PCOS (POLYCYSTIC OVARY SYNDROME)
Written by Slawomir (“Swavak”) Gromadzki, MPH
Before WW2 Polycystic ovary syndrome (PCOS) was regarded as very rare. Today, one in fifteen American women suffer from it. PCOS is associated with excess androgen (especially testosterone) in women and it is the most common ovarian disease. It affects 5 to 20% women. PCOS takes place when there is a larger than normal number of harmless cysts on ovaries. The cysts are follicles which contain eggs that haven’t developed properly. Often in PCOS, ovulation doesn’t take place as these follicles are unable to release an egg. This makes PCOS a leading cause of infertility.
The key symptom of PCOS is failure to ovulate regularly. Sometimes periods are absent. Other symptoms include infertility (difficulties becoming pregnant), excessive hair growth (hirsutism), weight gain, oily skin or acne, depression, hair loss, etc.
There is still a lot to learn about the causes of PCOS but the following conditions and factors are believed to contribute to the development of this condition:
– Excess testosterone caused by chronic high insulin levels and insulin resistance (the same as in type 2 diabetes) seems to be the most common cause of PCOS. It leads to high levels of insulin in the blood and too much insulin increases testosterone. The body’s tissues do not respond to insulin and extra insulin is produced to try to compensate. The high levels of insulin cause the ovaries to over produce testosterone. This interferes with the development of the follicles and prevents normal ovulation.
– Vitamin K deficiency. Vitamin K increases testosterone and fertility in males, while lowers the excess of the same male sex hormone (testosterone) in women. In women high testosterone is triggered by high insulin levels (insulin resistance) which leads to polycystic ovarian syndrome (PCOS). Polycystic ovary syndrome is also characterized by an overproduction of DHEA sulfate (DHEAS). Vitamin K2 supplementation helps women to recover from PCOS. K2 will give even better results combined with D3, magnesium, chromium, karela, alfalfa and alpha lipoic acid. One randomized control trial showed that Vitamin D, K and calcium (citrate not carbonate!) co-supplementation for two months among Vitamin D-deficient women with PCOS managed to lower DHEAS levels and testosterone levels.
– Thyroid problems, because ovaries need T3 thyroid hormone. Iodine Deficiency is regarded as one of the key factors contributing to PCOS. Almost all women know that iodine is required by thyroid to maintain proper functioning but they are not aware of the fact that after thyroid the ovaries contain the second highest concentration of iodine in her body. It means that iodine deficiency, which is very common today, must have a negative impact on ovaries too. This and other mentioned in this article factors make ovaries unable to release an egg and contribute to the development of cysts on the ovaries (PCOS). At the same time similar factors stimulate ovaries to produce too many male hormones. Women with PCOS usually have great results in treating this condition using Iodine supplements or adding more natural Iodine foods to their diet such as kelp, chlorella or spirulina. According to Dr. Jorge Flechas, “Iodine deficiency may cause the ovaries to develop cysts, nodules and scar tissue. At its worse this ovarian pathology is very similar to that of polycystic ovarian syndrome (PCOS). At present I have five PCOS patients who have been successfully brought under control with the use of 50 mg of iodine per day.” Also Dr Jeffrey Dach says that, “Iodine deficiency causes ovarian cysts and anovulation which can be reversed by iodine supplementation.”
– The use of the birth control pills which suppresses ovulation can be another common cause of PCOS. In case of most women birth control pills won’t cause this problem, as they can have normal ovulations after they stop using pills. Unfortunately, in some women ovulation may disappear for months or even years inducing PCOS.
– Vitamin B12 deficiency. Women with PCOS become depleted of B12 for many reasons with serious consequences such as fatigue, anaemia, memory loss, neurological and psychiatric problems, etc.
– Inflammation and overstimulation of the immune system caused by heated animal protein especially casein (dairy), gluten (wheat, etc.), refined oils and margarines, intestinal permeability (leaky gut syndrome), too much stress, environmental toxins, etc. This chronic inflammation contributes to PCOS as it disrupts hormone receptors, hinders ovulation, and stimulates production of adrenal androgens such DHEA.
– Zinc deficiency. Refined and low in zinc diet may contribute to PCOS because without this very important mineral ovaries can’t function properly.
– Artificial sweeteners contribute to PCOS through insulin resistance because they impair insulin and leptin signalling.
– Weight gain: Raised insulin levels can lead to weight gain, and being overweight makes the symptoms of PCOS more pronounced because excess fat causes the body to produce more insulin.
– Hormonal imbalance: Raised levels of testosterone and other male sex hormones results in many of the symptoms of PCOS (all women produce testosterone, but normally in much lower levels than men).
– Other causes (which also lead to insulin resistance, hormonal imbalance and overweight) may include the following: Lack of exercise, nutritional deficiencies (lack of vitamins, minerals including B-complex, magnesium, etc.), vitamin D deficiency (insufficient sun exposures), stress, anxiety, depression, toxins, lack of antioxidants in diet, consumption of meat, dairy, refined plant products, stimulants, sugar, plant oils (high in pro-inflammatory omega-6 fatty acids), stimulants, etc.
Failure to ovulate is the reason why women with PCOS are deficient in progesterone and estrogen. Lack of these two female sex hormones leads to increased levels of male sex hormone – testosterone. As a result such women experience different secondary PCOS symptoms such as infertility, hair loss, acne, etc. Therefore an effective treatment must address the listed above possible causes of the PCOS including: Insulin resistance, Thyroid problems and Iodine Deficiency, Birth control pills, Vitamin B12 and Zinc deficiency, Inflammation and overstimulation of the immune system, Artificial sweeteners, Sugar, Stimulants, Bad diet, Stress, Lack of exercise, etc.
In addition, read carefully and do your best to implement all the principles and recommendations included in the HEALTH RECOVERY PLAN >
– ADDRESS INSULIN RESISTANCE by avoiding sugar, reducing body weight, quitting smoking, avoiding refined oils, margarines and other and trans fat, and environmental toxins. If possible try also intermittent fasting (avoiding regular food and instead drinking 3 times a day 2 or 3 glasses of fresh raw vegetable juice with some super foods such as barley grass or chlorella powder). Fasting works very well to improve insulin sensitivity. Best supplements for insulin resistance are lipoic acid, Beta glucan (in Barley fibre), nettle, karela, alfalfa, chromium, magnesium, inositol, and berberine. Avoid fructose as it leads to insulin resistance. Use Alpha lipoic acid supplements. According to Dr Mercola: “This Antioxidant can smash insulin resistance and autoimmune disease. People with diabetes or metabolic syndrome tend to do much better when taking lipoic acid, as it enhances insulin sensitivity.” Also D-chiro-Inositol (DCI) appears to have very beneficial effects for PCOS. According to some studies, women with PCOS who received DCI lowered testosterone and blood pressure, increased frequency of ovulation, increased insulin sensitivity and improved glucose disposal. Avoid stimulants, meat, dairy, fats and oils except raw organic coconut oil.
