Polycystic ovary syndrome (PCOS) affects as many as 25% of women. Many women actually have PCOS and do not know it. PCOS is not a disease, but more so a group of signs and symptoms without a clearly defined etiology.
PCOS typically presents physiologically as a combination of hormonal imbalances and metabolic disorder. This may include high levels of androgens (like testosterone and DHEA), dysregulated cortisol, elevated blood sugar, high blood pressure, insulin resistance and abnormal cholesterol.
Sings and symptoms may include infrequent or absent periods, infertility, skin issues, hirsutism (excess growth of hair on the face, chest or back), thinning hair or hair loss from the head, alopecia, pelvic pain, low sex drive, sleep apnea, depression, anxiety and anovulation.
Factors that can contribute to PCOS include stress, overexertion, poor diet, nutrient deficiencies, lack of exercise, environmental toxins, endocrine-disrupting chemicals, obesity and chronic inflammation.
Diagnosis of PCOS would likely include the presence of high androgen hormones and an irregular menstrual cycle absent of ovulation, meaning anything outside of a 21 to 35 day cycle.
An ultrasound is not necessary to diagnose PCOS. What is more relevant are the collection of symptoms than the physical presentation of the ovaries. Technically, PCOS doesn’t even cause cysts, but rather an accumulation of follicles on the ovaries.
Women with these ovarian cysts can have no other PCOS symptoms at all. Conversely, women can have all the symptoms of PCOS with no cysts found on an ovarian ultrasound. The focus for diagnosing PCOS should be on systemic signs and symptoms, not simply an ultrasound.
Treatment of PCOS with a functional medicine approach is much different than a conventional approach. As with everything, functional medicine investigates all systems of the body at a much deeper level to find the root imbalances causing symptomatic presentations.
This includes running a comprehensive functional blood panel, a complete thyroid panel and advanced hormone panel, gastrointestinal testing that includes stool and SIBO breath testing, a full assessment of nutrient levels in the body, food immunology testing, heavy metal and environmental toxin accumulation testing and more based on the individual’s presentation.
Every PCOS patient is different, so identifying and treating the unique root imbalances that are causing symptoms is essential. It’s not a one-size-fits-all approach.
Some general things likely to be addressed include moving onto a nutrient-dense paleo diet with a focus on high-fiber foods, resistant starches and moderate to low carbohydrates; modifying exercise routines to the appropriate levels based on body type; optimizing nutrient levels like magnesium, vitamin D, zinc, B vitamins and anything else found to be deficient; balancing gut health by eliminating overgrowths or pathogens and restoring a healthy microbiome; clearing the body of metals and toxins; balancing hormones with herbs, botanicals and nutraceuticals.
Inositol has also been found to have positive effects in women with PCOS. Inositol can help improve insulin sensitivity and support normal follicle development, both specifically beneficial to a typical PCOS presentation.
More than anything else, stress in life needs to be very seriously addressed. Without doing so, other treatments will only get so far. Decreasing stress is often quickly dismissed as a luxury unavailable to most. Stress has become normalized in modern society, but it is for that same reason it is so detrimental to overall health. It is pervasive, relentless and the underlying cause of almost all disease.
The conventional medicine approach is likely to prescribe synthetic hormones in the form of an oral contraceptive (aka “the pill”) and possibly the antidiabetic pharmaceutical drug metformin. These drugs will only serve to mask symptoms without addressing the underlying dysfunctions presenting as PCOS.
By ignoring the underlying mechanisms causing health issues like high blood sugar, high cholesterol and hormone imbalances, potentially more serious diseases can present down the road that might be far more complicated––if not impossible––to treat.
It’s also worth noting that while the synthetic hormones in oral contraceptives can artificially induce bleeding, this is not the same as having a regular period. Over the long-term, this can have an adverse effect on fertility.
If you’re a woman who plans to have children, at some point you’ll need to move off birth control to do so. When that time comes, fertility could be impaired and hormone levels will almost certainly be dysregulated.
Creating harmony within by naturally balancing and nourishing your body now is the best way to ensure long-lasting health and happiness for yourself and for your future.