Polycystic Ovarian Syndrome (PCOS), Pt 3: Naturopathic Options
Polycystic ovarian syndrome (PCOS) occurs in 15-20% of females and is one of the common hormonal conditions that people see me in-office for naturopathic medical treatment. This is the final part of a 3-part series on PCOS, and in past posts in this series I spoke about:
Symptoms of PCOS (cystic acne, coarse body hair, hair loss, irregular cycles, & more)
Diagnostic criteria for PCOS & myths behind diagnosis of PCOS
Different subtypes of PCOS
Root causes of PCOS
Testing options for identifying the root causes of PCOS
In this third and final part, you will learn about some naturopathic options that address potential root causes of PCOS in addition to options that address co-morbidities of PCOS, such as high cholesterol, blood sugar issues, and more. Before we dive into naturopathic treatment options, it should be reiterated that PCOS is a life-long condition, and pharmaceutical/natural/integrative options have the potential to manage the symptoms of PCOS.
If you want to read Part 1 (symptoms, diagnosis, & subtypes), click here.
If you want to read Part 2 (root causes & testing options), click here.
Naturopathic treatment & philosophy
Licensed naturopathic doctors (NDs) are trained to provide integrative medical care that addresses root causes of disease in addition to supporting optimal cellular and organ function for the body to heal itself. Licensed NDs may use a combination of integrative therapies, ranging from natural to pharmaceutical, depending on their state of scope of practice. In most states where licensed NDs can practice, the following integrative treatment options (aka modalities) may be recommended:
Therapeutic diet
Lifestyle medicine & environmental medicine
Targeted vitamin, mineral, amino acid, & probiotic therapy
Herbal medicine
Intravenous and/or intramuscular micronutrient injections*
Pharmaceutical therapy*
& more
Since licensed NDs are trained in a variety treatment modalities, most patients seeing licensed NDs appreciate how treatment plans are personalized on their personal bio-individuality; their preferences between natural/conventional/integrative therapy; and their overall preference with how they want their treatment to look like.
To learn more about naturopathic education and state scope of practice, click here to visit the American Association of Naturopathic Physician’s (AANP) website.
*May be recommended depending on ND state scope of practice
Naturopathic options for PCOS
As stated before, naturopathic treatment addresses underlying root causes & supporting cellular and organ function to manage symptoms of PCOS. Although, it should be noted that licensed NDs may also recommend conventional therapies if patients do not response to a course of natural treatment that addresses root causes.
Conventional treatment for PCOS may involve metformin to address insulin resistance and pharmaceuticals to regulate hormone imbalances and symptoms of hormone imbalance. Conventional medications to address hormones can involve hormonal birth control to help regulate frequency of menstruation and spironolactone to help reduce symptoms of high androgens (cystic acne, coarse body hair, hair loss).
Read on below to learn about some natural options a licensed ND may recommend to address root causes of PCOS and more.
1) Addressing insulin resistance:
Addressing insulin resistance from a naturopathic standpoint means looking at diet, lifestyle, and supporting insulin sensitivity.
Diet & nutrition: Literature reveals that consumption of low-glycemic foods reduced symptoms of PCOS in comparison to those eating a “conventional healthy diet”. Additionally, literature reveals that the combined consumption of low-glycemic foods with protein led to lower insulin levels and lower levels of heart-specific inflammation in those with PCOS. Moreover, there is evidence that resistance starches can improve insulin response in females and has been shown to improve insulin resistance in those with type 2 diabetes, which is a co-morbidity of PCOS. Overall, There are a variety of low-glycemic foods, sources of high-quality protein, and sources of high-quality resistant starches that a licensed ND may recommend to support those who have insulin resistance
Lifestyle medicine: Science reveals that a combination of low-glycemic foods and exercise can increase insulin sensitivity.
Supporting insulin sensitivity with herbs, vitamins, and minerals: There is evidence that certain nutrients and herbs can promote healthy insulin sensitivity, such as:
Supporting insulin sensitivity with pharmaceutical therapy: The most commonly prescribed pharmaceutical for those with insulin resistance is metformin. This may be recommended by a licensed naturopathic doctor if labs indicate severe insulin resistance and/or the patient has not been responding to natural treatment
2) Addressing hypothalamic-pituitary-adrenal axis dysfunction:
HPA axis dysfunction occurs because of chronic states stress, and stress can be both emotional and physical. From a naturopathic standpoint, addressing HPA axis dysfunction entails identifying stressors and treating those stressors with holisitic options.
