Polycystic ovarian syndrome, or PCOS, isn’t just a reproductive disorder. It affects every part of your life – mentally, emotionally, and physically. Perhaps you’ve had to deal with the skipped periods, or maybe facial hair and weight gain. All of it might make you feel as if you’re less feminine or that your body is somehow broken. But your body isn’t broken. And despite what you may have been told, there are many herbs and supplements that can help you manage your symptoms naturally. In this article, I’ll go over 7 of my favorites.
The Types of PCOSBefore we discuss how to manage PCOS, we have to first discuss the different types of PCOS. Four types of PCOS are recognized today, each of which has a different underlying cause.
Insulin-Resistant PCOSInsulin resistance (IR) is highly prevalent among women who have PCOS, with recent estimates suggesting that it affects 35% to 80% of those diagnosed with the condition.1 When a person has IR, her body doesn’t respond to insulin efficiently. Since one of insulin’s main roles is to move glucose from your blood into your cells, an inefficient insulin response means high blood glucose levels and high insulin production. Over time, IR can lead to inflammation, high blood pressure, type 2 diabetes, and other serious health conditions.2 Excess insulin also elevates testosterone, which in turn can inhibit ovulation and sometimes even infertility.3
Inflammatory PCOSChronic inflammation can contribute to excess testosterone, which can lead to many of the symptoms observed in women with PCOS.4 While inflammation is a factor in every type of PCOS, it is the primary driver in inflammatory PCOS. So, what causes inflammation? It can be brought on by a mix of factors, such as environmental toxins, a poor diet, food intolerances, stress, and more.
Adrenal PCOSWomen with this type of PCOS produce more adrenal hormones than normal. This can happen when the adrenal hormones are secreted by the adrenal glands rather than by the ovaries, especially during times of high stress. In one study, researchers also noted that women with adrenal PCOS also had smaller adrenal glands than normal.5 Indicators of adrenal PCOS include:
- High cortisol level
- High dehydroepiandrosterone sulfate (DHEA-S) level without high levels of testosterone and androstenedione
Post-Pill PCOSSome oral contraceptives suppress hormonal signals between your pituitary gland and your ovaries. For many women, the signals return to normal once they stop taking the pills. But for others, the signal doesn’t return as expected. If you have this type of PCOS, you may experience PCOS symptoms that were not present prior to starting the pill. Fortunately, this type of PCOS is temporary – your body just needs time to adjust to the changes in hormones. Support your body with the right nutrition, supplements, and lifestyle changes.
Herbs and Supplements to Help Manage PCOS NaturallyI’m not against conventional medications when they’re necessary. But I don’t believe they address the underlying cause(s) driving this condition. Furthermore, long-term use of these medications can increase your risk of other serious health issues. Here are 7 of my top herbs and supplements for managing PCOS. They’re most effective when used in combination with a healthy diet and lifestyle.
1. VitexVitex (Vitex agnus-castus), also known as chaste tree or chasteberry, is one of the oldest known herbal remedies for female infertility and menstrual disorders.6 Vitex can influence sex hormone levels through the regulation of the pituitary gland, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and progesterone.7 When coupled with the fact that it can also reduce prolactin levels (which interferes with estrogen production), it’s no wonder vitex is a favorite among many women with PCOS.8 In one animal study, vitex was found to reverse the hormonal imbalance of PCOS.9 Another study involving 52 women with luteal phase defects showed that vitex supplementation could help reverse the defects. Two women in the study treated with vitex also got pregnant, suggesting that vitex may also help improve chances of pregnancy.10 Some women with PCOS shouldn’t take vitex if they have elevated LH levels. It should only be used when advised by a qualified naturopath or herbalist who can assess your condition.
