The Four Drivers of PCOS (and natural treatments)
Polycystic Ovarian Syndrome (PCOS) is a condition of high androgen hormones (like testosterone), where all other reasons for high androgen hormones have been ruled out.
The high levels of androgen hormones cause the symptoms of PCOS, such as cystic acne, irregular menstrual cycles, difficulty getting pregnant, weight gain, and excess facial hair growth.
In order to treat your PCOS you need to address your driver of PCOS.
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Before moving on, ask yourself, “Are you sure you have PCOS?”
CLUE: If you DON’T have high androgen hormones (like testosterone) on a blood test, and you DON’T have significant acne and/or facial hair growth, then you DON’T have PCOS. This is true even if your periods are irregular, if you struggle with your weight, or if you have polycystic ovaries (as seen on an ultrasound).
See my post for Are you sure it’s PCOS?
Ok, if you are sure you have PCOS, the next step toward balanced hormones is to find what DRIVES it.
THE 4 DRIVERS OF PCOS:
Insulin-Resistant PCOS
Most cases (up to 70%) of PCOS are driven by insulin resistance or high insulin levels. If your insulin levels are high, your ovaries produce high levels of androgen hormones that drive the symptoms of PCOS.
If your insulin levels are high, you have insulin-resistant PCOS. To test for high insulin levels you’ll need to ask your Doctor or Registered Naturopath to investigate your Fasted Insulin or HOMA-IR score in a blood test. Doctors often routinely check for HbA1c or glucose levels, but these are not accurate enough to examine for Insulin-Resistant PCOS.
Natural treatments for Insulin-Resistant PCOS include exercising regularly, eating a blood sugar-balancing diet, and supplementing with nutrients such as myoinositol, magnesium, chromium and/or berberine.
Post-pill PCOS
It is increasingly common to experience a temporary increase in androgen hormones once you stop taking certain birth control pills (such as Yasmin, Yaz, Diane, or Brenda). This typically happens for 3-12 months after coming off The Pill and is often temporary.
If you have been given a diagnosis of PCOS after coming off The Pill, and are not insulin-resistance, then you have Post-pill PCOS.
Some great natural solutions to treating Post-pill PCOS are to 1) wait it out. Know that it's temporary, and 2) take natural supplements such as Zinc, DIM, Spearmint Tea, and/or Peony & Licorice to block the temporary increase in androgen hormones. Read my post on “How to treat post-pill Acne”.
Inflammatory PCOS
When a body is experiencing chronic inflammation, the ovaries produce more testosterone.
If you have not recently come off The Pill, are not insulin resistant but have chronic inflammation, then you have Inflammatory PCOS.
Evidence-based natural treatment options for Inflammatory PCOS include finding the reason for the inflammation and correcting that. Some clues that you might have chronic inflammation lie in unexplained gut issues, unexplained fatigue, joint pain, headaches, autoimmune disease, or chronic skin issues like psoriasis or eczema. Supplements like NAC and Zinc can be helpful here.
Adrenal PCOS
When you only produce excess androgen hormones from the adrenal glands, but normal amounts from the ovaries, then you’re dealing with Adrenal PCOS. The adrenal androgen hormone is called DHEA-s and is often accompanied by high cortisol levels. This driver of PCOS accounts for 20-30% of cases.
Evidence-based natural treatment options for Adrenal PCOS include managing your stress levels and supplementing with good-quality Magnesium, adaptogenic herbs and/or B5 (pantothenic acid).
Still unsure? Fair enough!
PCOS is a complex hormonal condition. If you don’t neatly fit into just one of these PCOS categories, you’ll likely be an intricate combination of 2, 3, or all 4. Working with your Registered Nutritionist or Naturopath can help you find which driver to focus on first, to make the most improvement to your health. When holistically treating PCOS, getting the appropriate blood tests, nutrition plan and supplements is A MUST.
Book a FREE 15-minute phone call with me to get started on finding the root cause of your PCOS.
This blog was written by Tayla Wiehahn - A registered Naturopath & Nutritionist (NMHNZ).