Diet & nutrition: Hypoglycemia is a common physical stressor that I see in-office. Some symptoms of hypoglycemia (aka low blood sugar) are shakiness, faintness, irritability, sweating, and more when one is hungry. To prevent hypoglycemia and achieve steady states of blood sugar, choosing low-glycemic carbohydrates, emphasizing optimal protein intake, having meals or snacks every 3-4 hours, and having healthy fats in each meal may help.
Lifestyle medicine: Extreme levels of exercise can also be a stressor to the body, and choosing more-gentle exercises, such as yoga and tai chi, may support optimal HPA axis function.
Nervine herbs: Nervine herbs are a class of herbs that soothe the nervous system, which can be over activated during states of stress and worry. Some nervine herbs are: chamomile, lavender, lemon balm, and passionflower.
Adaptogenic herbs: Adaptogenic herbs are a class of herbs that help the body adapt to emotional and physical stressors. Some adaptogenic herbs are: ashwagandha, asian ginseng, rhodiola, and schisandra.
3) Addressing inflammation:
After labs reveal high levels of inflammation, a licensed ND will then seek to further investigate the root cause of inflammation in addition to initially supporting healthy inflammatory response with integrative options. Options that have been shown to reverse inflammation are:
Diet & nutrition: There is extensive literature that the Mediterranean Diet can help reduce inflammation in the body, specifically hs-CRP and TNF-a. Additionally, the Mediterranean Diet focuses on foods one can have rather than focusing on foods one cannot have, which makes adopting the specific diet easier to adopt since it is more of a lifestyle approach rather than a “diet”.
Turmeric (Curcumin): Curcumin is an antioxidant found in the herb turmeric, and there is evidence that targeted doses of curcumin can reduce inflammation in the body, specifically hs-CRP.
Essential fatty acids: Literature indicates that consecutive long-term supplementation of marine-derived omega-3 fatty acids reduced levels of inflammation, specifically reducing IL-6, CRP, and TNF-a.
4) Addressing post-hormonal birth control syndrome:
If a person’s clinical picture suggests that their symptoms are rooted in post-hormonal birth control syndrome, licensed NDs seek to support cellular & organ function by repleting the body of nutrients that are usually depleted while taking hormonal birth control. By supporting cellular & organ function, licensed NDs aim to help these tissues and organs reach a state of biochemical & physiological balance, which could potentially reduce symptoms. Some nutrients that are depleted by hormonal birth control include:
Folate
Vitamin B12
Vitamin B6
Vitamin B2
Vitamin C
Magnesium
Selenium
Zinc
5) Addressing co-morbidities:
Co-morbidities are conditions that occur in conjunction with other diseases, and it is important to also address these conditions to support overall wellbeing. Other diseases that can happen with PCOS are:
Diabetes
Heart disease & cholesterol issues
High blood pressure
Metabolic syndrome
Summary & Takeaways
As from what you saw in this post, naturopathic options for PCOS can depend on the root cause of a person’s PCOS picture while simultaneously supporting optimal cellular and organ function. Additionally, the options listed above are just some of the options a licensed ND may recommend, and are not all of the options. Depending on further training in other forms of natural and integrative therapies, your licensed ND may recommend more options to manage PCOS.
I hope this 3-part series on PCOS was enlightening and empowering, and that it helps you feel confident speaking to your trusted doctor about options for managing PCOS. Make sure that you work with a provider who can help identify root causes and co-morbidities for holistic healing and that you work with a provider who is able to see you and hear you.
If you are interested in adding a licensed ND in your healthcare team, the Institute for Natural Medicine is a great place to find a licensed ND in your state. And, if you are in the state of California, Realize A Healthy California is a great naturopathic resource to find a licensed ND in your city. And of course, if you are in Los Angeles or its surroundings, you can contact my office to learn more about visits with me.'
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