Polycystic ovarian syndrome is a hormonal condition which affects up to one in ten Australian women of child-bearing age, and up to 21 percent of Aboriginal and Torres Strait Islander people.
PCOS stems from hormonal imbalance - an excess of male hormones - and can cause infertility.
PCOS stems from hormonal imbalance and an excess of male hormones, called androgens. Levels of these androgens, together with insulin are elevated in people with PCOS, causing a range of symptoms, from acne to stubborn weight and facial hair.
In addition to these symptoms, people with PCOS may not ovulate every month, resulting in irregular cycles. An ultrasound might reveal a large number of follicles containing under-developed eggs on the ovaries.
PCOS will often look different for everyone, and not everyone with PCOS will experience all of these symptoms. PCOS symptoms can also change and evolve over time. The name polycystic ovary syndrome is misleading because the dark spots seen on ultrasound are not cysts, but follicles or underdeveloped eggs within the ovaries. For this reason, Australian-led PCOS guidelines for clinical diagnosis have been implemented universally, confirming diagnosis of PCOS when there is a combination of hyperandrogenism and ovulatory dysfunction. This means ultrasound examination of the ovaries is not required for diagnosis of PCOS in adult women.
It's also worth noting that some women can receive a diagnosis of PCOS, when they really have hypothalamic amenorrhoea, a condition where menstruation is halted due to dysfunctional signalling in the brain. Often because women don't menstruate for some time, it's assumed that they have PCOS. The appearance of the ovaries on an ultrasound can be similar, however, treatments are different for both conditions.
Listen to Melbourne Functional Medicine practitioner Rebecca Hughes talk about the common signs and symptoms of PCOS below.
Research has found people with the ‘atopic triad’ have a defective barrier of the skin and upper and lower respiratory tracts.
These genetic alterations cause a loss of function of filaggrin (filament aggregating protein), which is a protein in the skin that normally breaks down to create natural moisturisation and protect the skin from penetration by pathogens and allergens.
Filaggrin mutations are found in approximately 30 percent of people with atopic dermatitis, and also predispose people to asthma, allergic rhinitis (hayfever), keratosis pilaris (dry rough patches and bumps on the skin), and ichthyosis vulgaris (a chronic condition which causes thick, dry, scaly skin.)If one parent carries this genetic alteration, there is a 50 percent chance their child will develop atopic symptoms. And that risk increases to 80 percent if both parents are affected.
The connection between the gut microbiome and skin health is complex, however, research has found the microbiota contributes to the development, persistence, and severity of atopic dermatitis through immunologic, metabolic and neuroendocrine pathways.
Deficiency of Omega-6 essential fatty acids (EFA) has been linked with the increased incidence of atopic dermatitis, along with the inability for the body to efficiently metabolise EFA’s to gamma linoleic acids (GLA) and arachidonic acids (AA).
Changing weather conditions can certainly aggravate eczema symptoms, but the triggers are subject to change among individuals.
Mould exposure and susceptibility to mould can cause Chronic Inflammatory Response Syndrome (CIRS), of which dermatitis is a manifestation.
The causes of PCOS are still not fully understood but a range of consistent factors has been identified among people with PCOS, as discussed earlier.
As many as 95 percent of people with PCOS also experience insulin resistance, which prevents insulin from effectively performing its function of transferring glucose from the bloodstream into the body’s cells where it can be used for energy. This results in elevated levels of insulin and glucose circulating in the blood, and higher amounts of glucose being stored as fat. More than half of all people with PCOS will also develop type-two diabetes by age 40.
People with a mother, aunt, or sister with PCOS are 50 percent more likely to develop the condition, and PCOS is more than twice as prevalent among women of Aboriginal and Torres Strait Islander populations.
The conventional medicine approach to managing PCOS often involves addressing each of the different signs and symptoms separately.
The conventional treatments used to manage PCOS symptoms such as irregular periods, fertility challenges, excess hair, acne and excess weight can include:
Combined oral contraceptive pill: Current guidelines recommend the COCP should be recommended in adults with PCOS for management of hyperandrogenism and/or irregular menstrual cycles.
Metformin: An insulin-sensitising drug, used in combination with the OCP for management of metabolic features of PCOS such as high blood glucose and insulin resistance.
Letrozole: Considered ‘first-line pharmacological treatment’ for ovulation induction in people with PCOS with anovulatory infertility and no other infertility factors, to improve ovulation, pregnancy and live birth rates, while reducing multiple pregnancies compared to clomiphene citrate.
Gonadotrophins: Anti-androgen and testosterone lowering drugs can be used as second-line pharmacological agents in people with PCOS who have failed first-line oral ovulation induction therapy and are anovulatory and infertile, with no other infertility factors.
Surgery: Laparoscopic ovarian surgery can be a second-line therapy for people with PCOS, who are clomiphene citrate resistant.