The best and most effective way to treat insulin resistance (the most frequent cause of PCOS) is to implement all the principles and recommendations I included in the article about Type 2 DIABETES >
– Take 200 mcg of Vitamin K2 MK7. Vitamin K increases testosterone and fertility in males, while lowers the excess of the same male sex hormone (testosterone) in women. In women high testosterone is triggered by high insulin levels (insulin resistance) which leads to polycystic ovarian syndrome (PCOS). Polycystic ovary syndrome is also characterized by an overproduction of DHEA sulfate (DHEAS). Vitamin K2 supplementation helps women to recover from PCOS. K2 will give even better results combined with D3, magnesium, chromium, karela, alfalfa and alpha lipoic acid. One randomized control trial showed that Vitamin D, K and calcium (citrate not carbonate!) co-supplementation for two months among Vitamin D-deficient women with PCOS managed to lower DHEAS levels and testosterone levels.
– Inositol has demonstrated its ability to treat PCOS.
– Try to avoid Birth control pills. If your prolactin is high or normal, then the best herbal treatment to cope with pill-induced PCOS seems to be Vitex (also called Agnus castus). However, Vitex shouldn’t be used if your LH is elevated as it stimulates LH and would make symptoms even worse. In case your LH is elevated, try to use Peony & Licorice formula. And be patient as those herbs need time to generate results (usually within few months). Avoid licorice if you have high blood pressure. According to Jeri Lynn Prior, MD, “The fundamental problem with PCOS is not making progesterone for two weeks every cycle. This lack of progesterone leads to an imbalance in the ovary, causes the stimulation of higher male hormones and leads to the irregular periods and trouble getting pregnant. Progesterone is usually missing—replacing it therefore makes sense.“ If this is your problem then again using Vitex may help as it seems to be very effective in regulating progesterone.
– Korean red ginseng counteracts steroid-induced polycystic ovary in the mouse mode >
– Exercise every day for at least one hour trying to induce some perspiration and reduce tiredness. Fast walk outside is the best type of exercise. One of the key causes of fatigue is insufficient amount of mitochondria (energy producing power stations) in your cells. And the key cause of this shortage is lack of physical activity. Regular energetic exercise, therefore, is the best way to stimulate the body to make more mitochondria. No wonder marathon runners have the highest number of mitochondria in their cells! Exercise in the morning outside is the best way to boost serotonin and other hormones which are very important in the attempt to recover from fibromyalgia. In the beautiful book „Ministry of Healing” Ellen G. White wrote that, “The sick, shut within four walls, look out on houses and pavements, with perhaps not even a glimpse of blue sky or sunshine, of grass or flower or tree. Shut up in this way, they brood over their suffering and sorrow, and become a prey to their own sad thoughts. The pure air, the glad sunshine, the flowers and trees, and outdoor exercise amid these surroundings, are health- and life-giving. Outdoor life is the only remedy that many need. It has a wonderful power to heal diseases caused by the excitements and excesses of fashionable life, a life that weakens and destroys the powers of body, mind, and soul. How glad would they be to sit in the open air, rejoice in the sunshine, and breathe the fragrance of tree and flower! There are life-giving properties in the balsam of the pine, in the fragrance of the cedar and the fir, and other trees also have properties that are health restoring. In nature may always be found something to divert the attention of the sick from themselves and direct their thoughts to God. The beauty of nature leads them to think of the heavenly home, where there will be nothing to mar the loveliness, nothing to taint or destroy, nothing to cause disease or death.”
– Take Chlorella or at least Kelp to cope with iodine deficiency. I personally believe Chlorella is currently the best natural super food and natural remedy in the world. And you should agree with me after reading the article about Chlorella. Since Chlorella is a powerful detoxifier and energy booster it is better if you start with a smaller dose such as 1 teaspoon or 3 tablets 30 minutes before breakfast and the same amount 30 minutes before lunch with 2 glasses of water, vegetable juice or smoothie. Then gradually increase the intake every day (by approximately 1 tablet) until reaching the maximum dose of 2 heaped tablespoons or 10 – 20 tablets (500mg) 30 min before breakfast and the same amount 30 min before lunch. Altogether you can take 2-6 round tablespoons or about 20-40 tablets (500mg per tablet) of chlorella a day. The more you take the better results you will see. It is better and more beneficial to take chlorella alternately with moringa, barley grass, alfalfa, Clean Greens (Pukka), Vital (Pukka), Bee pollen or other super foods or formulas as in this way you will avoid possible overdosing of iodine or other Chlorella’s ingredients (although I never found any reliable evidence that taking large doses of Chlorella may be harmful). The dose depends also on age and body weight. While taking chlorella remember to increase your water intake to 3 times a day 2-3 glasses between meals. READ MORE >
– Try to use Saw Palmetto to lower testosterone.
– The compound found in buckwheat known as d-chiro-inositol have a therapeutic effect in polycystic ovary syndrome >
– PCOS should be also regarded as a condition caused by a physical response to a poor mental health (depression and anxiety) and emotional stress. Not everyone with PCOS will experience complete relief of symptoms even after following diet perfectly. This is because in nearly every case of PCOS there is an underlying EMOTIONAL factor which plays as important role as diet and must be addressed or otherwise one of key causes of the fibromyalgia won’t be eliminated.
Positive mental attitude, finding effective way to get rid of unforgivingness, fears, negative thinking is the key to final success!
Please read about MOTIVATION and EMPOWERMENT very carefully as it reveals the secret of finding true source inward peace and also strength necessary to control negative emotions and to overcome bad habits and will help you to gain a powerful motivation to not only practice but also enjoy the new and very healthy way of life.
– Methylcobalamin (form of vitamin B12) is another very important remedy which helped many women to reduce symptoms of PCOS, regenerate damaged nerves and to get rid of chronic fatigue as deficiency of this vitamin is regarded as “rampant” today. > Methylcobalamin (must be sublingual) 2,000 to 3,000 mcg a day under the tongue (only with breakfast) for one month. After 3 months reduce to 1,000 to 2,000 mcg a day (with breakfast). Read very important and interesting article on VITAMIN B12 >
– Treat inflammation by avoiding heated animal protein especially casein (dairy), gluten (wheat, etc.), refined oils and margarines, addressing intestinal permeability (Leaky gut syndrome), learning to control stress, removing toxins from the body, taking omega 3, turmeric, vitamin D3, probiotics, etc.
– Take 15-30 mg of Zinc after breakfast as refined and low in zinc diet may contribute to PCOS because without this very important mineral ovaries can’t function properly. In addition eat 1-2 tablespoons of pumpkin seed (soaked in water overnight) every day.
– Since hormonal imbalance (raised levels of testosterone and other male sex hormones) results in many of the symptoms of PCOS (all women produce testosterone, but normally in much lower levels than men) it is very important to regulate hormones by using the following natural remedies:
Licorice regulates estrogen and reduces elevated levels of androgens like testosterone >
Resveratrol significantly reduced ovarian and adrenal androgens >
Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome >
Tribulus terrestris may provide an alternative treatment for ovarian cysts >
– Avoid artificial sweeteners as they contribute to PCOS through insulin resistance because they impair insulin and leptin signalling.
