A primer in natural medicine
Heidi Fritz, MA, ND
Many women experience problems with their periods. But for up to 10 percent of women, the problems can be caused by an increasingly common condition called polycystic ovary syndrome (PCOS). Some of the characteristics of PCOS include elevated levels of testosterone and/or related hormones called androgens (hyperandrogenism), infrequent or prolonged menstrual periods (anovulation), and/or the presence of multiple ovarian cysts that may be seen on ultrasound.
PCOS is problematic from several perspectives. It may be associated with acne; hair growth in hormone sensitive areas such as the lip, chin, and abdomen (hirsutism); or thinning hair. These cosmetic features give rise to significant anxiety for many women.
Secondly, PCOS may result in subfertility, due to poor or irregular ovulation.
Finally, PCOS is associated with increased risk of several chronic diseases in the long term, including diabetes, heart disease, and endometrial cancer.
PCOS is characterized by poor insulin function, with elevated insulin secretion reinforcing the cycle of hormone imbalance and anovulation. Women who are overweight or obese are at increased risk of insulin resistance and prediabetes, but even thin women with PCOS have been shown to suffer from reactive hypoglycemia, where initial insulin oversecretion leads to rebound low blood sugar levels.
Dietary strategies that reduce insulin secretion, such as a high-protein, low-glycemic diet, have been shown to improve insulin sensitivity, promote weight loss, and reduce testosterone levels in women with PCOS. A low-glycemic diet limits intake of foods that break down into sugars quickly, such as bread, white rice, potatoes, and other starchy foods, as well as foods high in refined sugar.
A number of natural health products have demonstrated benefit in PCOS. Inositol has been the subject of more than 20 clinical trials in PCOS and has been shown to improve insulin function, improve ovulation, reduce testosterone, and reduce predictors of heart disease such as cholesterol and blood pressure.
NAC is a precursor for glutathione, which may be important for breaking down excess hormones in the body. A new meta-analysis shows that NAC improves ovulation and pregnancy rates in PCOS.
New research also shows that supplementation with chromium picolinate improves weight loss and insulin function, and regularizes ovulation.
Finally, evidence suggests that herbs such as black cohosh, chaste tree berry, and licorice may have a role in the treatment of PCOS.
Always consult a licensed naturopathic doctor to determine the most appropriate treatment for you.