PCOS is a complex condition that is used to describe a variety of clinical signs and symptoms, as well as biochemical irregularities. 

The three most common features of PCOS include:

1. Anovulation (no periods) or oligo-ovulation (infrequent or irregular periods);
2. Elevated levels of androgens in the blood; and
3. Polycystic ovaries (assessed by ultrasound).

Hormone Imbalances

As with most hormonal conditions, the cascade of events is complex.

Excess Androgen Production

The simplest explanation of hormone imbalance in females with PCOS is that they experience increased androgen (e.g. testosterone) production. Androgen production is natural in both males and females, however, it is the amount and the ‘potency’ of the androgens that can cause imbalance.
In males, androgens are responsible for masculinizing effects (e.g. beard growth, deep voice, balding). Therefore, it makes sense that high androgen levels in females can cause unwanted signs and symptoms (such as facial and upper body hair growth, scalp loss, and a deepening voice).
High amounts of insulin are thought to increase androgen production, as well as elevated production of luteinizing hormone (LH). An imbalance between LH and FSH (Follicle Stimulating Hormone) is what causes anovulation (no periods) and cysts to be formed on the ovaries.

High Oestrogen Levels

Androgens can also convert to oestrogens in the body, which is why women with PCOS may also have high oestrogen levels (sometimes referred to as oestrogen dominance). As with other hormones, oestrogen at high levels tends to cause unwanted signs and symptoms. 

Insulin Resistance & Excess Weight

Insulin is a hormone that is produced in the pancreas, and is released into the blood stream after food is consumed. Its main job is to move glucose (from the food) into cells to be used as energy. Insulin resistance occurs when the body produces insulin, but the insulin does not work efficiently. The body then tries to compensate by making more insulin, causing elevated insulin production.
Insulin resistance is commonly seen in females with PCOS. Whilst insulin resistance is often associated with excess weight, it is also seen in patients of normal weight. Elevated insulin levels have been shown to be a major contributing factor to the hormone irregularities that lead to PCOS.

Excess Cortisol (Stress!)

Again and again, practitioners see stress as a major contributing factor to illness and disease. Cortisol is the main stress hormone produced in the adrenal glands. Women with PCOS are often found to have higher cortisol levels. In women with amenorrhoea or menstrual irregularities, when cortisol levels return to normal, so does the menstrual cycle. Therefore, stress reduction and stress management may play an important role in the management of PCOS.

Altered Hormone Metabolism

It’s not just the levels of hormones that can cause and exacerbate PCOS, but also how the hormones are metabolised. For example, when androgens are metabolised, they can be formed into “less androgenic” metabolites or ‘”more androgenic” metabolites. PCOS patients generally favour the “more androgenic” metabolites.
Impaired metabolism of oestrogen and cortisol can also contribute to the exacerbation of PCOS.

Naturopathic Treatment of PCOS

1. Hormone Testing – As you’ve probably learned, hormones are complex! Testing for hormones is the only way to reliably measure hormones and enables our Naturopaths to make accurate treatment decisions that are specific to the individual. There are a variety of options available including blood hormone testing, saliva and urine. Read more about our Pathology testing here. Discover why we measure hormones through saliva and blood. 
2. Addressing the Underlying Causes – As we explained, insulin resistance, excess weight, and stress can be major contributing factors to the hormone imbalances evident in PCOS. Therefore, dietary and lifestyle changes are an imperative basis to PCOS management and treatment.
3. Nutrition – A natural and whole foods diet is key to the management of any chronic disease, including PCOS. Certain nutrients are particularly important for hormone health including Vitamin D, healthy fats, zinc, and protein. A high sugar diet should also be avoided due to the effects this has on insulin production.
4. Herbal Medicine – Herbs are well-known for their beneficial impact on balancing hormones and reducing insulin resistance.
5. Supporting Detoxification Systems – In any condition where there is an over-production of hormones, metabolism and clearance of hormones from the body becomes essential. This will involve supporting the digestive tract and the liver.
6. Lifestyle – Stress management and exercise help to support healthy hormone balance.

If you experience one or more of the following symptoms, our practitioners can assist you in finding the underlying cause and addressing this through natural treatment therapies:

• Irregular menstrual cycles – menstruation may be less or more frequent due to less frequent ovulation (production of an egg)
• Amenorrhoea (no periods)
• Hirsutism (excessive hair growth) and acne – due to increased androgens
• Scalp hair loss – due to increased androgens
• Reduced fertility – difficulty falling pregnant
• Mood changes – including anxiety and depression
• Insulin resistance, central adiposity (excess fat around the abdomen), overweight, and/or obesity

Our practitioners are qualified and confident in addressing hormone imbalances and associated conditions, such as PCOS. We are happy to work with other health practitioners (such as GPs, Acupuncturists, etc.) to achieve the best possible health outcomes for our patients.