– Avoid eating foods rich in refined sugar and other refined carbohydrates such as refined rice, white flour products (body turn white flour into blood sugar).
– Don’t use stimulants such as caffeine products, black and green tea or alcohol.
– If you are on a prescribed medication check whether bad mood is one of its side effects.
– Also make sure you don’t have symptoms of hypoglycaemia, candidiasis, allergy.
– Hot Foot Bath. Keeping your feet for about 30 minutes in hot water before going to bed can be very helpful in reducing blood or congestion in the ovaries. The very important benefit of water treatments such as hot foot bath is its ability to move blood from different parts of the body which is very helpful when the blood is congested and often overloaded with toxins and impurities. It might be very beneficial in case of PCOS, sinusitis, headaches or fibromyalgia. In this case the hot foot bath helps because high temperature of water dilates blood vessels in feet. As a result the congested blood moves from the brain to the lower parts of the body and brings great relief. At the same time you need to put a cloth wrung out in ice water on your forehead and neck, as it will constrict the blood vessels in the head, which also helps to ease the congestion. It is very important to drink a lot of (possibly distilled or at least filtered) water before and during water treatments, especially when they cause sweating. And don’t forget to pray before any treatment, asking the Great Physician to bless your efforts to cope with the disease. READ MORE >
– In the morning and evening take the alternative (contrast) hot and cold shower as it will give a tremendous boost to the blood circulation (including in your ears), improve metabolism, the elimination of toxins, and stimulate both the nervous and the immune system. Always start with hot shower and after about 3 – 5 minutes when your body is warm enough take a 3 – 5 min cold shower slowly reducing the temperature until it is really cold. After that, repeat this procedure alternating the flow of water from hot to cold, back and forth 3-5 times in a row. You can also start the whole treatment with hot shower followed by prolonged cold bath. Cold water stimulates blood to flow toward the internal organs whereas the hot water directs blood toward the skin. Hot water enlarges blood vessels while cold water causes them to shrink. Therefore, the alternating hot and cold makes the circulation move in and out like an accordion. This has the effect of increasing the rate of detoxification and moving nutrients more readily to various parts of the body. Hot and cold showers can be taken 1 to 2 times a day. The cold shower or bath, which is even more beneficial than hot, will not harm you if you precede it with good hot shower. Cold water by cooling our body forces it to burn more calories by activating the brown fat which boosts fat burning. Brown fat can play a very important role in controlling body weight because it is a heat-generating type of fat which burns energy instead of storing it. Although it is called “fat” it actually works more like a muscle than fat. Apart from cold also hot treatments such as sauna can be beneficial in treating inflammations, infectious diseases, skin problems, poor blood circulation, obesity, etc. as it boosts immune system and helps in eliminating toxins from our body. In addition it is also effective in removing excess fat which can be explained by the fact that fats become water-soluble when they are exposed to the temperature higher than 45 degrees Celsius (113 degrees Fahrenheit) thus forcing the body to eliminate the excess fat together with water during the process of sweating triggered by sauna or another prolonged hot treatment such as hot foot bath, hot shower, etc. Sauna is recommend especially after exercising. Also remember that although sauna or other hot treatments can be beneficial it must be frequently interrupted with cold showers. Apart from that, during any prolonged hot treatment a cold compress on the forehead and neck should be applied constantly. If you experience any health problems please consult the use of sauna and other prolonged hot or cold treatments with your physician.
– Eliminate any possible allergens. In one study corn, wheat, dairy, citrus fruits, and sugar were eliminated from diet. After 2 weeks without eating any of the potential food allergens, nearly half of the participants with fibromyalgia reported significant reduction of pain, and 76% reported a reduction in other symptoms such as fatigue, headache, bloating, heartburn or breathing difficulties. The most common problem-causing foods or ingredients for the patients in this study were dairy, sugar, corn, gluten, and citrus fruits.
– Almost every person in England is deficient in vitamin D. Vitamin D is important for human nervous system. Even in India 80% of people are deficient in vitamin D because they do not expose their bodies to the sun. While taking vitamin D3 supplements always remember to take also well absorbed magnesium (such as citrate) as vitamin D supplements lead to magnesium deficiency over time. If you can’t afford higher doses take at least 4,000 IU of vitamin D3 a day with meal. But since deficiency of this vitamin is so widespread (especially in the UK) it would be better to take 10,000 to 30,000 or even 50,000 IU a day with meals with appropriate doses of magnesium (50,000 IU shouldn’t be taken longer than 2 months). Another requirement for proper absorption of vitamin D is 200 mcg of Vitamin K2 MK-7 (Derived from Natural Natto) a day.
– Millions suffer also from Magnesium deficiency without even knowing it. Magnesium deficiency is often misdiagnosed because it does not show up in blood tests as only 1% of the body’s magnesium is stored in the blood. According to Dr. Norman Shealy, “Every known illness (including fibromyalgia) is associated with a magnesium deficiency. Magnesium deficiency may be responsible for more diseases than any other nutrient.” Dosage: Try to use a good quality magnesium of high bioavailability such as Magnesium citrate (MagCitra by HealthAid or powder by Viridian): 2 x 400mg 60 min before breakfast and about 1 – 2 hours before bed. If you take very high doses of vitamin D3 (over 30,000 IU a day) you will probably need 2 x 800mg of magnesium.
– Vitamin B6: 50mg a day with meal.
– Get Folate (Folic acid) by consuming green leafy vegetables every day or if you want supplement take it only in the form of folacin.
– Omega 3 fats have been suggested by research to have a calming and anti-depressive effect on the nervous system enhancing brain health and mental well-being. Rich sources of Omega-3 are: flax oil, flax seeds (must be ground), walnuts, almonds, and pumpkin seeds. Chia seeds are very helpful too as it is regarded as the best source of Omega 3 fatty acids. Mix 1-2 tablespoons with fruit juice or plant-based milk every morning and eat it after at least 30 minutes with your breakfast.
– Eat raw Sauerkraut every day or get a good probiotic formula such as UltraProbio >: with meals (2-3 x higher doses than recommended, for first month).
– The only oil to use is raw coconut oil.
– Walnuts and almonds may improve metabolic and endocrine parameters in PCOS >
– Avoid products with refined sugar, dairy, cheese, glucose, fructose, pizza, white flour products, and anything that weakens immunity.
– Eat more raw vegetables, cabbage family vegetables, carrots, etc.
– You can use magnesium spray on painful muscles!
– Never use refined salt but only Celtic salt (regarded as most healthy), Himalayan (pink, rock) salt or sea salt.
– Avoid stimulants such as alcohol, caffeine (in coffee, chocolate, green tea, cola drinks, etc.), theophylline (in tea) or and theobromine (in cacao and chocolate) because although they appear to give you a short time energy boost yet it is only a borrowed energy, which means sooner or later you will have to pay for it with the loss of energy. And, as soon as you feel exhausted you it will force you to use stimulants again and again thus causing a vicious circle and addiction. Apart from that stimulants also weaken your immune system and lead to nutritional deficiencies and may contribute to depression and other health problems. Dr. John Minton of Ohio State University discovered that the primary causes of breast cancer in women are coffee, tea, colas and other caffeinated foods and drinks. Dr. Minton eliminated caffeine and theobromine (chocolate, cocoa) from the diet of women with breast lumps and gave them a diet that consisted primarily of organically-grown plant foods. As a result, pain, swelling and lumps disappeared within two to six months.
