So, life is funny, isn't it?
Some years ago when I was in the therapeutic nutrition portion of school, we had to frequently choose topics to make extensive reports on, depending on what we were learning at the time. During a specific period, I chose PCOS, polycystic ovarian syndrome. Matters of women seem to touch me more than others, so I figured this was a good one to dive into. Of all of my reports and research I did on various topics, this one always stuck out to me for some reason.
Now, let’s fast forward to two years later; to just a little over two months ago. After crying in my doctors office, I almost walked out laughing after being diagnosed with PCOS myself. I could hear a little voice say “stop crying, go look at the report and get to freaking work.” I argued back and told the voice to just give me one day. Just one day to grieve a little. Be dramatic. Allow me to call my sisters, my boyfriend; go to the worst possible scenario that PCOS can bring, and then be talked off the ledge. Just one day. So that’s what I tried to do but I grabbed that report anyway, and got to studying my own work. To my pleasant surprise, it was good! I’ve been following my own advice and truly feeling relief with natural additions I had almost forgotten about. I’ve also been sharing tidbits on Insta and even though I already knew this disorder was very common (up to 20% of women at reproductive age), the amount of women I’ve been hearing from who have also been diagnosed with PCOS is startling. AND, the amount of women I’ve been hearing from who also don’t have any clue what to do, or where to start is exactly what has inspired me to write this.
Before I go into guiding y'all on ways to heal, and get some relief from this naturally, it’s important to go over a little of how you may have gotten here, as well as what it means to have PCOS, because I realize this is also not as talked about in a conventional doctor’s office.
While some cases may have been brought on by genetic factors, and the absolute answer as to why so many women have PCOS is not completely understood, we do know that PCOS is heavily rooted in blood sugar imbalance (specifically insulin resistance-which you will see mentioned A LOT in this post). Also, inflammation, obesity, lack of exercise, constant exposure to pollutants, and on-going high stress environments. More recent studies are seeing a high prevalence of PCOS in those with auto-immune diseases, like Hashimoto’s disease, autoimmunity of the thyroid. And go figure, I too have Hashimoto’s.
With PCOS, ovulation happens infrequently, or there is no ovulation happening at all, accompanied by certain markers on blood and saliva tests, which show hormonal abnormalities such as excessive amounts of androgens (male hormones, like testosterone), along with other markers like decreased progesterone. Ultrasounds can also show cysts on the ovaries. BUT, here’s some Willy Wonka naming of a disorder for you: one can still have PCOS without these cysts, and one can also have ovarian cysts without having PCOS. (Where is my confused emoji girl with her hands up, now?!).
And with these triggers and markers, any of the following symptoms can be present:
- irregular menstrual cycles
- excessive or heavy bleeding
- hirsutism (excessive facial/body hair, similar to that of a male)
- male pattern baldness on head
- Acanthosis Nigricans (darkening and discoloration of skin around neck, groin, underarms and skin tags)
- weight gain, especially around bottom
- inability to lose weight
- anxiety, depression, irritability
- low libido
- increased stress
- the possibility of infertility and/or miscarriage
No fun at all.
Typically, conventional health care will give you a few options like birth control pills to lower the elevated testosterone, treat acne, lack of ovulation, and regulate heavy and/or irregular periods. Some circles of thought consider this dangerous, and I agree. This post describes why in an easy-to-understand way. Or, doctors will prescribe anti-androgens, or something like Metformin, the diabetic medication that treats, *not cures*, elevated blood sugar (again, one of the strongest known roots in PCOS and cause of so many side effects). These may give you some relief to go on, and pretend like PCOS ain’t even there. Oh, but it is. And why keep PCOS in slumber, or masked, when we have so many natural tools at our fingertips (nutrition and lifestyle changes being the best ones) to not only free ourselves from annoying symptoms, but even possibly reverse this syndrome? It is possible, and why not try while getting stronger in the process? I believe that getting to the root cause of any disease instead of treating every little symptom with a pill, is always the best route.
