PCOS is responsible for 25-30% of infertility for women. Globally, 10 to 20% of all women have PCOS. Yet, it’s a largely unknown condition. Many women haven’t heard of it, until they have trouble getting pregnant. Then if they’re lucky, their medical practitioner figures it out for them. However, after that, the options for treatment aren’t fantastic.
Conventionally, fertility providers give Metformin which improves insulin resistance and ovulation rates. Then, the classic medication Clomid, or clomiphene, is used to improve follicle development and ovulation. Often women do what’s known as a “trigger shot” of hCG or human chorionic growth hormone, once follicles are mature, to make ovulation happen at the right time.
This treatment combination is effective for a certain percentage of women with PCOS. If it’s not, and women continue along a conventional route, they move on to IUI or intrauterine insemination with more powerful ovulation induction agents, or IVF which is in vitro fertilization.
What’s missing with this approach?
When we get patients who are well down the path of assisted fertility, we always wish they had started with us sooner, before the medications and assisted fertility started. Why? Because we find that natural treatment is highly effective in reversing PCOS!
Lots of women learn that diet affects PCOS; however there’s much more in the lifestyle and natural remedy realms that can turn this condition around. We focus on interventions that:
- Heal HPA-D (shorthand for the brain-adrenal axis of communication) – one driver of PCOS we write about here.
- Address inflammation – PCOS is an inflammatory condition.
- Clear toxins – one driver of PCOS is toxic burden from endocrine disruptors in our environment, coupled with poor detox ability.
- Address gastrointestinal microbiota – women with PCOS have disrupted microbiota colonies, compared to women without PCOS.
- Apply specific supplements and herbs – to address the particular drivers and symptoms each woman faces, such as things that help insulin resistance, lower testosterone and DHEA, help estrogen processing or metabolism, increase progesterone, and promote ovulation. There are natural herbs and supplements that help with all of these things!
- Use acupuncture – highly effective to regulate cycles for women with PCOS and improve fertility outcomes.
- Change lifestyle aspects that affect hormone balance, such as how you eat, sleep, feel, exercise, and manage stress.
PCOS is a hormone imbalance that is changeable
Wouldn’t you rather make changes that create hormone balance so that you can conceive naturally without intervention? And in the process, you become healthier overall, which puts you in a better place mentally and physically to become a mother!
What if you don’t know whether or not you have PCOS?
This is so common! You are not alone. In fact, the majority of PCOS women we see with fertility struggles do not know they have PCOS. Their gynecologist or other practitioners haven’t figured it out. This may be because they don’t present the classic symptoms of what we used to think all women with PCOS had: obesity and excessive hair growth. It’s not fun to tell a woman she has PCOS, but it’s important to know.
Many women are of normal weight or thin, and don’t have any excessive hair growth, yet have PCOS. These women tend to slip through the cracks. Blood sugar and insulin dysregulation can still be a factor for women of normal or thin weight, so it’s still important to check it out. But often these women have drivers that are stronger, such as H-PAD, a disrupted gut microbiota, or problems stemming from the endocrine disrupting chemicals in our environment.
If you don’t know whether or not you have PCOS, you can start by taking our quiz, which may help zero in on the likelihood that you have this imbalance. Then, get evaluated. Get an ovarian ultrasound to look for the classic “ring of pearl” cysts around your ovaries, which may be present but is not necessary for diagnosis. The name is relatively misleading because we now know that you can have this hormone imbalance, with or without the presence of polycystic appearing ovaries. Cysts are just one possible manifestation.The best time to look for this is during the follicular phase of your cycle, which is when you are on your period up until you ovulate (cycle day 5-9 is ideal).
In addition, there is important lab work to do. We outline labs in detail here.
what to do once you know you have pcos
So you’ve gotten your assessment and you know that you fall on the PCOS spectrum. What next? We like to discuss your options based on age. Of course the younger you are, the more time there is to reverse this condition and get pregnant naturally. If age is a factor, then it may make more sense to combine natural approaches with assisted fertility medications.
In all cases, we can’t advise highly enough to apply natural approaches. Why? This condition was years in the making, and will be months or years to undo it. It’s not just about getting pregnant, even though that may be your primary goal right now. PCOS increases health risks for you and your developing baby during pregnancy and beyond. These risks are similar to those with gestational diabetes, including increased risk for diabetes, heart disease, stroke, and even cancer and dementia.