– Every day include in your diet the 5 CRITICAL and MOST POWERFUL SUPER FOODS: Fresh raw sprouts; Freshwater algae (chlorella); Super grasses (barley grass, alfalfa, wheat grass); Fresh cold pressed vegetable juices; Fresh raw organic turmeric powder (HealthAid).
– Drink 1 or 2 glasses of fresh raw and possibly cold-pressed (using slow juicer) vegetable juices (carrots, beets, broccoli, kale or spinach, etc.) 2 to 3 times a day before meals or instead. It is even better to have them with chlorella or spirulina, alfalfa, turmeric and barley grass.
– Good quality Multivitamin-mineral formula or Vitamin B-complex: 1 tablet after breakfast. Please do not buy cheap formulas as their potency is very low and they contain only short list of inorganic ingredients. It must be a good quality formula such as Healthy Mega (HealthAid), VM75 (Solgar) or Special Two (NOW Foods) which are an excellent multi-vitamin and mineral formulas fortified with alfalfa powder, rutin, citrus bioflavonoids, bromelain, herbs, digestive enzymes and many other super nutrients. If your diet is very healthy and you stay away from refined foods, sugar and stimulants then take only 1/2 tablet after breakfast.
– Since Vitamin B complex (B1, B2, B3, B6, B12, Folate) play very important role in dealing with PCOS I recommand getting B complex with a good quality multivitamin-mineral formula which is high in B vitamins.
– Symptoms are reduced and sometimes disappear once you have less fat in your diet including all animal fats and bad plant oils and margarines. Make sure you use only raw organic coconut oil and flax oil (for salad dressing but not cooking).
– Avoid refined sugar and high glucose.
– Drink 3 times a day 2 or 3 glasses of distilled (or at least filtered) water about 30 to 60 minutes before each meal or about 2 hours after. During hot days you need even more. Your urine should be transparent, if it is yellow it means you don’t drink enough water. Read more about water >
– Try to avoid too much soy products as in some women they seem to have anti-estrogen effect and contribute to the lack of ovulation.
This is What I Did To Cure My PCOS Naturally
By Alyssia Michelle (source >)
Being diagnosed with any health disorder is hard to tolerate, but being diagnosed with Polycystic Ovary Syndrome, a disorder that affects mind, body, and spirit, can be debilitating on a woman’s health and outlook on life. When I heard that I was diagnosed with a disorder that could cause me a slew of problems including type 2 diabetes, cardiovascular disease, and infertility (to name a few), I felt broken. I felt like the one thing that was supposed to be natural, to have my period and be fertile, was taken from me and I was succumbed to this destiny. And instead of my doctor having an uplifting, encouraging conversation with me on ways to cure it, I was simply thrown into a statistic, a statistic that could not be changed because there is no known cure for it. After all, the gynecologists I saw gave me one option and one option only: take birth control to help lower the symptoms.
Being that I had been on birth control prior to my diagnosis and realizing it did me more harm than good, my only other option was to not take birth control. As a woman who loves children and hopes to have many healthy children one day, I was not okay putting synthetic hormones into my body, especially one that was stopping fertility at a given time, in a body already at an increased risk for infertility. Not thinking anything more of it, I lived my life exactly as I left the doctor’s office the day of my diagnosis: consumed with the feelings of being powerless, hopeless, and lifeless. With two periods a year, weight gain (and inability to lose weight), and various health problems, this became my new norm.
That was until one day I woke up and was no longer okay with settling in my life, especially not in the area of my health. I was no longer willing to leave my life choices in the hands of any one other than myself. So I reevaluated and presented myself with two new choices: continue on the same path that I am on, with the same exact results, or do something about it! I chose to do something about it. With this, I started to learn about Holistic health, and the more I learned how nutrition and environmental factors play into all areas of our health, the more I was eager to develop a plan to cure my PCOS and be the happiest and healthiest self yet. With evaluating my self, my environment, and putting curing PCOS at the top of my priorities, I have now had my period for 4 months in a row and I feel as alive as ever.
So What’s Really Going On In Your Body?
Currently, Polycystic Ovary Syndrome is the number one diagnosed reproductive disorder in all women, with nearly 5 million women being diagnosed. It is a disorder that doctors don’t know much of a cure for because various factors play a role including genetics, environment, toxic diet, vitamin deficiencies, metabolic issues, hormone imbalance, and emotional/mental stress. It is affected by various factors from what you eat, to how you consume goods, to the products you use, to even the thoughts you may have. This might sound overwhelming because with so many factors going into it, how can we know where to start? This is actually great news! In knowing this we can each, in our own way, evaluate various areas our lives, and make suitable changes. The following are topics I have researched and changed in my own PCOS challenge, or topics I have researched and found that helped others in curing their own PCOS. Remember, you are not alone and there is a community of women supporting you on your journey and wishing you healing.
What to Remove From Your Diet:
Anything High in Sugar/Artificial Sweeteners/Trans Fatty Acids:
Sugars increase insulin resistance (which is what women with PCOS already struggle with) so they need to be avoided at all costs! Some foods containing high amounts of sugar and trans fatty acids include cakes, cookies, biscuits, candies, muffins, sugary drinks (juices, soda), salad dressings, canned soup, and granola bars, french fries, chips, frozen dinners, vegetable oils, and shortening.
Processed and Refined Foods:
Another must to avoid. These all are toxic and stop hormone production as they are filled with preservatives and chemicals— everything from the ingredients, to the packaging. Avoid fast foods, hot dogs, bacon, sausage, beef jerky, non-organic lunch meats, salami, chicken nuggets, and the like.
Excess Caffeine, Alcohol:
Caffeine increases your body’s normal estrogen levels, which is already high in women with PCOS. Alcohol inhibits your liver from metabolizing molecules the way it should. Your liver is already working to rid itself of excess Insulin and Androgen production, and when you drink alcohol, your liver spends its time concentrating on filtering that out first, not to mention all of the toxins alcohol brings in.
Soy contains nutrients known as Phytoestrogens and substances known as Goitrogens. Phytoestrogens mimics the hormone Estrogen, which causes Endocrine disruption in women with PCOS. Goitrogens block your Thyroid from taking in Iodine, which causes Thyroid disruption and affects various aspects of PCOS.
What to Add to Your Diet:
Water, lots of water!
This may seem simple, but actually even mild dehydration can cause your body to feel and act less than it should. Women’s bodies are 55% made up of water, so if we aren’t putting in the water, our organs can’t work the way they need to. To get myself to drink more water, I add fresh lemon juice with a splash of 100% organic Cranberry juice. These additions aid in digestion, as well as cleansing of the kidney and liver… and it tastes like a sweet treat!
