No. 1 Cause of Infertility? Polycystic Ovarian Syndrome

June 22, 2017
Polycystic Ovarian Syndrome - Dr.Axe

It’s one of the most common hormonal endocrine disorders in women and referred to as a ‘silent killer.’ I’m talking about polycystic ovarian syndrome, aka polycystic ovary syndrome (PCOS), which affects anywhere from 5 percent to 20 percent of women of childbearing age.

While few women are aware of this disorder or what PCOS symptoms look like, PCOS is believed to be responsible for as much as 70 percent of infertility issues in women! Meanwhile, it’s associated with an increased risk for developing several medical risks, including insulin resistance, type 2 diabetes, high cholesterol, high blood pressure and heart disease.

And if it runs in your family, then you’re may be at a higher risk to develop this hormonal imbalance. The good news is there are many natural ways to treat PCOS symptoms, and it starts with doing everything you can to balance hormones naturally. Read on to learn more about PCOS and my recommendations on how to treat the symptoms of PCOS if you are one the estimated 5 million women in U.S. dealing with this condition.


What Is Polycystic Ovary Syndrome (PCOS)?

PCOS is one of the most common hormonal imbalances affecting women today. While PCOS has been recognized and diagnosed for over 75 years and is now considered the leading form of endocrine disruption in women of reproductive age, there’s still a lot to learn about how exactly this hormonal imbalance occurs in different women and how it can most effectively be reversed.

Alarmingly, estimates show that somewhere between 5 percent to 20 percent of women of childbearing age are affected by PCOS! However, less than 50 percent of women are properly diagnosed — which means millions have no idea what’s causing their underlying symptoms. (1) Common PCOS symptoms include weight gain, changes in mood, low libido and irregular periods, plus it’s considered to be the major cause of infertility issues in women.

The endocrine system is a very complex thing, especially in women. PCOS can develop for a number of different reasons, and symptoms can vary a lot from woman to woman. Currently, there is no known “cure” for PCOS, although the underlying hormonal causes are believed to be mostly reversible, and many women find effective ways to lower their symptoms without the use of medications.

For doctors, one of the challenges of identifying and treating PCOS is that it cannot be diagnosed with one test alone, plus PCOS symptoms closely mimic those of other hormonal disorders, like adrenal fatigue, chronic fatigue and thyroid disorders. While  PCOS symptoms can come and go depending on fluctuations in someone’s lifestyle, insulin resistance affects 50 percent–70 percent of all women with PCOS, and when left untreated, this can increase the risk for metabolic syndrome, hypertension, dyslipidemia, glucose intolerance and diabetes down the road.


PCOS Symptoms 

There are several PCOS symptoms common among woman dealing with hormonal issues, although every woman is different in the ways that a hormonal imbalance can be experienced. Classically, physicians have looked for multiple cysts on the ovaries (described as looking like a “string of pearls” when performing an ultrasound), but not every woman diagnosed with PCOS has visible cysts on their ovaries. PCOS can still be diagnosed if the majority of other common symptoms are experienced. (2)

The most frequent PCOS symptoms include:

  • irregular periods, including amenorrhea (missing periods)
  • trouble conceiving or infertility
  • changes in weight, especially weight gain and trouble losing weight
  • acne
  • insulin resistance (related to an increased risk for diabetes)
  • high testosterone levels
  • Hirsutism (excessive hair growth, including in places women don’t usually grow hair, such as on the face and abdomen)
  • male pattern baldness, thinning hair
  • fatigue
  • changes in mood
  • low sex drive

The term “polycystic” literally means that a woman’s ovaries have multiple small cysts on them, which is caused from ovaries not being released normally and therefore building up in the ovaries into little “sacks.” Normally, the ovaries release a small amount of male sex hormones (called androgens), but in women with PCOS, their ovaries start making slightly more androgens, which is the reason for masculine symptoms like extra facial and body hair.