Okay, so, before we really go any further, you must know this: since insulin resistance is such a big deal with PCOS, I can’t continue without noting that a lot of what you will see below will be about become insulin sensitive. So, let’s get clear on what this is. Insulin is the hormone that gets glucose, or energy from your food, into your cells. When you are insulin resistant, the glucose/sugar floats around in the blood, unused, causing damage to tissues, which also leads to weight gain and the release of that excess testosterone, and the decrease of of SHBG, the hormone that removes potentially harmful excess hormones, capiche? Understanding the "why" behind so many natural healing methods of PCOS, also takes understanding a bit about blood sugar regulation and insulin sensitivity.
Now we can really get started and on our way to healing. Your ultimate PCOS guide is here.
1)Diet. The first and easiest thing to know is that processed food. must. go. Like, yesterday. This is true for all of life but in healing from PCOS, it’s time to remove damaged, inflammation-inducing fats and oils (vegetable, corn, canola, soy, safflower, grapeseed… yes, even Earth Balance), refined carbohydrates (crackers, pasta, breads), and refined sugar, stat. Also:
- Focus on a whole food, real food diet. Read and get to know the ingredients when something is bought in a package. This is more important than reading the nutrition facts listed above the ingredients, in my opinion. Sure, something could have little sugar, or carbohydrates, but look at everything else there. Is it filled with chemicals you’ve never heard of, oils that are adding to your inflammation load, or fillers that are ruining your gut health?
- Reduce all sugars, even those found in natural sources like higher glycemic fruits. Yes, even excess fruit can add to blood sugar imbalance, like insulin resistance. This doesn't mean removing all fruits for good or never eating a banana, but it’s really important to stick with fruits that are lower in sugar, such as berries, and citrus, and up your intake of veggies instead. And now that you know this, you can bet that excess intake of even the “better” unrefined sugars like coconut sugar, maple syrup, and especially agave (which is basically just sugar…sorry, people). Once in a while is always doable, but use caution. However, if dessert is what you absolutely need, fruit is a great choice, instead of processed sugars.
- Reducing or removing grains is also a good idea to control blood sugar and improve gut function-which in turn, improves excess inflammation. If you still need grains, choose organic sprouted options, such as sprouted quinoa.
- Make sure you are getting enough high quality protein that is organic, grass fed, and/or pasture raised, and free of hormones. Upping your intake of high quality protein stabilizes blood sugar levels.
- Fuel your body with healthy fats such as avocados, avocado oil, soaked/sprouted nuts, olives & olive oil, coconut, coconut oil, grass fed butter and ghee. Seeds such as chia and flax are also beneficial and provide antioxidants that fight inflammation. Fats keep us fuller longer, and are another strong stabilizer for the blood sugar imbalance that is usually present in PCOS.
- Watch your starch intake. Even though I still recommend starchy carbs in vegetable form (potato, sweet potato, all squash, root veggies), be your own food detective after you eat them. Did you get sleepy, irritable, or crave sugar afterward? Chances are that may have been too much for your body to handle and process fast enough. Remember: insulin resistance, the hormone that helps get energy from your food to your cells, may be impaired.
- Switch out those 2-3 cups of coffee. Out in the inter-web, you’ll find a lot of word that coffee is good for PCOS, but take into consideration that coffee increases cortisol and adrenal production, which over time, can interfere with your ability to handle stress; something women with PCOS may already be struggling with. And, for women with cysts, coffee can increase those. Choosing green tea over coffee can not only help fight inflammation, but is great at increasing SHBG (sex hormone binding globulin) which is marked low with PCOS, and in turn, lowers elevated free testosterone in the blood. I love coffee, but my switch to matcha is just as enjoyable. Plus, matcha can also be done bulletproof style :)
- Limit Alcohol. Moderate, as opposed to excessive, alcohol intake can help improve insulin sensitivity, and lower inflammation. This is also key in optimizing liver function, whose job is to detoxify nearly everything in the body, including hormones.
2) Supplement. After you have adopted a real, whole food diet that is replenishing your body with the nutrients it so deserves and needs, it may be time to start implementing some other nutrients not as easily found in your diet that target specific causes and symptoms of PCOS. After (written above) is stressed in italics here because supplements cannot replace an unhealthy diet, and will only be working against a strong tide of a diet that is harming your body.
