PCOS - Polycystic Ovary Syndrome
What is Polycystic Ovary Syndrome (PCOS)?
Polycystic Ovary Syndrome (PCOS) is a condition that is very treatable through natural therapy such as diet, exercise, acupuncture, and Chinese herbal medicine. These treatments restore hormonal balance and ovulation while improving the environment for proper egg growth resulting in increased egg quality and likelihood of pregnancy and live birth. If you are considering getting pregnant or attempting In Vitro Fertilization (IVF) it is important to consider the value of regulating your reproductive system and whole-being before this occurs.
PCOS is an ovulatory disorder that tends to involve many aspects of the endocrine glands including the pancreas, ovaries, adrenals, thyroid, hypothalamus, and pituitary. These glands are responsible for optimal functioning and balance of a woman’s reproductive hormones.
This is why a holistic approach to overcoming PCOS is necessary. Strong commitment to lifestyle changes, regular exercise, recommended dietary guidelines and supplements, electro acupuncture, Chinese herbal medicine, avoiding toxins, administering self-treatment and cycle monitoring at home, removing obstacles in life that may sabotage success, and nourishing the spiritual side of life drastically increases a PCO woman’s chances of restoring health and balance to her reproductive system and overall well-being, which significantly increases the rates of regular ovulation, pregnancy, and live birth. 6-12 months of treatment is often required. Ideally after 3 normal cycles, hormones are balanced, ovarian environment is improved, and healthy eggs and pregnancy is much more likely.
What are the signs & symptoms?
Women with PCOS often present with vascular disorders, glucose intolerance, insulin resistance (when cells get resistant to insulin the pancreas reacts by making more, therefore more insulin is in the blood. More insulin in the blood causes the ovary to manufacture androgens. Follicles shrink due to lack of hormone balance and proper nourishment. The insulin resistance contributes to obesity and increases chances of developing diabetes), anovulation (no ovulation) resulting in erratic long or absent menstrual cycles with either heavy or light bleeding, excess androgens (male hormones), thick skin (esp behind the neck), increased hair growth (esp facial and below umbilicus), centralized obesity or increased fat stores around lower abdomen, loss of head hair, acne, have difficulty losing weight, and some women are actually very thin and lack secondary sex characteristics and live a very ‘type A’ lifestyle. The ovaries can display multiple small follicles which is where the syndrome’s name came from (these are actually cysts, not functioning follicles). These cysts never grow to regular size or produce mature eggs that will ovulate. This is caused by an excess production of androgens by the cysts and connective tissues on the ovary. These androgens (male hormones) enter the bloodstream and disturb normal reproductive hormone function. Estrogens also tend to increase out of proportion to other reproductive hormones. This causes an increase in Luteinizing hormone (why ovulation strips always test positive) and again compounds the production and excess of androgens such as DHEA and testosterone. These ovaries are often larger in physical size than usual and have a shiny white coating covering the surface. The quality of the egg, the follicular fluid (fluid that surrounds the egg), and the endometrium is also affected. The uterine lining will thicken in response to the high estrogen levels, becoming too thick and not being properly offset by adequate amounts of progesterone, which make conditions for implantation poor. This poor ovarian environment which produces poor quality eggs contributes to unhealthy pregnancies (i.e. gestational diabetes) and increased rates of miscarriage. When ovulation does occur, it is usually later in the menstrual cycle.
The Basics of The 10 Step PCOS Natural Treatment Program
Set out specific 1. goals, so we can monitor progress. These would always relate to the Chief Complaint and the top 3-5 changes in lifestyle or key signs and symptoms that when balanced/augmented will facilitate the manifestation of regulated cycles, reduced associated symptoms, or pregnancy and family. Ideally, our main goal is to see three healthy regular menstrual cycles before trying to conceive. When the recommended plan and lifestyle changes are deeply committed to, three healthy regular menstrual cycles and pregnancy are often achieved within a 6-12 month treatment period. Additional & more specific treatment goals are most often to get more quality sleep, reduce stress, lose weight, regulate blood sugar/insulin levels, reduce levels of circulating androgens, estrogens, & luteinizing hormone, manage acne, eliminate excess hair growth, promote regular ovulation & cycles, optimize overall reproductive health, reduce chances of miscarriage and aid in carrying pregnancy to term. Continued evaluation of treatment efficacy is achieved via observation and improvement of these goals and specific signs & symptoms associated to each individual case.
The remaining 9 steps (the 'how');
2. Electro-Acupuncture is administered once per week until the 12th week of pregnancy. According to current research on PCOS, electro-acupuncture helps induce regular ovulation in more than one third of women with PCOS. The patient population within this demographic which acupuncture has the greatest effect had a less androgenic hormonal profile before treatment and a less pronounced metabolic disturbance. For these women, electro-acupuncture offers an alternative to pharmacological ovulation induction. Because chances of miscarriage are higher in women with PCOS, it is also recommended that your husband receive acupuncture and/or herbal treatment to help optimize his sperm and reduce its role in the possibility of pregnancy loss.
