By Dr. Chelsea Cole, ND
What is PCOS?
Polycystic ovary syndrome (PCOS) is the most common hormonal disorder that affects women of reproductive age. At this time, there is no clear cause of PCOS, instead it is understood to be a multifaceted disorder with many potential causes. PCOS often involves abnormal production and breakdown of estrogen androgens, like testosterone, insulin resistance, and difficulty regulating fat and glucose breakdown.
How do Naturopath ‘s treat PCOS?
It is important to realize that women experience this syndrome in different ways, which makes it difficult to have one solid treatment choice. However, there are many treatment options depending on a particular woman’s experience of PCOS, and Naturopathic Doctors are able to help navigate the various ways to approach this syndrome. This article will focus on the benefits of diet in the treatment of PCOS.
What are the symptoms of PCOS?
If there are many different causes of PCOS, then it follows that there will be many different symptoms. With that said, menstrual cycle irregularity and physical signs of excess testosterone can be quite common. In particular, infrequent or absent menstruation occur frequently, and are likely due to a lack of ovulation, which can have negative implications for fertility. High levels of androgens can cause excess body hair on the face, hair loss from the scalp and acne. Due to the difficulties with regulating glucose, insulin, and lipids, women with PCOS can struggle with weight gain and obesity. While the name suggests that ovarian cysts are an integral part of the diagnosis, they do not have to be present in order for the diagnosis to be made. Based on these symptoms, women with PCOS are at a higher risk for infertility, type 2 diabetes, and cardiovascular disease.
How is PCOS diagnosed?
The diagnosis of PCOS can often be made without extensive lab testing, however, it is important to undergo some testing to rule out other causes, like thyroid dysfunction. In addition, testing blood glucose levels and cholesterol will evaluate the risk of developing cardiovascular disease and diabetes.
How can addressing the diet help women with PCOS?
Addressing the diet is foundational in managing PCOS. In women with PCOS, diets lower in carbohydrates and sugar improved menstrual cycle irregularity, insulin resistance, and cholesterol levels.[1] In contrast, high carbohydrate diets were associated with higher testosterone levels. Importantly, high protein diets were associated with improved depression and self-esteem, and diets high in healthy fat were helpful for women struggling with weight.[2] Based on this information, it makes sense to work towards a diet that prioritizes good fat and protein, while decreasing the intake of carbohydrates.
Can nutritional supplementation be beneficial for women with PCOS?
It is important to look closely at vitamin and mineral intake, as there are many studies that examine the effects of nutrient supplementation in PCOS. In women with PCOS and deficient vitamin D levels, supplementing with vitamin D helped to improve insulin resistance and elevated lipids.[3] While it may be necessary to take supplemental vitamin D, it can be found in the following food sources: salmon, sardines, tuna, eggs, and shiitake mushrooms.
Another study found that supplementing with magnesium and vitamin E improved insulin resistance and cholesterol levels in women with PCOS.[4] Some good food sources of magnesium include spinach, swiss card, beet greens, pumpkin seeds, and sunflower seeds. However, magnesium is found in many whole grains, legumes, and vegetables. Similar to magnesium, vitamin E is also high in sunflower seeds, spinach, and swiss chard, but it can also be found in many other leafy greens.
Omega-3 fatty acid supplementation can improve mental health, and insulin resistance, lower testosterone, and male-pattern hair growth in women with PCOS.[5] Omega-3 fatty acids are found in many different foods, but are particularly plentiful in flaxseeds, walnuts, and salmon.
The Mediterranean Diet & PCOS
At first glance, it may be difficult to glean what type of diet is most helpful, as much of the research is geared towards targeted nutrient therapy. However, a pattern emerges of a whole foods diet rich in cold-water fish, nuts, seeds, vegetables, and low in high carbohydrate foods and sugar. The Mediterranean diet fits this description, as it is high in healthy fats, and protein, and vitamin and mineral rich from the intake of fresh fruit, vegetables, nuts, seeds, and whole grains.
Making dietary modifications can be quite helpful for improving some of the symptoms and risks associated with PCOS.
While other approaches may still be needed, diet is a great place to start, and healthy food choices will have a positive ripple effect in other areas of health and wellness.
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[1] Moran L. et al. Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines. Journal of the Acendemy of Nutrition and Dietetics. 113 (4): 520-545, 2013.
[2] Ibid.
[3] Dastorani M. et al. The effects of vitamin D supplementation on metabolic profiles and gene expression of insulin and lipid metabolism in infertile polycystic ovary syndrome candidates for in vitro fertilization. Reprod Biol Endocrinol 16(1): 94, 2018.
[4] Jamilian M. et al. The effect of magnesium and vitamin E co-supplementation on glycemic control and markers of cardio-metabolic risk in women with polycystic ovary syndrome: a randomized, double-blind, placebo controlled trial. Horm Metab Res. doi: 10.1055/a-0749-6431, 2018.
[5] Amini M et al. The effects of fish oil omega-3 fatty acid supplementation on the mental health parameters and metabolic status of patients with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. J Psychosom Obstet Gynaecol. doi: 10.1080/0167482X.2018.1508282, 2018.