Polycystic ovary syndrome is a complex hormonal condition. It is a syndrome based on elevated androgen in females. Despite the name, it has nothing to do with the cysts on your ovaries. The syndrome is characterized by androgen excess, acne and hirsutism. It can also can lead to infertility, anovulation and insulin resistance. To treat PCOS you need to know what is driving it.

There are 4 types of PCOS you need to know about:

1. Insulin resistant PCOS

- Women with this type have a higher risk of developing metabolic syndrome and diabetes

- This type causes you to have high levels of insulin which drives your androgens

- Treatment involves diet, exercise and supplements like magnesium and inosotol¨

2. Post-pill PCOS

- It's common to have a temporary surge of androgens when coming off the contraceptive pill

- You meet the criteria for this type if you have PCOS symptoms except insulin resistance

- Treatment includes a natural anti-androgen supplement such as zinc, DIM, peony and licorice

3. Inflammatory PCOS

- Chronic inflammation can stimulate the ovaries to produce too much testosterone

- You can meet the criteria for this one if you have all the other symptoms as well as signs of inflammation such as fatigue, bowel issues, headaches, joint pain and skin conditions

- Treatment for this one is to identify and treat the underlying cause of inflammation. This could mean avoiding a food sensitivity or fixing an underlying gut problem

4. Adrenal PCOS

- Most women with PCOS have elevation of ALL androgens (DHEAs from adrenals and testosterone/androstenedione from the ovaries)

- However if you only have elevated DHEAs then you meet the criteria for adrenal PCOS

- Adrenal PCOS is not driven by inflammation or insulin resistance but instead it is genetic and an abnormal response to stress

- Treatment includes stress reduction, adaptogenic herbs, magnesium and vitamin B5 ("the anti-stress factor")

The consensus for natural treatment of PCOS includes a healthy diet (a whole foods and unprocessed diet), an increase in activity levels, reduction of stress and supplementation of adaptogenic herbs, adrenal support and anti-inflammatory nutrients.

Sources:

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2. Mortada R, Williams T. Metabolic Syndrome: Polycystic Ovary Syndrome. FP Essent. 2015 Aug;435:30-42. PMID: 26280343.

3. Moini Jazani A, Nasimi Doost Azgomi H, Nasimi Doost Azgomi A, Nasimi Doost Azgomi R. A comprehensive review of clinical studies with herbal medicine on polycystic ovary syndrome (PCOS). Daru. 2019 Dec;27(2):863-877. doi: 10.1007/s40199-019-00312-0. Epub 2019 Nov 18. PMID: 31741280; PMCID: PMC6895349.

4. Goswami, P. K., Khale, A., & Ogale, S. (2012). Natural remedies for polycystic ovarian syndrome (PCOS): a review. International journal of pharmaceutical and phytopharmacological research, 1(6), 396-402.

5. Jamilian M, Foroozanfard F, Bahmani F, Talaee R, Monavari M, Asemi Z. Effects of Zinc Supplementation on Endocrine Outcomes in Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial. Biol Trace Elem Res. 2016 Apr;170(2):271-8. doi: 10.1007/s12011-015-0480-7. Epub 2015 Aug 28. PMID: 26315303.

6. Maktabi M, Jamilian M, Asemi Z. Magnesium-Zinc-Calcium-Vitamin D Co-supplementation Improves Hormonal Profiles, Biomarkers of Inflammation and Oxidative Stress in Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial. Biol Trace Elem Res. 2018 Mar;182(1):21-28. doi: 10.1007/s12011-017-1085-0. Epub 2017 Jul 1. PMID: 28668998.