- Chromium: can help one to become more insulin sensitive, while a deficiency can lead to insulin resistance. Chromium is helpful for weight management, reducing cravings and hunger, and controlling fat and cholesterol in the blood. Recommended dose: 200-1000 mg./day
- Berberine: powerful in helping blood sugar dysregulation. Has proven to work better than the usually prescribed Metformin, by increasing SHBG (removes free testosterone), and decreasing harmful cholesterol and triglycerides. Recommended dose: 500-1000 mg./day
- B vitamins: a complex B vitamin can help convert fat and sugar to energy, helps control fat metabolism, keeping weight off.
- Zinc: can help control appetite, and regulate blood sugar, cure PCOS-associated acne, and reverse hirsutism. Recommended dose: 30-50 mg./day
- Magnesium: deficiency in this mineral is linked to insulin resistance and helps reduce mental and physical stress. Recommended dose: 500-1000 mg./day either spread out, or taken at night.
- Co-enzyme Q-10: produced in nearly every cell. Important in breaking down carbs; makes energy instead of storing as fat. Recommended:200 mg/day
- Vitamin D: extremely important for immunity and, research has proven, can normalize menstruation and fertility. Recommended dose: 2000-5000 IU/day, depending on tested blood levels.
- Herbs/Roots: I truly believe herbs/roots are some of the most powerful plants we can use for PCOS. Especially the following:
- Saw Palmetto: works as an anti-androgen, helpful with the side effects due to excess testosterone.
- Vitex (Chaste Tree): one of the most important herbs for PCOS, stimulates and normalizes the function of the pituitary gland ;helps control release of luteinizing hormone, which is often elevated in PCOS.
- Nettle root/leaf: increases sex hormone binding globulin (SHBG), removes free testosterone, reducing circulating levels in the blood.
- Red Raspberry leaf: strengthens and tones the uterus, promoting a healthy reproductive system.
- Red Clover: treats acne associated with PCOS, improves liver function and boosts fertility.
- Dandelion root/leaf: supports the liver in removing excess hormones, increases fertility
- White Peony: has been shown to positively influence low progesterone, reduce elevated androgens (male hormones), and acts to modulate estrogen and prolactin.
- Black Cohosh: helps lower elevated luteinizing hormone. Reduces anxiety and tension associated with PCOS.
- Licorice root: reduces testosterone synthesis, decreases serum testosterone concentrations, and helps modulate a stress response.
- Maca root: adaptogenic herb that helps support adrenals.
- Turmeric root: powerful anti-inflammatory.
- Cinnamon: brings blood sugar in balance.
- Holy Basil (tulsi): excellent stress reliever, anti-androgen properties, fights inflammation and can regulate blood sugar.
I personally like to make tea blends with many of the above-mentioned, so that I can get multiple helpful herbs in one cup. I also highly recommend tincture blends with any of the herbs mentioned above, like this one, and from this company.
3) Exercise. Yoga, pilates, walking, some strength training and even some HIIT can all be great for PCOS. It’s important to remember that workouts that put extra stress on the body or cause you to be lethargic afterward, may be putting you even deeper in the PCOS hole. The purpose of exercise is not just weight loss (although weight loss is helpful and important for those with PCOS, and following the guidelines in the food section above can help), but for increasing insulin sensitivity and glucose metabolism. If exercise is not something you’ve been up to as of recent, that’s okay. You can start slow and take daily long walks that will get you into the groove until you can build up your work-out tolerance. Just start!
4) Sleep. Sleep depravation creates the perfect storm to magnify the symptoms and challenges in PCOS, or any condition. Know that the more we put off sleep, the higher the chances are that we are creating even more insulin resistance. This happens because a lack of sleep causes us to crave more sugar, raise cortisol (a stress hormone) levels, and increase inflammation; all factors that cause insulin resistance. How much sleep each person needs is highly individual, but aiming for anywhere between 6-9 hours of sleep per night is a great goal to have. Plan accordingly. Set that “bedtime” alarm (I know there is one on the iPhone!) if you must. If it means going to bed by 8:30 to get that many hours of sleep per night, and wake up on time for work, do your best to dedicate that street-lights-just-came-on bedtime; your body and hormones will thank you for it. I like Valerian root, or Passionflower tincture or tea to get me in sleepy-mode.
