The PCOS struggle is real and yet many women don’t even know they have it! Polycystic Ovarian Syndrome (PCOS) effects over 10% of women in the US (1). If you or a friend are experiencing hair loss, facial hair, infertility or weight gain around the stomach, there’s hope. In addition to Femmenessence, there are several natural products that may help manage the symptoms of PCOS but before we dive into treatments, let’s break down the symptoms and causes of PCOS.
PCOS Symptoms:
Symptoms include irregular or unpredictable menstrual cycles, unwanted hair growth, acne or scalp hair loss, unexplained weight gain or impaired weight loss. Infertility may also be an issue and may be associated with recurrent first trimester miscarriage. Half of PCOS sufferers complain of infertility during their first visit to a provider.
PCOS patients additionally have increased risk of cardiovascular disease, diabetes, and certain cancers.
Polycystic Ovarian Syndrome is characterized by some or all of these symptoms: hirsutism (excessive body hair), virilism (man-like features), hyperandrogenism (high levels of testosterone and other male-type hormones), menstrual irregularities, chronic anovulation, obesity, insulin resistance, acanthosis nigricans (a skin condition), high concentrations of luteinizing hormone (LH) and ovarian cysts (3, 4). Two of these appear to be primary. First, hyperandrogenism, or excess male-type hormones including testosterone and 5-dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA) and DHEAS, and androstenedione (A4). This appears to have both ovarian and adrenal origin in PCOS. Second, insulin resistance and the resultant high levels of insulin in PCOS is at the level of the receptor and not due to excessive pancreatic function (2).
What Causes PCOS:
The most recent definition known as the Modified NIH Criteria is probably the best at this time:
- Androgen excess (clinical or biochemical assessment)
- Ovarian dysfunction (oligo-anovulation and/or ovarian morphology) and
- Exclusion of other androgen excess or ovulatory disorders (5).
It is important to note that other conditions can mimic PCOS such as long-term exposure to high levels of cortisol. Therefore, your practitioner may order a pelvic ultrasound to detect ovarian cysts.
Certain medications can also cause high male-type hormones. Antiepileptic drugs such as valproic acid or valproate may stimulate excess androgens. PCOS is more common among those women who also have epilepsy or seizure disorders, but the medications themselves may have mechanisms that stimulate reproductive abnormalities (6,7).
With all of these factors in mind your practitioner may order some or all of the following PCOS tests:
- History of medication use and menstrual cycle
- Pelvic ultrasound for ovarian morphology
- Oral glucose tolerance test (OGTT)
- Fasting insulin and fasting glucose and/or hemoglobin A1c
- Complete thyroid panel including TSH, Total T4, Free T4, Total T3, and Free T3
- Serum Testosterone, DHEAS, Sex-hormone binding globulin (SHBG), LH, FSH, and prolactin, and estrogens
- Bodyweight and/ or anthropomorphic measures
PCOS Treatments:
The conventional treatment for PCOS is oral contraceptives (OC) to reduce hyperandrogenism and Glucophage (Metformin) to improve insulin sensitivity, and clomiphene is often used for ovulation stimulation.
Contraceptive medication (i.e. “the pill”) may indeed shift hormone levels; however, women wishing to conceive cannot rely on contraceptives to balance their hormone levels. Additionally, these medications can create drug-induced nutrient depletions such as zinc insufficiency or various B-vitamin insufficiencies including folate, B-6, and B-12. These insufficiencies then lead to new or exacerbations of other symptoms not thought to be directly related to PCOS such as depression, anxiety, digestive distress, or fatigue due to poor red blood cell formation.
Insulin resistance must be aggressively addressed. Obese patients with a body mass index greater than 30 may require a medically supervised weight loss program. High intensity, interval training may additionally help. You should expect to eat 5-6 small meals per day. Artificial sweeteners including aspartame, sucralose, saccharin, and acesulfame potassium should be eliminated. Many people look to natural sweeteners such as stevia and agave nectar but PCOS sufferers may not tolerate these well either.