Foods High in Vitamin D, Calcium, Magnesium, Zinc, Chromium, Iodine:
Women with PCOS often lack these important vitamins/minerals which impacts hormone production, so it is important to pay special attention to foods that incorporate these.
– Vitamin D: In addition to obtaining Vitamin D from sunlight, eat foods such as Salmon, Tuna, Portobello/Shiitake Mushrooms.
– Calcium: Kale, Broccoli, Swiss Chard, Spinach, Collard Greens, and herbs such as Thyme,
Oregano and Basil.
– Magnesium: Dark leafy greens (spinach, romaine), Nuts/seeds (walnuts, almonds, pumpkin, peanuts), Whole grains (brown rice, quinoa, oats), Wheat germ, Barley, Beans/lentils (White beans, kidney, chickpeas), Avocados, Bananas, Dark Chocolate.
– Zinc: Cooked Napa Cabbage, Palm Hearts, Lemon Grass, Green peas, Dried Peaches/Plums, Apricots, Avocado, Blackberries, Raspberries, Dates.
– Chromium: Broccoli, Green Beans, Mushrooms, Asparagus, Potatoes, Bananas, Apples.
– Iodine: Sea vegetables, Cod, Scallops, Shrimp, Strawberries, Eggs, Sardines.
Low Glycemic Index Fruits/Vegetables:
Low GI fruits/veggies are important in managing insulin levels. Some that are low in GI include:
Fruits: Cherries, Grapefruit, Apples, Pear, Plum, Peach, Mango, Berries, Limes, Lemons
Veggies: Onions, Red Peppers, Cabbage, Mushrooms, Broccoli, Tomatoes, Brussel Sprouts
Nuts, Spices, & Herbs:
In a study published in the March 2011 issue of the European Journal of Clinical Nutrition, walnuts improved insulin sensitivity as well as increased a hormone that reduces the effects of testosterone. Certain spices and herbs produce similar results.
–Turmeric: Reduces Inflammation in essential organs associated with PCOS
–Bay leaf: Reduces blood sugar
–Chaste Tree: Stimulates pituitary gland
–Ginger: Improves cholesterol levels, reduces inflammation, rich in minerals that women with PCOS lack such as Zinc, Calcium, Potassium, Magnesium, and Vitamin D
–Peony and Licorice: Regulates estrogen and reduces elevated levels of androgens like testosterone.
Probiotics are important for women with PCOS, but mostly overlooked. When I started taking probiotics, within days, I could feel my digestive track was less inflamed, I was less bloated, and my body felt lighter. According to Nava Health and Vitality Center, “…beneficial bacteria in your digestive system have the capability of affecting your body’s vitamin and mineral absorbency, hormone regulation, digestion, vitamin production, immune response, and ability to eliminate toxins, not to mention your overall mental health”. I personally used a probiotic supplement just because my gut was seriously out of balance, but I have found that Kefir, Kimchi, Kombucha, Sauerkraut.
Change These Environmental Factors:
Avoid BPA products:
BPA is as an endocrine disruptor which interferes with your natural hormonal system. Studies find that women with PCOS have a higher amount of BPA in their blood, which cannot be metabolized by the liver. Avoid drinking out of cans, absolutely do not heat up foods in plastic containers (limit/eliminate all plastic products altogether if possible by using glass products), avoid drinking out of water bottles, and limit/decrease using canned foods.
Avoid Fluoride (water & products containing it) at all costs:
Fluoride creates a build up of calcium in your pineal gland.Your pineal and pituitary glands are SO extremely important to women with PCOS because these glands make and store many different hormones that are associated with PCOS. When there is a build up, your hormones can’t support your body the way you need them to. High fluoride can lead to increase in testosterone and cortisol, out of balance Melatonin production, as well as a decrease in metabolism functioning, energy balance, and nervous system activity. To begin clearing your Pineal Gland, do not drink fluorinated water, stop using fluorinated mouth washes and toothpastes, use water filters/drink distilled water, and avoid cooking with nonstick pans.
Cut Toxic Every Day Products:
According to a study published in the Journal of Environmental and Public health, many every day products have endocrine-disrupting properties, including “cleaning products, air fresheners, hair dyes, cosmetics, and sunscreens”. Since PCOS is associated with endocrine functioning, it is best to choose products that are as natural as possible so you do not ingest any. Use natural cleaning products, eat organically as possible, limit deodorants/perfumes/toxic skincare products, and take your shoes off at the door before entering your home to avoid bringing in outdoor pollutants.
Doctors are now in consensus that losing only 5-10% of your body weight can greatly reduce PCOS. Don’t think you need to start running marathons, or be a pro athlete! 30 minutes a day for at least 5 days a week can do wonders! Not only does exercise aid in weight loss because it allows for better insulin sensitivity, it also gets your hormones working again, it is a stress reliever (reducing cortisol and reducing production of androgens/insulin resistance), leads to less anxiety/depression, and it helps you be aware of your body, further encouraging you on your journey.
Above all else, believe you can cure yourself!
It is hard to be diagnosed with Polycystic Ovary Syndrome, it really is, but don’t feel powerless! It is a part of you, but not the whole you. It has made me who I am today— it has made me live a healthier, happier, greener life. For that, I can forever be thankful and look at the lesson it has taught me, rather than the burden. You ladies, are the creators of your reality. If you want something, put it at the top of your priority list. Dream of yourself being cured, dream of yourself living a life you wish, as the happiest and healthiest version of yourself. Keep this intention in mind, and you will be unstoppable in all areas of your life. That is the first and most important step to putting you on the path that you want. Have patience, practice self-love, and believe in yourself and your journey. All of the power you can ever dream of having is already inside of you. Good Luck!
What does the research say about dietary interventions on women with PCOS?
Written by: Joseph Gonzales, R.D. on April 12th, 2015
Is there anything that can lower DHEA? Also, is there any information about the cause of PCOS? I keep hearing it is Insulin Resistance, but my Insulin/Glucose were only mildly resistant, but my DHEA is three times too high. I don’t see Insulin as preceding the high DHEA due to DHEA being so high and Insulin/Glucose not as bad. I have read about Spearmint Tea being able to lessen hirsutism in PCOS women, but by what mechanism? Does it lower a particular androgen or all of them? I also read both Spearmint and Peppermint tea are unsafe, is this true and what is the safe amount?
Also, what about Saw Palmetto? I read it can cause sterility/impotence/permanent loss of libido. Is this true and were any of these effects reported by women? Does it lower all or a particular androgen?
Can you please give me information about Maca Root and how it effects the body? Is it healthy? Is it safe? Is it actually good for hormones/fertility? What about PCOS, would it have a positive effect? I have PCOS, Insulin Resistance & High DHEA are my only known imbalances. I have read Maca will make me more masculine & I have also read it can cause heart palpitations & is a stimulant. I also read gelatinized is best, but concentrated. Please help.
Ava/ Originally posted in Enhancing Athletic Performance With Peppermint
These are certainly good questions! First, it’s important to know exactly what polycystic ovarian syndrome (PCOS) is and how diet may have an impact.