3. Chinese herbal medicine will commence immediately and continue in conjunction with acupuncture until the 12th week of pregnancy, or, begin post mediclear dietary cleanse and continue in conjunction with acupuncture until the 12th week of pregnancy.
4. Supplements recommended are various combinations of the following;
- Mediclear Plus cleanse (Thorne) - an anti-inflammatory dietary cleanse to help understand sensitivities and optimize liver function and hormonal balance.
- Vitamin D - for general overall health and immune function, especially in our dark and rainy winters (full monograph)
- CoQ10 Q-Best- preliminary studies show CoQ10 improving egg quality, as well as being a powerful antioxidant (full monograph).
- Fish oil Pro EPA - regulates inflammation, promotes circulation, and delivers required fats for the proper production of sex hormones (full monograph).
- Prenatal multivitamin - essential nutrients and folic acid to prepare for and maintain a healthy pregnancy.
- Homocysteine B6, folate, B12 - women with PCOS have high homocysteine levels. B6, folate, & B12 convert homocysteine into a non-toxic substance and may help reduce the chances of miscarriage.
- Calcium D-glucarate - aid the liver in the elimination of excess estrogens manufactured from excess adipose tissue (full monograph).
- Inositol - myoinositol has been shown to restore regular ovulation, lower insulin, and decrease androgens (full monograph)
- Chromium Picolinate - evidence shows chromium can lower blood glucose and insulin levels (full monograph)
- N-Acetyl Cysteine CystePlus- lower insulin, glucose, and androgen levels (full monograph)
***All supplements available for purchase at Yinstill Reproductive Wellness. For full information on each please visit our website. *Supplements for the male partner will also be recommended.
5. Self-treatment & monitoring of cycle
- ***Stressors: Homework. Please create a detailed list of stressors in your life. Include everything both significant and minute. Bring this list with you to your next appointment. From here we can determine which stressors you have control over and which you do not, then proceed accordingly and develop a management plan.
- Posture: as per images and discussion. Remember to incorporate this into your life, eventually it will become instinct and your body will be reprogrammed resulting in better health.
- Disconnect and reconnect: leave all mobile tech devices at home, leave the home or office, and go out into nature.
- Castor oil packs &/or femoral massage is recommended daily from cycle day 3 until ovulation (click here for full instructions)
- incorporating hot foot baths before bed (click here for full instructions).
- Get enough quality sleep, this may be the most important single thing you can do to increase your fertility potential.
- BBT charting, Ovulation strips, observation of cervical mucous is highly recommended (temperature charts and ovulation strip use instructions available here).
- Recommended reading: The Infertility Cure by Randine Lewis (available for borrowing at Yinstill).
6. Other treatment therapy
- reproductive health counselling (Holly Yager)
- integrative life coaching to be sure self-sabotage is not playing a role in the fulfillment of your dreams (Thomas Kevin Dolan)
- massage / cranio-sacral therapy to ensure unimpeded flow to reproductive organs (Natalie Woodhouse)
- chiropractor to evaluate physical structure (Dr. Stephanie Bonn).
7. Diet & nutrition. This is an important area to focus on. Losing just a small amount of weight and exercising regularly helps restore fertility in most women with PCOS.
- A primarily whole food high fiber, paleolithic, low glycemic, diet (http://www.glycemicindex.com) focusing on reducing portions if necessary is of utmost importance when optimizing fertility and restoring hormone balance.
- Ask your practitioner whether how much raw food is right for your body type.
Include cruciferous vegetables of the Brassica genus. Some of these vegetables include broccoli, Brussels sprouts, cabbage, collards, cauliflower, kale, kohlrabi, mustard greens, rapeseed, and root vegetables such as turnips and rutabagas. These foods help the liver detoxify and restore hormonal balance.
- Eliminate foods that may be causing inflammation and candida. Start by eliminating gluten, dairy and sugar (especially white refined, glucose-fructose, or high fructose corn syrup). Consider doing an anti-inflammatory dietary cleanse such as Mediclear Plus by Thorne Research. This is an ‘elimination-reintroduction’ style of cleanse which can help determine foods you may be sensitive or allergic to, i.e. the foods that are causing problems.
- Emphasize: dark leafy greens (spinach, kale, collards), complex carbohydrates high in fiber such as non-starchy veggies, small servings of whole grains (with cold pressed extra virgin olive oil sprinkled on top), lean meats/poultry or seafood (crab, mussels, clams), and organ meats, fresh fruits, bananas, and foods fortified with B12.