2. PeonyPeony (Paeonia lactiflora) is another key herb for treating fertility problems, including PCOS, hyperprolactinemia, and ovarian failure. It has been shown to have a positive effect on low progesterone and elevated androgens.11 Paeoniflorin, an active constituent of peony, acts on aromatase, an enzyme critical for healthy ovarian follicle function. Peony is often used in combination with other herbs. In one study, women with PCOS were treated with a combination of peony and licorice. After just 4 weeks of treatment, their serum testosterone and free testosterone levels had significantly decreased, and some women were successful in achieving pregnancy.12 Another study showed that the same herbal mixture may help induce regular ovulation and pregnancy in women with high androgen levels and irregular periods.13
3. InositolInositol refers to a group of sugar molecules in your body that provide structure to your cells and are involved in cell signaling. Interestingly, they’ve also shown promising results in clinical studies when used to manage PCOS. There are 9 forms of inositol, but the two that are known to have the biggest impacts are myo-inositol (MI) and D-chiro-inositol (DCI). MI-to-DCI (MI:DCI) ratios vary depending on the specific tissue needs. Research has so far shown that healthy ovaries require a high MI:DCI ratio of approximately 100:1.14 In women with PCOS, this ratio is significantly lower at just 0.2:1.15 They also mediate different functions of insulin, including cellular glucose uptake and glycogen synthesis.16 An imbalance in MI:DCI ratio isn’t surprising when we know many women with PCOS have the insulin-resistant type. Research studies have shown that an MI:DCI ratio of 40:1 was best for PCOS therapy to restore ovulation and normal hormone levels.17
4. BerberineBerberine is a bitter-tasting compound found in some plants like European barberry, goldenseal, Oregon grape, goldthread, and tree turmeric. It has a long history of use in traditional Chinese medicine for its antimicrobial, antidiarrheal, and anti-inflammatory properties. Berberine is also known to improve insulin sensitivity and high androgen levels, making it a popular choice for women with insulin-resistant PCOS.18 In one study, researchers compared the effects of berberine to those of metformin in women with PCOS undergoing in vitro fertilization (IVF) treatment. Both treatments improved pregnancy outcomes and normalized metabolic parameters. However, the women who took berberine achieved more live births and had fewer side effects.19 Because berberine increases insulin sensitivity, it may not be appropriate for women who are hypoglycemic or those who take other insulin-lowering medications.
5. Bioidentical ProgesteroneWomen with PCOS tend to have sporadic or absent ovulation, which means their bodies aren’t producing progesterone normally. The lack of progesterone disrupts the balance of other hormones, which results in difficulty getting pregnant. One way to correct this hormonal imbalance is by using bioidentical hormone replacement therapy. Conventional synthetic progesterone therapies were developed to act like progesterone, but they may come with side effects. Bioidentical progesterone is derived from yams or other plant sources and is chemically identical to the progesterone produced by your body. Studies have shown that bioidentical hormones have fewer risks and are more effective than their synthetic counterparts.20
6. Cortisol-Balancing HerbsChronic stress is known to be a critical contributor to PCOS because it can lead to excess androgen production. To help bring down cortisol (the “stress hormone) levels, my go-to supplements are reishi and spearmint tea. One study involving breast cancer patients showed that supplementation with reishi lowered anxiety and depression and improved quality of life.21 Reishi is also known for its potent ability to inhibit testosterone.22 Mentol, a compound in spearmint, promotes relaxation by acting on the GABA receptors in your brain.23 Like reishi, spearmint also has strong anti-androgen effects. In one study, women with PCOS who drank spearmint tea had significantly lower testosterone levels and higher LH and FSH levels after 30 days.24
7. Vitamin DVitamin D deficiency is frequently seen in people with chronic medical conditions, so it may not come as a surprise that it plays a role in PCOS.25 Research has shown that vitamin D support reduces insulin resistance and normalizes testosterone levels in patients with PCOS.26
Manage PCOS With a Women’s Health Specialist in BostonIf you have PCOS, you may feel that you’ve been robbed of your identity as a woman. But more and more experts believe that there was a survival advantage to insulin resistance, high androgen levels, and delayed fertility for our ancestors. Couple this with the fact that there’s mounting evidence of dietary and environmental toxins playing a role in the development of PCOS. It means that PCOS may simply be a mismatch between this “survival advantage” and your environment.27 The good news is that PCOS is manageable with herbs and natural supplements. It’s important to focus on the underlying cause of your specific type of PCOS though, which means you can benefit significantly with the guidance of a woman’s hormone specialist. If you’re looking for a naturopath who specializes in women’s health, I’m available to help. I offer tele-consults as well, so you can start feeling better today regardless of where you are.