Common signs are hirsutism (excess hair growth), anovulation, and obesity, with signs of the disease likely generating in adolescence. Some women may not be obese and present only with anovulation and high levels of angrogens. Affected women generally have multiple ovarian cysts and may be infertile. PCOS is tightly related to metabolic issues like insulin resistance/glucose intolerance, and obesity. Women are more likely to develop earlier than expected glucose intolerance states boosting the risk type 2 diabetes and cardiovascular disease. It is hypothesized that excess levels of circulating insulin may decrease the concentration of sex hormone–binding globulin (SHBG – a beneficial hormone that helps removes excess dangerous hormones from the body), thereby increasing the amount of unbound free testosterone. Modifying sex hormones may be a useful to improve symptoms and risk factors associated with PCOS. Inflammation also seems to play a role, as C-reactive protein (CRP) levels appear to be elevated in young women with PCOS. Adopting a healthful diet in adolescence may lower risk of developing metabolic complications associated with PCOS. One study found young women with PCOS tended to have lower fiber intake, poorer eating pattens (eating late at night) and over-consumed calories. This type of eating pattern can lead to weight gain, which unfortunately is one of the largest problems surrounding PCOS. The good news is if we know some of the factors helpful for weight loss PCOS can be better managed.
Obesity tends to exacerbate almost all diseases and PCOS is no exception. Obese women with PCOS tend to have increased free testosterone (a common type of androgen hormone) and more insulin resistance. The obesity and PCOS connection is so strong research suggests prevention and treatment of obesity is important for the management of PCOS. This might be why we see so many studies conducted on weight loss.
Dietary interventions for women with PCOS:
A study in The American Journal of Clinical Nutrition looked at the difference between a high-protein diet (>40% of calories coming from protein; 30% fat; 30% carbohydrate) and a standard protein diet consisting of (<15% protein; 30% fat; 55% carbohydrate). There were 57 women with PCOS enrolled in the study, but only 27 women completed the study after the 6 month period. The women were not asked to limit calories, but were told to exercise 30 minutes a day. The high-protein diet resulted in greater weight loss, waist circumference and decreases in blood glucose than the standard protein diet. Women eating the standard protein group still lost weight (-7 lbs.) just not as much as the high protein group (-17 lbs.), but interestingly they had significantly lower testosterone levels than the high protein group (after adjusting for weight loss). When you look at the diets recommended and actual intake of nutrients there were no differences in saturated fat or fiber intake. In fact, as you’ll see from many of these studies researches are trying to keep total fat constant so they can measure the differences in biomarkers from different diets and see what works. Anyway, the high-protein groups were asked to avoid sugar and starchy carbohydrates and replace those foods with vegetables, fruit, nuts, and more protein from meat, eggs, fish, and dairy products. Beans and legumes were discouraged as protein sources because of their higher carbohydrate content. This is true, but beans still have a low-glycemic index so it was interesting the diet was designed as such. Just shows they really wanted to make sure folks were eating high protein and low carb. Both groups were advised to limit intakes of sweets, cakes and soft drinks and consume 6 servings of fruits and vegetables a day. Although this study found a higher protein diet was better for weight loss and glucose control versus the standard protein diet perhaps the lower levels of testosterone seen in women eating a standard protein diet are relevant. When we look at a similar study with the same type of design comparing high protein diets (HP: 30% protein, 40% carbohydrate, and 30% fat) with high carbohydrate diets (HC: 15% protein, 55% carbohydrate, and 30% fat) researchers found similar results. This time women were asked to restrict their calories by 1,000 kcals. After one month weight loss occurred in both groups, but there were no differences between the groups (about -4.0 kg ) . There and there were no statistical differences between the groups in circulating androgens or glucose levels, but when both groups were studied together circulating androgens and insulin sensitivity measurements did improve. There was no increased benefit to a high-protein diet.
A dietary intervention on obese women with PCOS compared two different diets on weight loss. Women were randomized to either a low-glycemic vegan diet or a low-calorie weight loss diet for 6 months. The vegan group lost significantly more weight at 3 months, but not at 6 months. Interesting the vegan group consumed even less calories (almost 300 kcal’s less) than the low-calorie dieters after 6 months.
Meta-analyses take into account several intervention studies at once, which can be very helpful. This meta-analysis tracked diet and exercise interventions on different sex hormones. Both interventions were found to offer significant improvements in hirsutism, and improved levels of follicle-stimulating hormone (FSH) levels, sex hormone-binding globulin (SHBG), total testosterone, androstenedione, and free androgen index (FAI) – a useful measure of the testosterone/SHBG ratio. All of these hormones play a role in PCOS. It is unclear exactly what foods were eaten in the dietary interventions, but in general the groups reduced daily caloric intake by roughly 500 calories and shot for macronutrient percentages of 50% carbohydrate, 30% fat, 20% protein. Exercise programs varied per study group as well , but in general 30 minutes of moderate exercise (walking, biking, aerobics) daily was recommended, but not always monitored. I think it is important to list the lifestyle methods performed as they do not seem drastic, however, the results were significant and note worthy.
Lastly, different diets were compared in this review. The most impactful was a low-glycemic diet, improving menstrual regularity and reducing insulin resistance, fibrinogen (a clotting factor), and cholesterol, while also improving quality of life. A low-carb diet seemed to help for some of these factors as well, including weight loss. A high-carbohydrate diet appeared to increased the free androgen index (which is a different conclusion than we saw before). The review concludes that all diets were helpful for weight loss and therefore should be a focus for all overweight women through reducing calories but making sure adequate nutrient intake and healthy foods are being consumed regardless of diet composition.
So what does this tell us? Well, it seems like diets for diabetes and heart disease prevention may also help women with PCOS. If controlling hormones and losing weight are some of the largest factors associated with PCOS, let’s look at some data comparing sex hormones and metabolic profiles between omnivores and vegetarians in pre- and post-menopausal women. Note that these women did not have PCOS, but this may help understand potential changes in sex hormones from certain dietary patterns. There were 62 women in the study. The vegetarians reported higher levels of sex hormone-binding globulin (SHBG), bowel movements, and total fiber intake as well as lower levels of free estradiol, free testosterone, dehydroepiandrosterone sulfate (DHEA-s) and BMI. After controlling for BMI (to make sure weight was not a factor on other variables) these changes were still significant. Researches concluded the rise in SHBG could be explained by the higher fiber intake and may explain the lower risk of developing type 2 diabetes.
Another study that looked at the ability of diet to reduce bioavailable sex hormones included 104 healthy postmenopausal women with high testosterone levels. Researchers tracked changes in testosterone, estradiol, and sex hormone-binding globulin (SHBG) over 4.5 months. Intense dietary counseling was performed. These women even had specially prepared group meals twice a week! The diet was designed to reduce insulin resistance: low in animal fat and refined carbohydrates and rich in low-glycemic-index foods, monounsaturated and omega-3 (polyunsaturated) fatty acids, and phytoestrogens. Women in the intervention group significantly boosted levels of SHBG while decreasing serum testosterone, compared to women who made no dietary changes. Furthermore, the intervention group significantly decreased body weight, waist:hip ratio, total cholesterol, fasting glucose level, and insulin resistance. The authors concluded that increased phytoestrogen intake decreases the bioavailability of serum sex hormones in hyperandrogenic postmenopausal women.
