Polycystic Ovarian Syndrome is the most common endocrine disorder for women in their 20s, 30s, and 40s. It impacts up to 10% of American women before menopause.
That is an incredible statistic!
So why isn't it discussed more? Part of the reason is that as a syndrome, it's not very well understood. PCSO is a combination of complex hormonal and metabolic imbalances resulting in excess testosterone in the body. This excess testosterone then impairs ovulation (resulting in cysts), and is associated with blood sugar imbalances, cardiovascular disease, fertility challenges, difficulty losing weight, mood swings, and troubling hair and skin changes.
Standard medical approach to treatment typically includes oral contraception (OCPs) to raise estrogen, and reduce upstream precursor hormones of testosterone. It is effective at reducing risks associated with lack of ovulation, and can help many women with certain PCOS related symptoms. But what about women who don't tolerate OCPs, who a aren't getting sufficient relief from OCPs, or who would like to focus on root cause healing?
Prior to my training as a Functional Medicine PA, I began my healthcare journey in Traditional Chinese Medicine. Many patients in my women's health practice came for PCOS and saw great benefit. They were treated with acupuncture and Chinese Herbs. The herbs have profound impact on regulating hormones and supporting pelvic blood circulation. The acupuncture supported sex hormone balance, while strongly regulating stress hormones in the body. Chinese Medicine has a special place in my heart, but required weekly acupuncture treatments, which was not always possible for my patients.
Fast forward to today, and I typically work with PCOS from the functional medicine angle. This approach prioritizes whole-body healing. Key tenants of working with PCOS include:
Diet as a tool to reduce blood sugar imbalances and insulin resistance (a key component of PCOS, which unchecked, results in elevated androgens and downstream metabolic disease)
Lifestyle modifications to reduce inflammation in the body (which otherwise further encourages hormone imbalance)
Regulation of testosterone, estrogen, testosterone, and cortisol with botanicals and supplements to reduce symptoms, restore the menstrual cycle, improve hormone balance, restore insulin sensitivity, and promote optimal fertility (when desired).
As a first step for women looking to heal PCOS, I recommend the following self-care steps:
Pay attention to how you feel after simple carbohydrates. If you have energy or mood dips and swings, this is often a sign you do not tolerate this type of nourishment. Instead, focus on eating complex carbohydrates that are naturally loaded with fiber.
Play with eliminating foods that tend to cause inflammation in the body. Common culprits are gluten, dairy, sugar, and processed foods. Elimination diets can be helpful to get clear on what foods don't work for your body. However, it's also reasonable to start with a simple food journal. If you ever notice a flare up in acne, a sleepless night, a bought of stomach cramps, or worsening mood or PMS, write down all the foods you were eating the 2-3 days before, and see where the connections might lie.
Prioritize sleep and boundaries. Inadequate sleep and poor boundaries are the two greatest culprits for cortisol imbalance from what I've seen in all my years in practice. Cortisol imbalance directly impacts sex hormone production, and blood sugar regulation. If you find yourself regularly stressed, saying yes to things you truly want to say NO to, often tired throughout the day and maybe even wired at night, struggling with extra weight around your mid-section, and teetering on burnout, these are non-negotiable. Functional medicine has tools to help balance stress hormones, but ultimately, if sleep and boundaries aren't top of mind, there can be no lasting adrenal healing.
Move your body- but not too much. Exercise is a foundational tool to balance cortisol, insulin, and even sex hormones. It supports detoxification, improves pelvic blood flow, and regulates metabolism. A general rule of thumb is to move your body more than half the week, for at least 40 minutes. If you are wondering if you might be exercising too much, a great question to ask yourself is: how do I feel after I workout? If you require significant recovery time, or find yourself fatigued, that is too much for your body at this time, and shifting you away from hormone balance.
These self care techniques may seem simple, but often the simplest things can be the most difficult at first. For women with modest hormonal imbalance, they may actually be sufficient to reverse hormone dysregulation associated with PCOS. For women with significant PCOS symptoms, they are the foundation of self-care for healing.
Interested in a deeper dive into the physiology of PCOS? Take a look at my new Micro Course on the topic!
Functional medicine tools to support PCOS are vast, and an individualized approach is helpful to propel you towards better understanding how to find your own hormonal balance and healing. If you're ready for more individualized support, schedule a discovery call to learn more about how functional medicine can support you.