 

Common PCOS symptoms - Dr. Axe

 


Natural Remedies for PCOS Symptoms

1. Eat a Nutrient-Dense Diet

As you’ve learned, an “appropriate diet” is a bit different for everybody. In women who are overweight, mostly sedentary and battling insulin resistance, following a diet aimed at healthy weight loss that’s low-glycemic, low-sugar and nutrient-dense helps. On the other hand, in women who are battling adrenal or thyroid “burnout,” who are underfed, overly stressed and fatigued, resting and focusing on eating more nutrient-dense calories is likely the best approach. (3)

No matter the cause of hormonal imbalance, nutrient density and eliminating exposure to toxins are important. It’s crucial for everybody, whether hormonally balanced or not, to boost the metabolism and therefore help with hormone production by eliminating various toxins that enter our bodies through modern and processed foods. Hormones can easily go amuck when the body’s bombarded by things like artificial sweeteners, pesticides, preservatives and so on.

Rather then focusing on what needs to be eliminated from the diet, think about “nourishment” being the goal, especially eating a variety of natural anti-inflammatory foods — think vegetables, fruits, grass-fed/pasture-raised meat, wild fish (like salmon), nuts/ seeds (like chia, flax, hemp, almonds and walnuts, and unrefined oils/fats (including coconut oil, olive oil and avocado). (4) Something positive to remember is that the same dietary treatment used to fight PCOS also helps treat a whole host of other common diseases, including obesity, heart disease, autoimmune diseases, diabetes and so on.

Whether gaining or losing weight will be beneficial for your specific case of hormonal imbalance, anything that does not come in a bag or a box is more supportive than the packaged stuff that does. Support your thyroid and adrenal glands by reducing stress placed on them caused by a poor diet. This means experimenting with removing common allergens or sensitives, toxins, and chemicals, including:

  • too much alcohol or caffeine
  • most sources of sugar and sweeteners (including high-fructose corn syrup, packaged sweet products and refined grains that trigger insulin spikes, are inflammatory and irritating to the gut)
  • as much packaged and processed foods as possible, since these are filled with many types of artificial ingredients, preservatives, sugars, sodium and potential endocrine disruptors
  • hydrogenated and refined vegetable oils (soybean, canola, safflower, sunflower and corn), which are highly inflammatory
  • common sensitivities, including conventional dairy products and gluten

2. Reduce Stress (Both Physical and Psychological)

One of the keys to solving any hormonal problem is to take a close look at the “mind-body connection.” That’s because stress can have drastic impacts on the endocrine system and therefore hormone production.

Different things work for different people when it comes to combatting chronic stress, whether it’s spending more time in nature, yoga, meditation, prayer, journaling and so on. Try to address which areas of your life cause the most stress and how you can handle them appropriately. Remember that “stress” can show up in the body in many different ways; even skipping sleep, your diet and exercise routine can be perceived as stressful if they aren’t quite what your body needs.

Adaptogen herbs are a unique class of healing plants that can help promote hormone balance and protect the body from the effects of cortisol caused by chronic stress. They also can be used to treat PCOS, along with tonic herbs. (5) These herbs include ashwagandha, holy basil and maca root. While they won’t take the place of a healthy diet and dealing with stressful circumstances in your life at their root, they can help the body improve thyroid function, lower cholesterol, reduce anxiety and depression, and offer support against PCOS symptoms.

3. Get Enough Rest 

Sleep in crucial for cell regeneration, hormone production, stress control and even weight management. In fact, sleep deprivation can have the same negative effects on health and hormones as a lack of activity and a poor diet can.

In a review published in Human Reproduction, researchers looked at a cross-sectional study of women with and without PCOS. They found that “sleep disturbances were twice as common in women with PCOS compared with those without,” and women with PCOS especially had difficulty falling asleep. (6)

Consistently going without enough sleep increases stress hormones in the body, including cortisol, and changes levels of hormones that control your weight and appetite, including insulin and ghrelin. The more stressed you are, the more sleep you likely need — but the general recommendation that works well for most people is aiming for seven to nine hours nightly.