About DHEA and PCOS:
It is not clear the role of dehydroepiandrosterone (DHEA) on PCOS risk, however, since 20-30% of women experience excess androgen production it seems super important to research! DHEA serves as a good biomarker for androgen production. Therefore, DHEA may help researchers as they explore how certain foods or dietary patterns may help lower DHEA. One study found DHEA could be lowered by exercise and diet. Women with PCOS either followed a calorie restricted diet (35% protein, 45% carbohydrate and 20% fat), or an exercise program for 24 weeks. At the end of the study both interventions seems to help lower DHEA.
Reminder about medication and PCOS:
Check with your doctor about medications like metformin, as it has been studied extensively for the treatment of PCOS with positive results. Since medications come with side-effects it is important to weight the risks vs. benefits with your healthcare team. Often with PCOS you’ll find both medication and lifestyle intervention(diet and exercise) can be most effective. Perhaps if lifestyle is going so well that you are seeing improvements than tapering off the medication can be achieved? Interestingly, a few studies give hope that dietary changes may control PCOS as well as metformin. (Please keep in mind this may not always be the case and a few published studies does not justify avoiding potentially needed medications). Regardless, this study randomized 46 overweight women with PCOS to either a diet consisting of 1200-1400 kcal/day diet (25% proteins, 25% fat, and 50% carbohydrates plus 25-30 gm of fiber per week) or to take metformin for 6 months. Both groups had significant improvements in menstrual cycles, reductions in BMI, and luteinizing hormone levels and androgen (testosterone, androstenedione, dehydroepiandrosterone sulfate) concentrations. One method did not seem to be better than the other. Clinical outcomes such as menstrual cycle patterns, ovulation, and pregnancy rates were also similar in both groups. This suggests high insulin and androgen hormone levels may be improved by diet or metformin. A second study looked at women with PCOS either eating a similar low calorie diet vs taking metformin for 12 weeks. Weight loss was seen in both treatments, but the diet group in this case was more effective in improving insulin resistance in the overweight and obese women. This study also looked at CRP levels and found both groups significantly lowered levels. This may be proof that diet works like metformin, which gives hope there is options for PCOS treatment. Still we need longer term follow up studies to see how these women are doing years after the experiment. Have the stuck to their diets? Did they end up needing medication? And what exactly were the participants eating and how could their diets improve? Lastly, Dr. Greger has a video presenting a study where lifestyle intervention reduced diabetes incidence by 58 percent, compared to only 31 percent with the drug. The lifestyle intervention was significantly more effective than the drug, and had fewer side-effects.
What about exercise and PCOS?
Many of the studies recommended about 30 minutes of exercise a day so perhaps the combination of diet and exercise has better results. That said, some studies did isolate diet alone (or rather did not tell participants to change exercise patterns) and exercise alone has been shown to help women with PCOS. My advice would be do both! Why perform one without the other as it would seem together diet and exercise can be more powerful. Obviously if limited in either capacity do what you can. I believe when dealing with any disorder mindfulness is important as well as social support and stress reduction techniques.
Dietary supplements and herbs for PCOS:
Marjoram is an herb that has been found to reduce DHEA and insulin levels in women with PCOS.
Dr. Greger mentions this study on spearmint in women with PCOS showing in just 5 days women were able to drop their free and total testosterone levels by about 30% drinking two cups of tea a day. I am unsure about mint and safety, check with your doctor if on medications with specific food interactions. To my knowledge mint should be safe for women with PCOS.
Maca root may be used to improve sexual function. In a petri dish there appears to be antioxidant activity. There seems to be limited data on concerns with psychological symptoms from taking maca. In other research, men taking maca had better health scores and significantly lowered an inflammatory marker, IL-6, known to increase cancer risk. It’s been traditionally consumed for nutritional and medicinal properties, but I am unsure how much is deemed unsafe. I did not see any research on maca and masculinity or heart palpitations. (If anyone find’s any or has more to add please add the research citation in the comments section). Again, I would speak with your doctor about their recommendations for usage. Visit our site on women’s health for more information that correlates with metabolic syndrome.
Lastly, there is some research that suggests supplements like magnesium, n-acetylcysteine, cinnamon, alpha-lipoic acid and/or omega-3 fatty acids may modulate factors associated with insulin sensitivity, thereby helping women with PCOS. One article in Today’s Dietitian mentions these supplements and other research on PCOS.
Comments about PCOS and diet:
Dr. Forrester is an esteemed member and volunteer with NutritionFacts. He elaborates on his findings 2 years ago and gives suggestions about the best diet for PCOS.
Weight loss is an important factor for PCOS as we see in study after study. I think overweight women need to find the best route of weight loss that works for them. I do not think calorie restriction is needed to loss weight. A high fiber diet low in the glycemic index seems to offer the best solutions. You would think with all this research an optimal diet could be recommended. I mean even this study titled “The optimal diet for women with PCOS?” fails to confirm the best approach. What is helpful about this study (and all the others referenced here) is that it provides awareness about dietary trends. Since women with PCOS are at greater risk of type 2 diabetes and heart disease any diet that promotes weight loss and glycemic control may be beneficial. One interesting note is that most studies are performed on calorie restriction rather than dietary composition. The authors conclude a diet low in saturated fats and high in fiber from low-gycemic index foods are recommended.
My dietary suggestions for women with PCOS:
– Boost fiber intake to help modulate hormones and lower circulating testosterone
– Promote weight loss in overweight women
– Improve glycemic control and avoid developing diabetes
– Help manage symptoms like acne and hirsutism
– Focus on foods that help reduce inflammation
Of course, discuss these parameters with your healthcare team as dietary treatments are individualized. I highly recommend utilizing a registered dietitian for personal dietary advice.
Polycystic Ovary Syndrome (PCOS)
A New Epidemic that Causes Infertility, Excess Hair, Acne and More By John Lee, MD
In the 30 years that I practiced medicine, I rarely saw a woman with polycystic ovary syndrome (PCOS). Today, estimates are that 10 to 20 percent of women have PCOS, and I would guess that among young women the number is even higher, qualifying this as an epidemic.
I have had many e-mails and letters from women in their late teens and twenties with PCOS. Their doctors tend to prescribe two treatments, both of which affect symptoms only, and neither of which is particularly successful. One treatment is temporary chemical castration, using birth control pills, androgens (male hormones), androgen blockers, synthetic estrogens, Lupron or similar drugs that block hormone production. The other is prescribing the new oral drugs for Type II diabetes, which reduce insulin resistance. I have a much safer, simpler, more effective and less expensive approach that treats the cause and not just the symptoms of PCOS.
What Is PCOS?