5) Reduce toxin load. This means beauty and household cleaning products. The skin is an excellent way for toxins to enter our system and wreak havoc on our reproductive system. After all, the skin is our largest organ. Cleaning up what we use on the daily will ease up the toxic load you are exposed to. For me, this meant switching from my beloved gels, to nail polish that is free of the most toxic reproductive harm, chemicals often referred to as the “big 5” and even “the big ten,” like these brands. You can switch to safer skin care like Beautycounter, and even refer to EWG.ORG to check their Skin Deep cosmetic database to see how what you are currently using rates on the toxicity scale. They even have a database for your household cleaners, as well as recommendations for what you can use instead.
6) Reduce your use of plastic. This could easily go in the paragraph above but needs its own number-it’s that important. Remember above when I mentioned that a cause of PCOS may be “constant exposure to pollutants?” Well, look no further than the plastic water bottle you’re using every day. Especially plastic that is not BPA free. Women with PCOS have been shown to have more BPA in their blood (up to 30% more) than women without, and by a lot. Not only that, but BPA from plastic increases androgens (male hormones), and mimics the way free testosterone binds to SHBG, the very substance that is trying to get excess hormones out of the body, and that in itself is dangerous. Start carrying your own stainless steel or glass water bottle to avoid cheap plastic bottles that have been heating up in a truck while transported to you. Same goes for food storage. Part of being an adult means better tupperware, amiright?! Switch out those plastic containers and opt for stainless steel or glassware instead.
7) Reduce your stress. Elevated stress of all kinds (emotional and physical) raise cortisol levels, which are typically already elevated in women with PCOS. Cortisol, a stress hormone we absolutely need, can turn into a bad thing really fast when elevated, as it stops other necessary hormones for functioning properly. Elevated cortisol also makes one more insulin resistant (there it is again) and makes any pre-existing depression or anxiety worse. So, you can see how reducing stress is not just important in terms of uncomfortable negative feelings and thoughts, but also for your physical condition and hormonal status. I highly recommend picking up meditation, a restorative/gentle yoga practice, spending time in nature, getting a massage, practicing an instrument, and talking with people you feel safe with and trust. These are all great ways to reduce your stress.
8) Cultivate more joy. I know you're probably thinking: easier said than done. But this can be as simple as writing a long list of all the things you love to do(which I highly, highly suggest), and make it a point to do one of those things every single day. I am not going to guarantee a cure with this recommendation, and may be lacking scientific evidence here, but I do know for a fact that more joy in your life will change your relationship to this syndrome in the healthiest way-which is everything. It is often our relationship to disease that is hurting us more than the actual disease itself. While we may not always see the markers on tests improving quickly, we still have the ability to feel good, and maybe even happy in the process, and this makes all the difference in how much PCOS can negatively impact your life or not. Cultivating more joy and reducing your stress (to jump back to #7 for a sec) might just mean removing the obligations that no longer serve you, saying no to that party you don't really want to go to but are being guilted into, or maybe even ending a relationship in which your teaching there has been learned. I firmly believe that more joy is a key in healing, not some frivolous act you don’t deserve.
9) Find a practitioner who's values are in line with yours. This is so important. If the way you would like to go about treating your challenges is not being heard or respected, or is constantly being met with a "well, you could try X pill," and that is no longer sitting well with you, it may be time to seek out a new one. A functional medicine practitioner will be more likely to look at all of you, as a whole human (what a concept, huh?), and will be able to spend more time to listen to what you need, as well as be open to other healing modalities that may not be "conventional." In most cases, this will sometimes cost a bit more but this is true investment in YOU. Looking for one can be tricky but there are directories made by leading functional medicine practitioners, such as this one, that can point you in the right direction.
So, there it is. As you can tell, PCOS relief and reversal is largely based on nutrition and lifestyle improvements, as well as natural remedies that are no big secret. They're not unattainable; behind a hidden door only doctors have access to. You CAN heal. In the meantime, be gentle with yourself, but diligent, and know that all things worth having take time. You got this.