4. Exercise in an Appropriate Way

If you have a predisposition to developing hormonal imbalances, keep in mind there’s a fine line between too little activity and too much. Generally speaking, women’s bodies are more susceptible to hormonal changes when exercise is increased beyond healthy levels. For example, “female athlete triad” is a condition that can contribute to PCOS, which is caused by too much exercise coupled with a restrictive diet and too little calories. Female athletes can be more susceptible to irregular periods, according to multiple studies. (7)

Of course, this doesn’t mean you need to cut out exercise all together, since there are many benefits of exercise that can help with hormonal balance. It’s just a matter of finding which amount works best for you. If you’re someone who battles high levels of cortisol and chronically unstable blood sugar levels, you might be dealing with some extra body weight and turning to exercise to help shed unwanted pounds. This is still a good approach, but more isn’t always better, and pushing yourself too hard when you’re struggling with exhaustion can cause even more hormonal stress. (8)

Take a close look at all of the types of stress that are being placed on your body, and consider if doing gentler exercise, or intense exercise but for shorter periods of time (such as high intensity interval raining), will do you some good. Focus on getting enough activity to help with insulin sensitivity and burning excess fat, without causing the adrenals to become overstimulated.

5. Avoid Exposure to Endocrine Disruptors

Endocrine disruptors are chemicals that interfere with the production, release, transport, metabolism or elimination of the body’s natural hormones. In today’s industrialized society, we come across these more than ever before: in the air we breath, water we drink, soil used to grow food, and beauty or household products we buy. These disruptors can mimic naturally occurring hormones, especially estrogen, which can result in either overproduction or underproduction of actual hormones. (9)

While it doesn’t pay to stress over air pollution, you can do your best to avoid chemical products, including: dry-cleaning chemicals, skin-care products loaded with artificial ingredients, non-organic produce sprayed with pesticides and chemical compounds known as xenoestrogens — including industrial compounds such as polychlorinated biphenyl, bisphenol A and phthalates used in plastic and aluminum cans.

6. Support Your Body Using Alternative/Complimentary Treatments

Some women with PCOS find relief from symptoms when turning to complimentary practices like chiropractic care, acupuncture, massage therapy and herbalism. These can help relieve stress and restore proper “energy” to the body, likely by lowering stress hormones and improving sense of well-being.

For example, according to the Journal of the International Society of Gynecological Endocrinology, “acupuncture therapy may have a role in PCOS by increasing blood flow to the ovaries, reducing of ovarian volume and the number of ovarian cysts, controlling hyperglycaemia through increasing insulin sensitivity and decreasing blood glucose and insulin levels.” (10)

Experiment with different options to see which work best for you, whether it’s receiving adjustments from a chiropractor who can help with managing chronic pain and getting you back on your feet, or trying herbs to help you sleep and unwind more easily.


What Causes PCOS?

The underlying cause of PCOS symptoms is an abnormally high level of male sex hormones compared to female hormones. Male sex hormones, or androgens, include testosterone, DHEA-S and others. A 2017 study led by the University of Birmingham revealed that a class of androgens, known as 11-oxygenated C19 steroids, majorly contributes to androgen excess in women with PCOS, while previous research has primarily focused on the androgen testosterone. (11)

The vast majority of the time, male sex hormones are high in PCOS patients (called hyperandrogenism). High levels of testosterone can prevent the ovaries from releasing an egg each month like they normally do in women without hormone imbalances, which is why irregular or skipped periods and trouble getting pregnant are common among women with polycystic ovary syndrome.

However, sometimes these male sex hormones aren’t so high that they are considered above normal levels. (12) This can still cause problems when female sex hormones aren’t proportionate to male sex hormones; it’s the ratio of hormones that seems to be the critical factor. For example, estrogen might be low, or testosterone might be very high even compared to estrogen that’s also high. Female sex hormones can drop for one reason or another, and male sex hormones can rise. This is the exact reason there’s an “imbalance,” although women get to this point for different reasons.

