Women’s health issues are often marginalized and the research underfunded, and none so much as polycystic ovary syndrome, or PCOS. As many as five million women in the United States are affected by PCOS and it has been estimated that 50 percent of women with the condition go undiagnosed. Some women suffer for years before being diagnosed, and even when diagnosed, treatment is limited.

Considered to be the most common endocrine disorder among women of reproductive age and a leading cause of infertility, PCOS is a condition in which a woman produces abnormally high levels of androgens (typically thought of as male sex hormones), including testosterone, resulting in an imbalance of estrogen and androgens in the body. These hormonal imbalances lead to an irregular or absent menstrual cycle, infertility, weight gain, and can cause cysts to grow on the ovaries, exacerbating the hormonal imbalance and often leading to numerous other health issues. PCOS may also cause unwanted changes in a woman’s appearance such as acne, facial hair, as well as male pattern baldness. If it isn’t treated, it can lead to more serious health problems, including diabetes, high blood pressure, depression and anxiety, and endometrial cancer.

Causes and risk factors for PCOS

PCOS was once regarded solely as a reproductive disorder affecting women of childbearing age, but it is now recognized as a metabolic disorder with a variety of causes and risk factors. Insulin resistance, obesity, chronic inflammation, and exposure to endocrine-disrupting chemicals are all involved in the development of PCOS. One theory worth highlighting is that insulin resistance is a significant contributor to the development of PCOS. Up to 70 percent of women with PCOS have insulin resistance, which leads to elevated levels of insulin in the body, and insulin is known to increase the synthesis of testosterone. Excess androgens, like testosterone, in turn, lead to a further elevation in insulin levels, which then stimulates further androgen synthesis. This vicious cycle results in a “snowball effect,” worsening PCOS symptoms and making sufferers especially susceptible to weight gain and chronic inflammation, conditions that significantly compound the syndrome’s progression.

Dietary and lifestyle changes

Restoring insulin sensitivity is an essential place to start for anyone with PCOS and requires significantly reducing sugar and carbohydrate intake. Focus on filling half your plate with non-starchy vegetables then add a four-ounce serving of quality protein (wild-caught fish, grass-fed beef or bison, organic chicken or pork, free-range eggs, and pasture-based dairy are good choices) and some healthy fat (such as pasture-based butter, organic coconut oil, or organic olive oil) to create a balanced meal. Eating this way at every meal is one of the keys to optimal health and blood sugar balance. 

Exercise helps PCOS by improving insulin sensitivity and increasing metabolism. Exercises like walking, weights, or yoga can all be restorative, but it’s most important that you discover a form of exercise you enjoy doing. Aim to be physically active five days a week for at least 30 minutes a day.

Another important step in managing PCOS is to avoid endocrine-disrupting chemicals, chemicals that mimic hormones or disrupt their normal production and function. These include BPA, commonly found in the linings of food cans (look for BPA-free on labels); phthalates, found in many conventional body care products, plastic wrap, and plastic food storage containers; pesticides used in conventional agriculture; perfluorinated chemicals (PFCs), found in non-stick cookware and water and stain-resistant fabrics; and chemical sunscreens such as oxybenzone.

Supplements That Can Help

These supplements can be taken individually, but work synergistically to address the symptoms of PCOS, so are best taken together. Look for a formula that contains all of them.

D-Chiro Inositol (DCI)

DCHiro is the most promising inositol compound for PCOS. Inositol compounds play an often unappreciated role in insulin signaling. Low levels of DCI have been observed in individuals with impaired insulin sensitivity and PCOS. A study from the Medical College of Virginia found that DCI taken daily had multiple beneficial effects in the treatment of 22 overweight women with hormonal imbalance. Not only did it improve insulin sensitivity, but a significant number of the women saw an improvement in ovulation. Serum androgen and ovarian androgen production also decreased in the group that was supplemented with DCI, suggesting it also helped restore hormonal balance. Try 25 mg daily.

Vitamin D

Several studies have highlighted the link between PCOS and vitamin D status. Researchers from the Medical University of Graz, Austria found that women with higher blood levels of vitamin D were much less likely to be insulin resistant. A study conducted by researchers at Columbia University found that vitamin D combined with calcium supplementation helped normalize menstrual cycles for seven of 13 women with PCOS. Of the seven, two became pregnant and the others maintained normal menstrual cycles. Try 500 IU daily.

Omega-3 Fatty Acids

Because of their strong anti-inflammatory activity, omega-3 fatty acids help improve liver health and cardiovascular health in women with PCOS. In an Australian study, omega-3 fatty acid supplementation reduced liver fat content and other cardiovascular risk factors, including triglycerides, and systolic and diastolic blood pressure in women with PCOS. In particular, researchers found that omega-3 fatty acids were helpful in reducing hepatic fat in PCOS women with hepatic steatosis. Try a fish oil that supplies 1,000 mg of EPA and DHA daily.

Cinnamon

A small study published in the journal Fertility and Sterility showed cinnamon greatly reduced insulin resistance in women with PCOS. This may be due to the fact that unique compounds in cinnamon bark produce a 20-fold increase in sugar metabolism. Achieving this glucose balance is important for women with PCOS. Try 75 mg daily.

Calcium-D-Glucarate

Oral supplementation of calcium-D-glucarate has been shown to inhibit beta-glucuronidase, an enzyme produced by colonic microfl ora and involved in liver detoxifi cation. Elevated beta-glucuronidase activity is associated with an increased health risk involving elevated hormones. Calcium-D-glucarate’s inhibition of beta-glucuronidase activity allows the body to excrete hormones from the bowels before they can become reabsorbed, helping to promote hormonal balance. Try 25 mg daily.

MACA

While maca traditionally acts as an energy-producing herb known for boosting libido and reducing stress, it also contains 50 phytochemicals known for balancing hormone levels. In females with PCOS, maca is believed to help by balancing estrogen levels in the body. Estrogen levels that are either too high or too low can make it di« cult for a woman to ovulate and become pregnant. Therefore, balancing the amount of estrogen that a woman produces, and in turn, the amount of related progesterone produced, is very important for increasing reproductive health, fertility, and decreasing symptoms related to PCOS such as irregular menstrual cycles, excess hair growth, and more. Look for maca that has been pre-cooked, or gelatinized, and try 125 mg daily.

According to Sasha Ottey, Executive Director of PCOS Challenge, Inc, a PCOS support organization, “PCOS is one of the most critical, underserved, under-diagnosed and under-funded conditions affecting women’s health.” While symptoms can vary from woman to woman, you know your body best. If you suffer from PCOS, take charge of your health and try these approaches to manage the disorder naturally.

References available upon request.