Weight loss drugs: People with PCOS are prone to weight gain due to insulin resistance, but can experience improvement of symptoms with sustained weight loss.
Antidepressants and anti-anxiety drugs: People with PCOS experience higher rates of depression and anxiety, and a conventional medicine approach may extend to pharmaceutical treatments.
Acne medication: A range of pharmaceutical and topical treatments may be explored for PCOS-associated acne.
The functional medicine approach to PCOS is also multifaceted, but instead of masking the symptoms, aims to address the underlying causes of the condition. Our PCOS specialists will first use functional testing methods to determine a range of contributing factors such as hormone levels, thyroid and adrenal function, and liver health, and then develop a protocol helping you with:
If hormone levels can be returned to balance, the ovaries can resume normal function, regulating periods, improving skin health and reducing new body hair growth. Our practitioners may support hormonal balance with anti-androgen herbal medicines like liquorice and white peony, which have been found to stimulate aromatase which converts testosterone to oestrogen. Inositol may also be used in conjunction with folate to reduce testosterone and hormone-mediated acne and hair growth. While Vitamin D can normalise Anti-Mullerian Hormone (AMH) levels, which are excessive in PCOS.
An underactive thyroid increases the risk of PCOS. Interestingly, some conventional medications used for PCOS like Metformin, can have a detrimental effect on thyroid function. Iodine is crucial to the health of both the thyroid and ovaries, so increasing iodine intake with supplements or foods, such as seaweed and salt-water fish, may be beneficial for PCOS.
Weight loss can improve insulin resistance, thereby reducing blood glucose and aiding hormonal balance. Current PCOS treatment guidelines recommend 150-250 minutes of moderate intensity physical activity or at least 75-minutes of vigorous exercise per week, including strength training on two non-consecutive days each week. Healthy weight loss can also be supported with a low-GI diet rich in whole foods, while generally avoiding inflammatory foods like gluten, dairy and sugar.
In addition to dietary and lifestyle changes, blood glucose can be lowered with the use of various supplements including cinnamon, chromium, magnesium and probiotics.
Chronic stress leads to impaired adrenal function, releasing stress hormones which elevate androgens. This creates a vicious cycle which contributes to mood disorders, weight gain, acne and unwanted hair growth, while also causing fatigue and exhaustion, which makes it difficult to exercise. Our practitioners can work with you to personalise a protocol helping you reduce stress levels, re-energise and improve moods, which may include a combination of herbal medicines as well as lifestyle changes including improved sleep, relaxation and mindset activities.
Are you ready for a personalised, natural functional medicine treatment? Our unique model of care was designed with you in mind. Find out how, then book a call today
Polycystic ovarian syndrome (PCOS) is a hormonal condition which affects up to one in ten Australian women of child-bearing age, and up to 21 percent of Aboriginal and Torres Strait Islander people. PCOS is caused by an excess of androgenic hormones which can cause infertility.
The causes of PCOS are yet to be fully understood, yet a range of consistent factors identified among women with PCOS include family history and genetics, hormones levels, diet, and lifestyle factors including activity levels, smoking and alcohol intake.
The best natural treatment for PCOS involves addressing the underlying causes of the condition by seeking the help of a PCOS naturopath like our PCOS specialists Vicki van der Meer who is available for consultations in our Melbourne clinic or via telehealth, or our remote-based functional medicine practitioner Rebecca Hughes via telehealth.
Vicki and Rebecca will first use functional testing methods to determine a range of contributing factors such as hormone levels, thyroid and adrenal function, and liver health, and then develop a protocol helping you with balancing hormones, supporting thyroid function, healthy weight loss, balancing blood sugar levels, and reducing stress.
Yes. People with a mother, aunt, or sister with PCOS are 50 percent more likely to develop the condition, and PCOS is more than twice as prevalent among women of Aboriginal and Torres Strait Islander populations.
As with most chronic health issues, dietary, environmental and lifestyle factors can influence genes to express disease.
PCOS cannot be self diagnosed. It is characterised as hyperandrogenism and ovulatory dysfunction, which is diagnosed by a medical practitioner along with testing.
The name polycystic ovary syndrome is misleading because the dark spots seen on ultrasound are not cysts, but follicles or underdeveloped eggs within the ovaries. This is why an ultrasound examination of the ovaries is not required for diagnosis of PCOS in women.
It's also worth noting that some women can receive a diagnosis of PCOS, when they really have hypothalamic amenorrhoea, a condition where menstruation is halted due to dysfunctional signalling in the brain.
Often because women don't menstruate for some time, it's assumed that they have PCOS. The appearance of the ovaries on an ultrasound can be similar, however, treatments are different for both conditions.
Some of the most prominent signs are acne, stubborn weight gain, excess facial hair, and irregular menstrual cycles.
Assessment by a PCOS naturopath or PCOS specialist will help to determine the cause of your symptoms.
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