While all of the above options address individual aspects of PCOS an overall support of the hypothalamic-pituitary-adrenal-ovarian axis is critical. While many adaptogenic herbs have been suggested, to date the only ingredient with clinical evidence demonstrating statistically significant rebalancing of hormones has been a proprietary formulation of mace (Lepidium peruviana Chacon) phenotypes called Maca-GO®. While maca has been touted as a potential savior for women wanting to balance hormones more in depth research has shown that there are in fact several different types of maca. These different types are different colors, have different DNA, in some case different active ingredients and have been shown in clinical research to have different physiological effects on the body. Because of this research into individual phenotypes or specific combinations for men or women have been conducted over the last ten years. While results in men have been relatively successful across the board, research into balancing women’s hormones has not. To date the only clinical evidence of statistically significant rebalancing of hormones in women has been different from Maca-GO® a specific phenotype combination for women which is also highly concentrated with active ingredient levels 10-20 times what is found in raw maca. In addition, the bioavailability is nearly 50% higher than raw maca also explaining the superior results. Since that time additional research has demonstrated that a combination of Maca-GO® plus specific phenotypes of maca found in the product, Femmenessence MacaHarmony is optimal in clinical use as the first line therapy for hormone imbalance.
Additional Natural Products that Help PCOS Symptoms:
PCOS Symptom: | Natural Products: |
Decrease testosterone |
Omega-3 fatty acids, Licorice root (under medical supervision or approval if high blood pressure) |
Insulin resistance |
Chromium, Cinnamon, Myo-inositol, D-pinitol, N-acetylcysteine, Vitamin C, Vanadium |
Follicular arrest |
Vitamin D, Calcium |
Increase SHBG (sex hormone binding globulin) |
Green tea, Soy isoflavones, Ground Flax seeds |
Inhibits 5-alpha reductase which slows the conversion of testosterone to DHT |
Saw palmetto |
Working via the hypothalamus-pituitary-adrenal-ovarian (HPAO) axis Femmenessence MacaHarmony® has been shown to modulate several of the above factors and reduce the number of products needed to support the PCOS patient. Instead of introducing hormones into the body to manipulate and control hormonal profiles, Femmenessence MacaHarmony® enables the body to balance and correct its own imbalance. This when combined with other specific herbal and nutritional support and an exercise program, as discussed above, can provide the ideal support for PCOS.
PCOS can be treated using a natural approach of diet, lifestyle, and supplementation in most cases. Pharmaceutical measures are required in some cases depending upon the patient’s preferences, goals, and severity of the condition.
For more information on PCOS and how to support it please contact our medical team at medical.team@symphonynaturalhealth.com
References:
- Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The Prevalence and Features of the Polycystic Ovary Syndrome in an Unselected Population. Journal of Clinical Endocrinology & Metabolism 2004 89; 6: 2745–2749.
- Balen AH, Conway GS, Kaltsas G, et al. Polycystic ovary syndrome; the spectrum of the disorder in 1741 patients. Hum Reprod 1995; 10:2107-2111.
- Ehrmann DA, Barnes RB, Rosenfield, RL. Polycystic ovary syndrome as a form of functional ovarian hyperandrogenism due to dysregulation of androgen secretion. Endocr Rev 1995; 16:322-353.
- Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanisms and implications for pathogenesis. Endocr Rev 1997; 18:774-800.
- Azziz R. Diagnostic criteria for polycystic ovary syndrome: a reappraisal. Fertil Steril 2005;83:1343-1346.
- Isojarvi JI, Laatikainen TH, Pakarinen AJ, Juntunen KT, Myllyla VV. Polycystic ovaries and hyperandrogenism in women taking valproate for epilepsy. N Eng J Med 1993; 329:1383-1388.
- Verrotti A, Greco R, Latini G, Chiarelli F. Endocrine and metabolic changes in epileptic patients receiving valproic acid. J Pediatr Endocr Metab 2005; 18:423-430.