Polycystic Ovarian Syndrome is a common cause of hormone irregularity in women. The most common signs of PCOS are hirsutism (think hair growth on women’s chins), irregular cycles and polycystic ovaries on ultrasound. It effects 5-10% of women. The health issues of PCOS run much deeper than acne and extra hair growth. Women with PCOS are at an increased risk for glucose intolerance, cholesterol problems, fatty liver, sleep apnea, mood disorders and obesity.
PCOS can fortunately be diagnosed rather easily, though it can take many women years to pin down a proper diagnosis. History or irregular periods (usually less then 9 per year), hirsutism (thick pigmented body hair in a male distribution, and acne can be enough to diagnose. Labwork can certainly support the diagnosis as well specifically serum total testosterone is typically elevated. Labwork to rule out other possible endocrine diseases may be needed as well. Since metabolic health can be severely compromised in PCOS, checking lipids, apo A/B, Ha1c and liver numbers is beneficial.
Spironolactone is a mild diuretic that has activity against androgens helps balance the hyperandrogenic signs of PCOS and thus improve acne and extra hair growth. For regulating cycles, a progestin IUD can be beneficial. Progesterone cyclical can be beneficial- taken every 1-2 months for 10-14 days. Shepherd’s Purse extract used every 4 hours as needed for heavy bleeding days is a nice, natural way to decrease bleeding. Metformin is commonly used to decrease the liver from making glucose and therefore decreasing insulin release from the pancreas. If on metformin, its advised to take a B12 supplement as metformin tends to block absorption of B12. Other recommendations for PCOS management are DIM 300-600 mg, Chaste Tree Berry , inositol, NAC and a daily Vitamin D. Supplements like Berberine can also be beneficial for PCOS women as it may help steady blood sugars and prevent insulin resistance.
PCOS takes a toll on the body. To combat this physiologic stress, following a low inflammatory lifestyle can be helpful. Omega 3, chia seeds and Curcumin are known inflammation reducers. Eating a low inflammatory diet can be very beneficial too- lots of salmon, fresh leafy greens, nuts, beans, 35 grams of fiber. Avoiding inflammation is key too! Cut out processed food, artificial sweeteners, alcohol, dairy, highly processed meats (lunch meat, sausage), any smoking or vaping.