What is PCOS or Polycystic Ovary Syndrome?
PCOS is also known as “Stein-Leventhal Syndrome”. It is an endocrine disorder characterized by increased androgens, ovulatory dysfunction and polycystic ovaries. In patients with PCOS there is an increased risk of insulin resistance, diabetes, lipid abnormalities, obstructive sleep apnea, cardiovascular disease and endometrial carcinoma1.
Who gets it?
PCOS is the most common endocrine abnormality in this population, producing symptoms in 5%- 10% of women of reproductive age and 3. Symptoms can consist of menstrual irregularities, excess body hair on chin, upper lip, nipples and lower abdomen, acne, weight gain and sleep apnea4. In most cases, patients have no symptoms, however PCOS is the most common cause of decreased fertility2.
What happens if I have it?
While the course is typically benign, getting pregnant may be problematic (usually fertility must be drug induced). Miscarriage rates are higher among women with PCOS. Pregnant women with PCOS experience a higher incidence of perinatal morbidity from gestational diabetes, pregnancy induced hypertension and preeclampsia. Babies of women with PCOS are at an increased risk of neonatal complications like preterm birth and admission to intensive care unit 2.
How do we diagnose it?
1. The Rotterdam criteria – presence of 2 of the following: androgen excess, ovulatory dysfunction and polycystic ovaries. In adolescents with PCOS androgen excess is central to the presentation while postmenopausal women do not have the consistent PCOS presentation 4. 2. Pelvic ultrasound can confirm the presence of cystic ovaries
Will I need to be tested?
To make sure we know if you have PCOS or not, we will run some lab tests. The tests that are ordered depend on each person’s individual case. Here is a complete of what could be ordered: 1. Hormone panel- FSH, LH, total testosterone, DHEA + cortisol 2. Thyroid panel- r/o thyroid disorder 3. Serum prolactin- r/o hyperprolactinemia 4. Pregnancy test- r/o pregnancy in women with oligo or amenorrhea 5. Fasting insulin and glucose, HgA1c
How is PCOS conventionally treated?
First line treatment includes weight loss, increased exercise and diet change to reduce the risk of diabetes. It has been shown to work better than treatment with pharmaceuticals. Drug treatment consists of inducing regular menses by lowering androgens and increasing sex-hormone binding globulin using low-dose estrogen birth control pills and Metformin to improve insulin sensitivity. Low dose prednisone or dexamethasone is used in patients with concomitant adrenal hyperandrogenism4.
At Hawaii Naturopathic we look to diet as the foundation for good health. For PCOS we focus on…
1) Raw food vegan diet- delicious meals prepared by raw food chefs in our certified kitchen.
2) Portfolio diet – increasing the intake of fiber, plant-sterols and nuts, to lower cholesterol and bind excess hormones for excretion5.
3) Focusing on liver cleansing foods: beets, artichokes, parsnips, dandelion greens, watercress, burdock root tea and cruciferous vegetables
4) Foods high in omega 3 and 6 fatty acids: vegetable, nut and seed oils
5) Drink lemon juice in water first thing in the morning- to promote good gall bladder and liver function necessary to remove excess hormones
6) Avoid estrogenic foods: animal products, apples, cherries, clover, olives, plums, yam, nightshade family, peanuts, soy products, rice, barley, oats, and wheat. For a full list visit the University of Minnesota’s website: http://enhs.umn.edu/current/5200/estrogen/estrofood.html
Supplements we recommend are…
1) Vitamin A
2) Vitamin C
3) Vitamin D plays a role in normal blood sugar metabolism. Additionally a study in 2006 concluded some women with PCOS had a low vitamin D levels
4) Vitamin E
5) Zinc 30 mg everyday- play a role in appetite control and involved in all aspects of insulin metabolism
6) Multivitamin-Women with PCOS may have deficiencies in many minerals and vitamins
8) Milk thistle – for additional liver support
9) Omega 3 fatty acids 2 grams daily, EFAs are important components of the cell membranes around every cell in the body. They are a major component of hormone and help control inflammation in the body
10) Adrenal support -Ashwaganda is also an adaptogen and works similar to schizandra but also supports thyroid function
11) Gymmena-helps control insulin levels
12) Nymphea odorata- decreases ovarian cyst buildup
13) DIM -hormonal balancer
14) Vitex-hormonal balancer
15) Saw Palmetto- for androgen excess
16) Schizandra-improves the HPA axis as well as well as liver and respiratory function
17) Chromium-helps to maintain normal blood sugar and insulin
17) B vitamins are necessary and play an important role in energy production, fat burning and hormone balancing. They also help the liver to process and excrete excess hormones from the body
If you think that you might fit the PCOS picture or if you would like a consult on this, or any other hormone conditions, come see us at Hawaii Naturopathic Retreat Center. Our Naturopathic Doctors would be happy to talk to you!
Hawaii Naturopathic Retreat Center
239 Haili St.
1. University of Chicago Medicine http://www.uchospitals.edu/specialties/pcos/pcos.html
2. Boomsma CM, Fauser BC, Macklon NS (2008). “Pregnancy complications in women with polycystic ovary syndrome”. Semin. Reprod. Med. 26 (1): 72–84
3. Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO (June 2004). “The Prevalence and Features of the Polycystic Ovary Syndrome in an Unselected Population”. Journal of Clinical Endocrinology & Metabolism 89 (6): 2745–9. doi:10.1210/jc.2003-032046. PMID 15181052
4. Emedicine: PCOS http://emedicine.medscape.com/article/256806-overview#a0101
5. Portfolio diet- http://www.health.harvard.edu/blog/portfolio-beats-low-fat-diet-for-lowering-cholesterol-201108263248