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A Natural Approach to Polycystic Ovarian Syndrome
Dating back to 1935 when the term polycystic ovaries was first coined, we have come a far way in our knowledge and understanding of this complex female syndrome. It is estimated to occur in 3-12% of women and it incorporates a variety of different symptoms, namely grouped into three categories: 1) androgenic (acne, oily skin, inappropriate facial and body hair growth, and male-pattern baldness), 2) menstrual (anovulatory, irregular periods, infertility, and multiple cysts on the ovaries), and 3) metabolic (blood sugar swings and obesity). It is typical for those with PCOS to have higher testosterone levels, insulin resistance, and blood sugar irregularities. For those suspecting PCOS, their doctor should test pituitary hormones like FSH and LH as well as progesterone, estrogen, testosterone, and a cholesterol panel. Generally an ovarian ultrasound confirms diagnosis, although a lack of cysts does not necessarily rule out PCOS as these can come and go.
Diet and Lifestyle Changes for PCOS The foundation for any disease is a healthy diet and lifestyle with effective stress-management techniques, and with those who have PCOS these basics cannot be over-emphasized. Because the mechanism of insulin-resistance in PCOS patients is thought to involve a defect that happens after insulin binds to the cell, the main focus of a PCOS diet is a low-glycemic load to correct insulin resistance. By keeping refined carbohydrates reduced and heavily focusing on vegetables, berries, high-fiber foods such as whole-grains and legumes, nuts and seeds, and clean, lean protein such as wild salmon and free-range poultry, blood sugar stability and weight loss will occur. Diet and exercise are first-line approaches to treatment with PCOS, therefore it is not surprising that the effects of exercise on PCOS have been studied and documented. The take-home message of a recent systematic review was that moderate intensity exercise in those with PCOS decreases insulin resistance, promotes weight loss, and improves ovulation. Based on the available evidence, it would be in the best interest of those with PCOS to build an exercise routine into their weekly schedule – forty minutes per day, at least five days a week – incorporating resistance exercises, aerobic training and stretching.
D-chiro-inositol Holds Promise for PCOS A promising steroisomer of inositol called D-chiro-inositol has been shown in women with PCOS to decrease serum testosterone by 55% (p=0.006), improve insulin resistance (p=0.07), and significantly promote ovulation compared to a placebo group (86% vs. 27%)3. D-chiro-inositol is found in small concentrations in certain foods and in our body. It appears to mediate the insulin-resistance signalling pathway involved in PCOS. Although it is not yet widely available in commercial supplements, a similar compound called D-pinitol that appears to convert to D-chiro-inositol in the body has similar benefits and may also be used. Another option is to seek out foods that are the highest in D-chiro-inositol such as lecithin from soybeans and egg yolks, chick peas, brown rice and wheat germ.
Helpful Herbs for Treatment Herbs also play a valuable role in the treatment of PCOS. One major goal of herbal therapy would be to increase sex-hormone binding globulin (SHBG), a protein in the blood which binds excess androgenic hormones such as testosterone. Herbs that increase SHBG include nettle root (Urtica dioica), green tea, soy and flax seeds. In addition, licorice root (Glycyrrhiza glabra) reduces serum testosterone and saw palmetto (Serenoa repens) can inhibit the conversion of testosterone into its more potent form, dihydrotestosterone. Even though PCOS is a very complex health condition, our knowledge and understanding has grown exponentially since it was first discovered. Those with PCOS should be comforted to know there are an assortment of different natural treatments protocols that are effect at reducing or fully eliminating the symptoms associated with PCOS. References: 1) Diamanti-Kandarakis E, Papavassiliou AG. Molecular mechanisms of insulin resistance in polycystic ovary syndrome. Trends in Molecular Medicine 2006 2) Harrison CL, Lombard CB, Moran LJ, Teede HJ. Exercise therapy in polycystic ovary syndrome: a systematic review. Human Reproduction Update 2010 3) Nestler JE et al. Ovulatory and metabolic effects of d-chiro-inositol in the polycystic ovary syndrome. New Eng J of Med 1999 4) Gaby, AR. (2011). Nutritional Medicine. Concord, NH: Fritz Perlberg Publishing. 5) Infertility Workshop. Understanding D Chiro Inositol. Retrieved June 20, 2014, from http://infertilityworkshop.com/blog/understanding-d-chiro-inositol/ 6) Armanini D et al. Licorice reduces serum testosterone in healthy women. Steroids 2004 7) Hudson, T. (2008). Women’s Encyclopedia of Natural Medicine. New York: McGraw-Hill.
Sacha Elliott, ND has a family practice in North Vancouver, BC at Canopy Integrated Health. She focuses on motivating, educating and empowering her patients to create balance in their physical, mental and emotional health. She treats a variety of health conditions and has a special interest in women’s health and fertility, hormone imbalance, and mental/emotional imbalance. She holds a Bachelor of Arts degree in Psychology from the University of British Columbia and has completed a four year doctorate program at the Boucher Institute of Naturopathic Medicine. www.drsachaelliott.com
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