Polycystic Ovary Syndrome (PCOS)

Guest post by Reilly Edmonds, Osteopathic Medical Student

Reviewed by Ashley Maltz, MD

Polycystic ovary syndrome, also referred to as PCOS, is a common condition affecting the hormones of women of reproductive age. As its name suggests, a woman with PCOS may have multiple cysts in the ovaries. Cysts naturally occur throughout a woman’s menstrual cycle; however, additional cysts occur due to an overstimulated egg follicle. Egg follicles are normally released during ovulation, but if the egg does not get released, it can fill with fluid and form a cyst. The lack of ovulation and release of an egg makes it difficult to become pregnant and is often the cause of infertility in women with PCOS. 

PCOS Symptoms

Polycystic ovaries are just one indicator that a woman may have PCOS but are not necessary for the diagnosis. Other symptoms of PCOS are variable between individuals and may include the following:

• Acne or oily skin
• Heavy, long, intermittent, unpredictable, or absent periods
• Excess hair growth on the face or body (also called hirsutism)
• Infertility
• Male-pattern baldness or hair thinning
• Weight gain, particularly in the abdominal region

The World Health Organization estimates that 8-13% of women of reproductive age experience PCOS, with up to 70% of cases going undiagnosed. The prevalence of PCOS is higher among some ethnicities, as well as in women with a family history of PCOS or type 2 diabetes.

To address PCOS effectively, it’s crucial to understand its root causes and work to alleviate the contributing factors. Studies suggest underlying chronic inflammation leading to insulin resistance may be the contributing factor. This chronic inflammation can cause excessive insulin release in your body, desensitizing the cells that use insulin as a signal to take up glucose for energy. If the body takes up less glucose, this glucose stays in the blood and leads to elevated blood sugar, more inflammation, and weight gain. These imbalances in blood sugar can impact the ovaries, resulting in hormonal imbalances and increased male sex hormone levels.

Managing PCOS

The good news is that PCOS can be managed through diet, lifestyle, and supplements to help regulate hormones and improve fertility.

PCOS Diet

The PCOS diet resembles a diet aimed at controlling blood sugar levels. Some recommendations include:

• Reduce or eliminate gluten, and minimize other processed grains
• Reduce or eliminate dairy
• Get 3-6 cups of vegetables each day
• Include protein and fat at every meal (this helps modulate insulin production)
• Eliminate added sugar as much as possible

Other factors that can help balance hormones include maintaining a healthy gut, stress reduction, exercising, and getting quality sleep. It is important to eat probiotic-rich foods and prebiotic fiber, which include fermented foods and lots of green vegetables respectively. Stress reduction looks different for each person, but you may try to include more mindfulness, breath work, and guided meditation. Breath, by James Nestor, is a book that delves into the art of breathing and how it can help with wellness and stress reduction. 

PCOS Supplements

There are also supplements that may assist your body in reducing insulin resistance and inflammation that lead to hormonal imbalance. These include:

• Curcumin: anti-inflammatory, improves hyperandrogenism, lowers luteinizing hormone (LH), reduces insulin resistance, and induces ovulation in women with PCOS
• Vitamin D: plays a role in glucose metabolism, improves insulin sensitivity, decreasing insulin resistance, and suppresses pro-inflammatory cytokines
• Inositol: lowers insulin resistance, improves reproductive function, improves oocyte quality, and restores ovulation in patients with PCOS
• CoQ10: anti-inflammatory by downregulating expression of genes encoding inflammatory cytokines in PCOS

If you feel you are experiencing symptoms of PCOS, talk with one of our providers who can help you manage your symptoms through an integrative approach.

References:

1. González F. Inflammation in Polycystic Ovary Syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids. 2012 Mar 10;77(4):300-5. doi: 10.1016/j.steroids.2011.12.003. Epub 2011 Dec 8. PMID: 22178787; PMCID: PMC3309040.
2. Kiani AK, Donato K, Dhuli K, Stuppia L, Bertelli M. Dietary supplements for polycystic ovary syndrome. J Prev Med Hyg. 2022 Oct 17;63(2 Suppl 3):E206-E213. doi: 10.15167/2421-4248/jpmh2022.63.2S3.2762. PMID: 36479481; PMCID: PMC9710389.
3. Marshall JC, Dunaif A. Should all women with PCOS be treated for insulin resistance? Fertil Steril. 2012 Jan;97(1):18-22. doi: 10.1016/j.fertnstert.2011.11.036. PMID: 22192137; PMCID: PMC3277302.
4. “Polycystic Ovary Syndrome.” World Health Organization. World Health Organization, n.d. Web. 15 Sept. 2023.
5. Vázquez-Martínez, Edgar Ricardo, et al. “DNA Methylation in the Pathogenesis of Polycystic Ovary Syndrome.” rep. Bioscientifica Ltd, 1 July 2019. Web. 15 Sept. 2023.