Research continues to reveal more information about the root causes of PCOS and other hormonal imbalances, which sheds light on how complex this type of disorder can be. Like most other disorders, there seems to be genetic factors involved in the development of PCOS, coupled with lifestyle and environmental factors.

Some of the common causes of polycystic ovary syndrome include:

  • genetic predisposition
  • poor diet (especially a high-glycemic diet that’s high in sugar and refined carbohydrates)
  • chronic stress
  • inappropriate level of physical activity, whether too high or too low depending on the women
  • thyroid disorders or imbalances, such as hypothyroidism
  • exposure to high amount of endocrine-disrupting chemicals
  • for some women, having a high percentage of body fat, being overweight or obese
  • for some women, having a low percentage of body fat (usually from following a restricted diet that’s too low in calories)
  • high insulin levels
  • high levels of inflammation

PCOS is commonly regarded as a condition that runs in families, but this doesn’t mean someone is doomed to experience it if she is genetically predisposed. Having a family history of PCOS just means a woman needs to be careful how she manages her stress, diet and lifestyle.

Insulin and inflammation can also play a role in PCOS. Excess insulin, the hormone produced in the pancreas that allows cells to use glucose, can cause the ovaries to increase male sex hormone production, which throws off the ovaries’ normal ability to ovulate. Low-grade chronic inflammation can also stimulate polycystic ovaries to produce more androgens.

Many people think of the typical PCOS patient as someone who is overweight or obese and struggling with insulin resistance. A high percentage of PCOS patients d0 deal with weight gain at some point, however we now know that there are plenty of women who are normal weight, or even underweight, who also develop hormonal disruptions that lead to PCOS. PCOS patients come in all shapes and sizes, and their histories can be very diverse, which makes treating this condition even more complicated.

A woman’s diet and body weight is highly correlated with her level of hormonal health. For example, according to the PCOS Foundation, studies show that approximately a whopping 40 percent of all women with diabetes and/or glucose intolerance between the ages of 20–50 have PCOS! Being overweight seems to complicate hormonal issues and PCOS symptoms, and weight loss improves the endocrine profile and increases the likelihood of ovulation and pregnancy in women with PCOS.

Studies have found that in women who are are overweight, menstrual cycles and ovulation can both improve with as little weight loss as dropping 5 percent of initial body weight. (13)

In overweight women, it’s still debated as to which comes first and affects the other: weight gain or hormonal imbalance. And in women who are normal weight or very lean, excess body fat obviously isn’t the underlying cause of the problem; in fact, in this case the opposite might be to blame — restricted diets that are too low in calories, high amounts of stress and overexertion through very high levels of physical activity can also throw off a woman’s delicate hormonal balance (a condition refereed to as hypothalamic amenorrhea).

 

Causes of PCOS symptoms - Dr. Axe

 


The Female Reproductive System and PCOS

To further understand how polycystic ovary syndrome manifests in different women, plus how it should be treated, it helps to have some background on the female reproductive system.

Hormones are created from glands in your brain that receive signals from organs throughout your entire body. Your adrenal, thyroid and pituitary glands are so important that they control nearly every aspect of life, including your internal thermostat, ability to metabolize food, heart rate, digestion, mood, fertility and so much more. When your body picks up on stressors of any kind, hormone production can be stalled before reproductive hormones like estrogen or progesterone can make their way to the ovaries.

The “control center” of your endocrine system is considered your hypothalamus, an almond-size part of the brain that acts as your endocrine system’s main point of contact. The hypothalamus constantly receives information from various hormones throughout your body that travel through the bloodstream up to the brain. The hypothalamus signals the release of one of two hormones depending on the information it gets, either releasing hormone or inhibiting hormone (called follicle-stimulating hormone and luteinizing hormone, both of which control the menstrual cycle and fertility).