Reversing your PCOS before pregnancy is ideal for you and your future baby. Then after pregnancy, prevent PCOS from reoccurring. Once the genetic switch has been turned on for PCOS, you can reverse it, but you will always have greater chances that it will return if you don’t correct the drivers behind it.
What can you do in the natural arenas?
Lifestyle, lifestyle, lifestyle! ACOG (American College of Obstetrics and Gynecology) advises diet and lifestyle as the FIRST-LINE TREATMENT for PCOS.
PCOS has a genetic component like most conditions. However it’s the environment that usually turns it on. The big environmental factors that can flip the switch are diet, toxic exposures, stress, and disrupted gut microbiota. These are all things easily fixed with the right lifestyle changes.
To make it easier for women, we designed the PCOS solution program. You can have fun while we guide through these lifestyle changes step by step. Take advantage of our support team of Functional Medicine practitioners, a health coach, mentor graduates of our program, and a community of peers. Research shows that it’s hard to make lifestyle changes alone, and community support is essential!
Research also shows that breaking down big changes into bite-size steps makes them easier. In our program we provide bite-size daily lessons and action wins, along with cutting-edge techniques to change habits based on behavior science. You’re guided through a six-week program that will address every driver of PCOS. Participants see results with their cycle regularity and ovulation just through doing this lifestyle program.
Beyond the program
Women on a mission to conceive may want some individual support. We offer this as an add-on within our program. You can add on consultations with some of our educational staff, or even become one of our clients or patients. What’s the purpose of doing this? Once you identify your dominant PCOS drivers or root causes, you might want to address them more specifically with lab testing and customized supplement, herb, and hormonal protocols.
Let’s say if you determine during the program that exposure to endocrine disrupting chemicals in our environment is THE root cause and primary driver of your PCOS. You may want to test to find out:
- What your specific toxic exposures are.
- What you’re liver detox capacity is.
Then you can get a customized protocol to both improve your detox ability, as well as clearing out the specific toxins found in your body.
If you determine that a disrupted microbiota is your primary PCOS driver, you may want to test to find out:
- What is disrupted exactly? Is there an overgrowth of undesirable microbes, including bacteria, yeast, or parasites?
- Is there an undergrowth of beneficial microbes that make you lean and process your hormones?
Then you can get a specific protocol for adjusting your microbiota colonies, with diet, herbs, supplements, and potential medications.
But what about getting pregnant with pcos?
You may be thinking that things like environmental toxins and gastrointestinal microbiota are projects that aren’t going to help you get pregnant. However, they will. Whatever your underlying causes or drivers are, addressing them well help you achieve what you want – cycle regulation, ovulation, and conception!
When we get women who come in with the intention of working with their PCOS naturally, with Functional Medicine, lifestyle and nutrition, we typically see these women getting results! We see women with PCOS:
- Address imbalanced gut microbiota and boom! Regulate cycles and get pregnant.
- Deal with HPA-D, feel much better, get cycles back, and get pregnant.
- Work with detoxification and estrogen metabolism, get rid of PMS, develop healthy regular cycles, and get pregnant.
- Reverse insulin resistance, lose weight, start ovulating, and get pregnant.
Why aren’t these approaches given by my doctor?
Polycystic ovarian syndrome has been around for a long time, but it’s been poorly diagnosed and very misunderstood by the medical profession. The number of women affected is rising significantly, so medicine is following, and more providers are aware of the existence of PCOS, and it’s on their radar to assess for it.
However, as is the case with other “syndromes,” the lifestyle factors and the natural treatment is not what you get from your conventional practitioner. Their toolbox is what it is – primarily medications that manage symptoms. In this case, the medications are aimed at getting you pregnant, and once you’re pregnant you’re done with care. Usually you don’t learn anything about the syndrome or the fact that it’s something to deal with beyond simply getting pregnant.
Seeking natural medicine doesn’t always get you the right diagnosis and treatment plan either. Many natural practitioners don’t take a root cause approach. It’s the practitioners, both conventional and unconventional, that train in a root cause Functional Medicine approach, who tend to put these pieces together. So when you seek help for your PCOS in the natural realm, look for practitioners trained in Functional Medicine who specialize in polycystic ovarian syndrome.
Learn more about the PCOS SOLUTION Program.