition, supplementation, manual therapies, stress reduction and exercise programs to provide best practice and support the patient in achieving their health goals. Even with diet, lifestyle, supplements and supportive care from a multimodality team (which may include acupuncture or chiropractic care), it is important to note that treatment for PCOS should be individualised and what works for one woman may not work for another.
In conclusion, PCOS is a common hormonal disorder, with various biological drivers. Supporting your PCOS patient through the development of a therapeutic relationship, which may include a combination of therapeutic practices that work together to identify and implement the right treatment plan for the individual can work to reduce symptoms, improve overall health, decrease the risk of related conditions such as diabetes, and ultimately augment your patient’s quality of life.