Your pituitary gland can basically overcompensate when the body’s under stress and starts creating imbalances. This impacts how much estrogen and testosterone, growth hormones, hunger hormones, and stress hormones are ultimately released. Under stress, the pituitary gland secretes adrenocorticotropic hormone, which tells your adrenal glands to release a cascade of stress-related hormones, including cortisol and adrenaline. These kick off your body’s “fight or flight” response — for example, adrenaline boosts your blood pressure and heart rate, while cortisol releases glucose to your muscles so you have the energy to escape scary situations. (14)
Not recognizing that modern-day stress in your life isn’t actually life-threatening, your HPA axis (which stands for hypothalamic–pituitary–adrenal axisa complex set of feedback interactions between your endocrine glands) responds the same exact way to all types of stress, and this wreaks havoc on your entire endocrine system, resulting in abnormal levels of female sex hormones reaching the ovaries. (15) The result? PCOS symptoms, including experiencing no ovulation, no egg released, no menstrual cycle and various signs of male hormones dominating.

Different PCOS Solutions for Different Women

PCOS is a complex condition, and the road to resolving the hormonal imbalances that cause it are not the same for every woman. Practitioners, and women with PCOS, both agree that there isn’t a “one size fits all” approach that balances hormones best.

For many years, the most common advice for battling PCOS symptoms was to follow a low-glycemic diet and work on losing weight and managing blood sugar in a healthy way. However, this won’t work to solve PCOS for women who are underweight or even normal weight, so usually another approach needs to be considered for these types of patients.

Diet isn’t everything, and other lifestyle factors — especially stress, but also things like meal timing, carbohydrate intake and level of exercise — all play an important role in a woman’s reproductive system. The body is able to detect different kinds of stressors, both internal and external. Internal stressors are those that disrupt your body’s healthy patterns , such as mismanaged blood sugar, inadequate sleep or lack of physical activity. External stressors are those that cause chronic, underlying stress outside of your body and reduce a sense of general well-being.

When visiting your doctor, he or she might prescribe birth control pills or hormone replacements such as metmorphin to help you have regular menstrual cycles and decrease symptoms like insulin resistence. However, these only mask the problem of PCOS symptoms and don’t ultimately solve them. It’s still possible to have problems with fertility and getting pregnant once the medications are stopped because a woman’s diet, stress and exercise patterns aren’t addressed.

The real key is to consider each woman’s body individually in order to look at what nature demands of her. If, for example, someone has a background of doing no exercise, adding more in is one good approach. If a woman exercises too much and has a low body fat percentage as a result, she should focus on having more downtime and replenishing her body with enough fuel to boost female sex hormone production. Some experts recommend thinking of the best treatment approach as essentially “doing the opposite of what caused the problem to begin with,” which makes logical sense!

While it might seem complicated, fortunately the best options for moving forward for women with different types of PCOS all fall within the same general categories, focusing on all aspects of health: mainly eating a balanced diet and eliminating as much physical and psychological stress as possible. Keep in mind that the body experiences “stress” in different ways, some physical (such as a poor diet, too little calories, nutrient deficiencies, or lack of sleep and rest) and some psychological (such as emotional trauma, depression and anxiety).

The body can’t necessarily tell the difference between hating your job, exercising to exhaustion, dramatically limiting calories or skipping sleep — they all send the message of “stress”! So no matter how a woman’s hormones got out of whack to begin with, she can help rebalance them by eating a natural, nourishing diet and giving the body enough relaxation and rest to restore homeostasis.

Read Next: Top 3 Essential Oils to Balance Hormones Naturally


From the sound of it, you might think leaky gut only affects the digestive system, but in reality it can affect more. Because Leaky Gut is so common, and such an enigma, I’m offering a free webinar on all things leaky gut. Click here to learn more about the webinar.

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