What is PCOS and how can a Naturopath help ?
We should start by distinguishing the difference between the terms “polycystic ovary” and “polycystic ovarian syndrome (PCOS).”
A polycystic ovary contains a number of small cysts within the ovary. These cysts are actually follicles that have failed to develop and release an egg. They can be common in approximately 20 percent of women, many of whom will have normal hormone profiles and a regular cycle.
Polycystic ovarian syndrome ( PCOS ) is a much more complex endocrine disorder involving hormonal imbalances and is often characterised by anovulation (cessation of periods), menstrual irregularity and impaired glucose regulation.
Typical symptoms of PCOS are –
– Infrequent, absent or irregular periods due to hormone imbalances (eg elevated LH : FSH ratio, elevated free androgen index ( FAI), low progesterone and high Free testosterone , low SHBG, elevated prolactin and reversal of E1:E2 ratio). Note – not all patients will exhibit imbalances in all of these hormones.
– Difficulty conceiving and infertility
– Increased body hair that can be on the face, upper lip, neck, chin and abdomen
– Abdominal obesity or weight gain
– Poor sugar metabolism with elevated insulin levels
– Fatigue
– Hunger
– Acne or oily skin especially on the face, neck back and shoulders.
– Elevated cholesterol and triglycerides
– Hypertension (high blood pressure)
– Sleep problems
– Mood changes
Some women experience a number of these symptoms and others just a few.
Implications for general health
There is evidence to suggest that the thyroid and reproductive systems are intrinsically linked. So for women with PCOS who are also suffering fatigue, infertility and irregular menstruation, further investigation of thyroid function may be also indicated as hypothyroidism can also be present in many PCOS cases.
In PCOS cases where there has been a reversal in E1: E2 ratio (these are types of oestrogens) and there is a family history of oestrogen dominant disorders such as endometriosis, it is appropriate to consider ways of reducing exposure to xenooestrogens and supporting the natural clearance of oestrogen from the body.
There is a theory that elevated insulin can increase the adrenal glands production of adrenal androgens. There is also theory that high cortisol levels may contribute to insulin resistance. So supporting the adrenal gland in PCOS is especially important during times of chronic stress.
A common symptom of PCOS is abdominal weight gain. There can be several mechanisms at play here for an individual, however the underlying issue is usually insulin resistance. In a nut shell insulin resistance (which is a pre diabetic state) is where insulin becomes less effective in transporting adequate levels of glucose ( ie energy) from the blood into the cell. What this means is that people with insulin resistance often consume more kilojoules because they are not receiving adequate energy within the cell where it is needed. When there is insulin resistance ( ie poorly working insulin), insulin levels will rise increasing fat storage which can often see a rise in triglycerides which is then a concern in the longer term for the cardiovascular system. Increased insulin also increases ovarian androgen production. So it’s a vicious cycle.
So what can be done to help –
From a Naturopathic point of view, there are many ways a naturopath can support a patient with PCOS. The important thing to remember is that PCOS is a complex condition involving mutiple systems and as such usually requires a comprehensive treatment plan.
Dietary support – A naturopath will help you plan a low GI, high fibre diet that is right for the individual to support healthy glucose metabolism and weight management. It is also vital to ensure the diet is low in bad fats (trans and saturated fats) and high in beneficial polyunsaturated fats. A Naturopath will also advise ways to reduce exposure to synthetic compounds that interact with oestrogen receptors and have been linked to oestrogen dominant disorders. A Naturopath will also help you identify foods that are pro inflammatory so they can be reduced.
Herbal Medicine – There are a multitude of herbal medicines available that have been shown to support healthy follicular development, reduce testosterone and LH and improve progesterone levels. Herbal medicine can also be useful in reducing blood glucose levels and supporting insulin function. It can also be effective in supporting adrenal function, lifting mood and promoting liver clearance. It is important you seek the advice of a well trained professional when using herbal medicine as they contain active chemical compounds that exert an action in the body. A Naturopath or Herbalist can prepare a specific herbal medicine that is best indicated for you.
Nutritional Medicine – There are various nutrients such as chromium, lipoic acid, omega 3 fatty acids, B vitamins, vitamin A and magnesium ( to name a few) that can assist in the management of insulin function, carbohydrate metabolism, liver detoxification, hormone balance and healthy lipid profile. Again it is important you seek professional advice to ensure the most appropriate and most bio available nutritional supplementation regime.
Exercise is one of the most important things you can do to support yourself when you have been diagnosed with PCOS. Exercise will not only promote weight loss, it may also assist in improving your hormone levels by elevating lowered SHBG, reducing the release of oestrogen from adipocytes ( fat cells), improving insulin function, reducing blood lipids, lifting mood and supporting sub optimal thyroid function.
Stress management – In addition to supporting the adrenal gland and nervous system function via herbal and nutritional medicine a Naturopath will also talk to you about various relaxation techniques and stress management tools. A Naturopath should have a referral list of recommended professionals in your local area who can help such as counsellors, personal trainers, hypnotherapists, massage therapists and integrative medicine GPs.
It is also important to note that no two patients are ever the same and many natural medicines are contra indicated in certain cases and can interfere with the action pharmaceutical drugs. So, it is always recommended patients seek professional advice from a qualified Naturopath or Nutritionist when considering natural medicines.
If you would like to know more please contact Sydney Naturopath Kathleen McFarlane 9331 5500.
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