PCOS refers to multiple cysts on the ovaries and a host of other problems that go along with them, including anovulation (lack of ovulation) and menstrual abnormalities, hirsutism (facial hair), male pattern baldness, acne, and often obesity. Such women may also have varying degrees of insulin resistance and an increased incidence of Type II diabetes, unfavorable lipid patterns (usually high triglycerides), and a low bone density. Laboratory tests often show higher than normal circulating androgens, especially testosterone.
PCOS occurs when a woman doesn’t ovulate, which causes a disruption in the normal, cyclical interrelationship among her hormones, brain and ovaries. Normally, the hypothalamus, a regulatory center in the brain, monitors the hormone output of the ovaries and synchronizes the normal menstrual cycle. When monthly bleeding ends, the hypothalamus secretes gonadotropin-releasing hormone (GnRH), which stimulates the pituitary gland in the brain to release follicle stimulating hormone (FSH) and luteinizing hormone (LH). These hormones direct an ovary to start making estrogen (mostly estradiol), and stimulate the maturation of eggs in about 120 follicles.
The first follicle that ovulates, releasing its egg into the fallopian tube for a journey to the uterus, quickly changes into the corpus luteum, which is a factory for making progesterone, and raises progesterone’s concentrations to 200 to 300 times higher than that of estradiol. This huge surge of progesterone simultaneously puts the uterine lining in its secretory or ripening phase, and turns off further ovulation by either ovary.
If fertilization does not occur, the ovary stops its elevated production of both estrogen and progesterone. The sudden fall in the concentrations of these hormones causes shedding of the blood-rich uterine lining and bleeding (menstruation). Then, in response to low hormone levels, there is a rise in GnRH and the cycle starts all over again.
But what happens to this cycle if, for some reason, ovulation is unsuccessful? For example, if the follicle migrates to the outside of the ovary, but does not “pop” the egg and release it, the follicle becomes a cyst, and the normal progesterone surge does not occur. The lack of progesterone is detected by the hypothalamus, which continues to try to stimulate the ovary by increasing its production of GnRH, which increases the pituitary production of FSH and LH. This stimulates the ovary to make more estrogen and androgens, which stimulates more follicles toward ovulation. If these additional follicles are also unable to produce a matured ovum or make progesterone, the menstrual cycle is dominated by increased estrogen and androgen production without progesterone. This is the fundamental abnormality that creates PCOS.
Why Eggs Won’t Pop and Progesterone Isn’t Made
But what causes dysfunctional follicles that won’t release eggs? I am convinced, from wildlife studies and from what I have observed in my practice, this is due to the exposure of female embryos to xenobiotics, environmental pollutants that chemically act like estrogen on the developing baby’s tissues.
When a female embryo develops in the womb, 500 to 800 thousand follicles are created, each enclosing an immature ovum. Studies show that the creation of ovarian follicles during this embryo stage is exquisitely sensitive to the toxicity of xenobiotics. When the mother is exposed to these chemicals, she experiences no apparent damage. But the baby she is carrying is far more susceptible, and these chemicals may damage a female embryo’s ovarian follicles and make them dysfunctional; unable to complete ovulation or manufacture sufficient progesterone. This damage is not apparent until after puberty.
Lifestyle Factors that Cause Dysfunctional Follicles
There are other factors that contribute to dysfunctional follicles. These include stress (leading to the production of high cortisol levels by the adrenal glands), lack of exercise, and poor nutrition. Stress alone can cause anovulatory cycles. Birth control pills shut down normal ovary function, and sometimes it never recovers when the pills are stopped. Our diets are full of petrochemical contaminants — also xenobiotics — that derail normal metabolism. We take prescription drugs such as Prozac that impair the functioning of our limbic brain, including the hypothalamus, which may affect the menstrual cycle.
The Diet Connection to PCOS
By far the biggest lifestyle contributor to PCOS is poor diet. Young women with PCOS tend to eat far too much sugar and highly refined carbohydrates. These foods cause an unhealthy rise in insulin levels. According to Jerilyn Prior, M.D., insulin stimulates androgen receptors on the outside of the ovary, causing the typical PCOS symptoms of excess hair (on the face, arms, legs), thin hair (on the head), and acne. Eventually, this type of diet will cause obesity, which will cause insulin resistance (the inability of the cells to take in insulin), which will aggravate the PCOS even more. The androgens also play a role in blocking the release of the egg from the follicle.
Women, who have a high number of dysfunctional follicles to begin with, due to xenobiotic exposure in the womb, will have worse problems if their diets are high in sugary foods and low in nutrition. Since this is exactly the type of diet favored by teens and young women, it’s easy to understand why there is so much PCOS in that age group. Fifty years ago, the average person age one pound of sugar a year. Today the average teenager today eats one pound a week! Potato chips, corn chips, pasta and white rice are all highly refined carbohydrates that also act on the body much the same as sugars do.
When you look at the whole picture of PCOS, you can understand why the hormone-blocking and insulin-lowering drugs don’t work for very long. These approaches don’t address the underlying cause of the problem. They only suppress symptoms. Improvement is only temporary and both types of drugs have terribly unpleasant side effects.
By the same token, you can’t just take progesterone, and you can’t just cut out the sugar. You usually need to do both. Exercise and good nutrition are also very important in maintaining hormone balance, and I have covered both at length in What Your Doctor May Not Tell You About Premenopause.
Treatment of PCOS
I recommend supplementation of normal physiologic doses of progesterone to treat PCOS. If progesterone levels rise each month during the luteal phase of the cycle, as they are supposed to do, this maintains the normal synchronal pattern each month, and PCOS rarely, if ever, occurs. Natural progesterone should be the basis of PCOS treatment, along with attention to stress, exercise, and nutrition.
If you have PCOS, you can use 15 to 20 mg of progesterone cream daily from day 14 to day 28 of your cycle. If you have a longer or a shorter cycle, adjust accordingly. The disappearance of facial hair and acne are usually obvious signs that hormones are becoming balanced, but to see these results, you’ll need to give the treatment at least six months, in conjunction with proper diet and exercise. If your symptoms fade, try gradually easing off the progesterone (take half the dose, for example) and see how it goes. If your symptoms return, stay on the full dose for six more months. Ideally, as a young woman, you would use the progesterone cream only during the months you need it, and encourage your body to return to its own normal hormonal rhythms as much as possible. Some women with many damaged follicles may always need to supplement with a little bit of progesterone cream.
Why Haven’t Doctors Figured This Out?
There are several reasons why doctors don’t recognize the role of progesterone deficiency in PCOS. They may not be aware that the hypothalamus responds not only to the rise and fall of estrogen, but also to the rise and fall of progesterone. Since standard tests usually indicate that a woman with PCOS has plenty of estrogen, and she is still having periods, the doctor assumes she is still ovulating and producing plenty of progesterone.
The odds of a woman having estrogen dominance and progesterone deficiency rise to 50 percent in the female population by age 35, yet doctors rarely measure progesterone concentrations. They may fear giving progesterone because of all the side effects caused by synthetic progestins, and may not be aware that natural progesterone, unlike synthetic progestins, is remarkably free of side effects when given in normal physiologic doses.
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