- Reduce or eliminate coffee and alcohol intake. These have both been associated with increased risk of miscarriage and elevated homocysteine levels.
- Eat good fats - Good fats are in foods such as fish (salmon, sardines), avocado, nuts, seeds, and olive oil. Bad fats are in foods such as dairy products, meat, cookies, pastries, processed foods, some margarines. Good fats contain omega 3 and omega 6 fatty acids, these are essential and must be obtained from the diet. It is easy to get omega 6 fats, but less easy to get omega 3 as they are mostly in fish. Omega 3 fats have anti-inflammatory effects. You can also get some omega 3 from flaxseed oil or from a mixture of nuts and seeds.
- Local organic foods should always be a focus.
- Drink Spearmint tea to help lower androgen levels.
- Learn to use buckwheat, it is gluten free and high in D-Chiro inositol
- Add apple cider to your daily intake as it helps rid the blood of excess sugars.
- Use extra virgin cold pressed olive oil on your grains or starches to lower the glycemic index.
- High fiber intake aids the body in eliminating excess hormones and helps manage blood sugar levels.
- ELIMINATE high fructose corn syrup and all its derivatives (also called glucose-fructose in Canada). This man-made sweetener acts differently than regular sugar; 1. it by-passes the body’s normal function of knowing when it has enough food in the gut, 2. it is stored in the liver as triglycerides and fat, 3. it is chemically similar to alcohol so it can damage liver function.
- Ensure the following ‘Dirty Bakers Dozen’ foods are always organic; celery, nectarines, apples, grapes, strawberries, peaches, bell peppers, spinach, cherries, pears, lettuce, potatoes, and ALL animal products.
- Chew food sufficiently.
- Relax when eating.
- Drink enough water.
- Avoid processed foods (shop on the perimeter of your grocery store).
- Add Cinnamon to anything you desire to aid in regulation of blood sugar levels.
8. Avoid toxins in your environment that are known to disrupt hormonal balance which are major contributors to conditions such as PCOS. Basically; avoid or completely eliminate the use of;
- Non-organic animal products (meats, eggs, dairy)
- Excessive consumption (especially non-organic): flaxseed, soy, whole grains, sunflower seeds, fruits, legumes, alfalfa sprouts, pomegranate, fennel, hops (beer), coffee.
- Water that has been stored in a plastic container
- Cleaning agents that contain scent (laundry, body, hair, dish, household)
- Dryer sheets and fabric softeners
- Cosmetic lines that are not completely transparent about their ingredients
- Microwaving food, especially in plastic containers
- domestic and agricultural pesticides
- Phthalates (used to soften plastic).
9. Nurturing your spiritual side is also strongly recommended when attempting to overcome any medical condition. This can look different for everyone. We usually know what works for us in the arena of spiritual nourishment. Be sure to dedicate time in nature, her healing effects are unmatched. Bring more joy into your life, this is the best therapy for managing stress.
10. Physical activity is also paramount when women with PCOS are wishing to restore balance to their menstrual cycle and optimize fertility. We recommend the Yinstill PCOS Exercise Program.
Western biomedicine will usually diagnose PCOS via ultrasound of the ovaries, measurement of waist to hip ratio when centralized obesity is observed, anovulation or long erratic cycles are reported, hair growth on the face and below umbilicus is present, and acne with oils skin is part of a woman’s medical history. Lab tests may include; prolactin, androgens, insulin, and estrogen. Treatment is comprised of clomid with or without metformin, hcg, and IUI. Progesterone may be given periodically to induce bleeding. Drugs like spirolactone is sometime administered for unwanted hair growth. More aggressive treatments include stimulation with gonadotropic medications and In Vitro Fertilization (IVF). Women with PCOS often react well to the gonadotropic injection therapy but pregnancies and term birth rates are not as high.
For those that desire evidence based medicine, clinical trials in Europe and Australia have shown that acupuncture can lower elevated levels of testosterone and luteinizing hormone which inhibit ripening of eggs and ovulation in PCOS patients. Acupuncture also decreases insulin resistance and reduces sympathetic nervous system activity both of which are often abnormally high in PCOS. Working at all these levels, acupuncture can improve ovary function and increase ovulation frequency restoring more regular menstrual cycles. Furthermore, better quality eggs are produced because the damaging effects of high testosterone and LH are ameliorated. One of the problems for PCOS patients doing IVF is poor egg quality. From this point of view creating a better ovarian and follicular environment (ie one lower in testosterone and LH) for the eggs in the few months before an IVF cycle will allow for the possibility of recruitment of better quality eggs when the stimulating drugs are used. Another problem that PCOS patients face when doing IVF is a higher than normal risk of hyperstimulation. Some researchers in China have found that acupuncture during the IVF stimulation reduced this risk.