Updated: Nov 30, 2022
To determine a proper PCOS treatment plan, it's key to first identify the root cause of your PCOS type.
I remember my first solo doctors visit once I turned 18 years old. I always knew something was wrong – I just didn’t know what. It never occurred to me that my genes have a predisposition to a condition that forced me to better understand my body. The doctors did a wonderful job writing me prescriptions, but a horrible job explaining what caused this disorder in the first place.
I often see women asking questions like
“ Is keto good for PCOS?” or "What’s the best exercise plan for PCOS” or even “What’s the best diet for PCOS?”
This is kind of like asking, “What type of oil should I use for cooking?” Answer is,
“It depends on what type of dish you’re making.”
To determine a proper treatment plan
its key to first identify the root cause of your PCOS and understanding your PCOS type.
There are 4 different types of PCOS called "phenotypes". Since there are various factors that
cause PCOS, it's common for women to experience different symptoms.
This is why PCOS is considered a "condition" or "syndrome" and not a disease.
Did you know that research has found that high insulin levels may stimulate the ovaries to produce more androgens?
This is the classic type of PCOS and certainly the most common. Inflammation and insulin resistance are key contributors; affecting 65-70% of women with PCOS. Elevated insulin and leptin levels inhibit ovulation and stimulate the ovaries to make androgens. Insulin resistance is caused by sugar, smoking, trans fats, and environmental toxins.
Has your doctor told you that you are borderline diabetic, or you had an abnormal glucose tolerance test?
You probably have elevated insulin, and you may also have elevated LH (luteinizing hormone). You are likely to be overweight, however you may also be a normal weight. “Normal-weight” insulin resistance can happen; especially in the years following dieting or eating disorder.
Treatment ideas: The first step is to drop sugar. Especially refined sugar. A small amount of fructose is healthy (like a strawberry or peach), but a large amount is a major contributor to insulin resistance. You may also consider gentle intermittent fasting, which works well to improve insulin sensitivity.
Best supplements for insulin resistance are magnesium, lipoic acid, inositol, and berberine.
Hormone medications like birth control pills are not a treatment for this type (or any type) of PCOS because it impairs insulin sensitivity.
Birth control pills are designed to subdue ovulation. For most women, it's a temporary pause, and ovulation will usually begin rather quickly after the pill has stopped. But for some women, ovulation can be suppressed for months or even years. During that time, it is not out of the norm to be given a diagnosis of PCOS. This is the second most common type of PCOS that I see. But this certainly deserves more research.
Have you had regular periods before starting the pill? Did you have acne as well?
It likely you now have elevated LH on a blood test, although you may have normal LH and high-normal prolactin.
Treatment ideas: If your LH is high, the best herbal remedy is Peony & Licorice. If your prolactin is high to normal, then the best herbal treatment is Vitex (also called chaste tree or Chaste berry).
Please seek professional advice before beginning any new herbal routine.
Inflammation often results from stress, environmental toxins, intestinal absorbency and inflammatory foods like gluten or dairy. Inflammation is an issue for PCOS because it interferes with ovulation, disrupts hormone function, and encourages the production of adrenal androgens such as DHEA and androstenedione.
Do you have indications of immune dysfunction such as recurring infections, headaches, joint pain or skin conditions (like alopecia or acne)?
It’s common for blood test for this PCOS type to shows inflammatory biomarkers such as vitamin D deficiency, abnormal blood count, or elevated C-RP or gluten antibodies.
Treatment ideas. Develop a routine to reduce stress and your exposure to environmental pollutants like pesticides and plastics. Remove inflammatory foods such as gluten, dairy, and sugar. Reverse intestinal permeability with zinc, berberine, and probiotics. Take magnesium because it is anti-inflammatory, lowers blood pressure and improves insulin resistance.
Many studies have found some women with PCOS produce androgens in the adrenals, rather than the ovaries. This inhibits hormonal functioning and causes problems like increased abdominal fat, chronic infections, inflammation, impaired sleep, glucose sensitivity, skin conditions and more. It is common for women with adrenal PCOS to not experience insulin resistance, therefore, a separate treatment plan is necessary. Stress (elevated cortisol or adrenaline levels) is major contributing factor of this type of PCOS, especially in underweight to normal weight Cysters, with non-cystic ovaries and normal insulin sensitivity. Prolonged stress, extreme diet or rigorous exercise can significantly worsen symptoms for women with this PCOS type.
Treatment: Get at least 8 hours of sleep, decrease stress by developing a self-care routine, and reduce endurance workouts and focus on HIIT. It may also be a great idea to STOP dieting and focus on herbs and supplements that target stress, sleep and decreasing androgens.