A new study published in the journal Human Fertility has shown that probiotic supplementation in women with PCOS promotes favourable effects on weight loss, insulin resistance and overall improved lipid profiles (triglycerides and very low-density lipoprotein cholesterol (VLDL-c) levels).
PCOS - A Hidden Epidemic?
PCOS is an increasingly common yet poorly understood endocrine and metabolic disturbance, affecting women of reproductive age.
The syndrome presents clinically as a group of symptoms to include; menstrual dysregulation, ovulatory dysfunction, hyperandrogenism and metabolic disturbances such as hyperinsulinemia and obesity. PCOS manifests as polycystic ovaries, alongside reproductive, metabolic and psychological disturbances (Willacy, H 2017). It is important to note that PCOS encompasses a whole menu of symptoms and these can be mild to severe. As such, each individual can end up with a combination of symptoms very particular to them, despite the underlying cause remaining the same as the next person. The syndrome can be debilitating for many women, whose lives are affecting physically, mentally and emotionally to varying degrees.
Commonly reported symptoms include:
- Lack of ovulation
- acne/oily skin
- Acanthosis nigricans
- Weight gain/difficulty losing weight
- Increased risk miscarriage
Treatment is usually directed at symptoms, thus dependent on the patient presentation and addresses one or all of the following - menstrual dysregulation, fertility and symptoms of androgen excess,
The oral contraceptive pill is a common first-line treatment in decreasing androgen production. Combined hormonal contraceptives promote negative feedback in the production of LH, resulting in decreased synthesis of androgens by the ovaries.
For those women wishing to get pregnant, selective oestrogen receptor modulator clomiphene is the first line treatment and increases FSH from the pituitary. Aromatase inhibitors block the conversion of testosterone and androstenedione to estradiol and estrone and have a higher ovulation rate than clomiphene Ovulation induction by gonadotrophins and laparoscopic ovarian drilling (LOD) are considered to be second-line therapies for ovulation. A third line treatment for infertility is IVF.
Anti-androgen topical creams, hair removal creams and laser surgery are all orthodox treatment of androgen symptoms. However, these do not address root causes.
Metformin to lower insulin levels and prevent type II diabetes is also a first-line treatment. The insulin-sensitizing agents, metformin and troglitazone, not only reduce circulating insulin concentrations but reverse the metabolic and endocrine anomalies often present in PCOS. Metformin is also thought to deliver short-term benefits related to ovulation and cardiac risk.
A More Natural, Effective and Long-Term Approach
“Of all the natural therapies you might like to explore, healthy diet and lifestyle changes are the most sensible and helpful”
Treating PCOS through diet and targeted supplementation allows one to address root cause as opposed to symptom management by addressing blood sugar, detoxification pathways and hormonal balancing. Essentially once you fix the blood sugar/insulin imbalance, hormonal balance is more likely to follow. This approach essentially treats the metabolic syndrome first; making diet an obvious place to start.
Research has concluded that a healthy lifestyle has been shown to reduce body weight, abdominal fat, reduce testosterone, improve insulin resistance, and decrease hirsutism in women with PCOS. It is well documented throughout the literature that weight loss/exercise improves PCOS features, but it is noteworthy to add that this is not correlated to a particular diet type.
Kowalik, A. and Rachoń, D. 2014, p.19) state that:
‘decreases in weight and body composition and improvements in pregnancy rate, menstrual regularity, ovulation, hyperandrogenism, insulin resistance, lipids and quality of life occurred with weight loss independent of diet composition. (p.19).
The following list outlines a typical dietary approach in treating PCOS:
Blood Sugar Regulation:
- Consumption of a low glycemic Index whole foods diet for blood sugar regulation.
- Avoid refined sugars and simple carbohydrates.
- Diet based on :fruits, vegetables, whole grains, healthy fats and moderate protein.
- Recent studies show even a moderate reduction in dietary carbohydrate reduced the fasting and post challenge insulin concentrations among women with PCOS - improving reproductive/endocrine outcomes.
- High-fibre foods further help with insulin resistance by slowing down digestion, thus reducing blood sugar reactions. Specifically, cruciferous vegetables, such as broccoli, cauliflower, and brussels sprouts will provide fibre, aid hormonal balancing by preventing oestrogen dominance and assist with oestrogen clearance.
Improve Liver Function:
- The liver breaks down and removes excess hormones from the body - if .congested estrogen is not metabolized properly and can be reabsorbed back into the body.
- Avoid alcohol, increase liver supportive foods such as leafy greens, probiotics, cruciferous veggies, herbs, high antioxidant foods, apple cider vinegar.
- Include foods rich in phytoestrogens which have a balancing effect on hormones and menstrual cycles (soybeans and soy products, tempeh, flax seeds, oats, barley, lentils, sesame seeds, yams, alfalfa, apples).
- Increase healthy fats and avoid saturated fat which blocks essential fatty acids production and stimulates oestrogen production.
- Include more omega 3 rich foods such as oily fish, flax, nuts, linseeds. 50 gram omega 6 and 2g omega 3 per day (Harris & Cheung, 2004, p.106).
- Include a clinical grade probiotic to boost beneficial bacteria. Which will affect the PH of the intestine which will lead to healing providing bacteria that produce nutrients that heal the colon competing with bad bacteria already present for nutrients and positioning on the colon wall.
- Probiotics have lowering effects on belly fat and body weight. Additionally, many women diagnosed with PCOS suffer from a Leaky Gut.
- Increase intake of fermented foods and prebiotic foods which help to feed healthy bacteria.
Herbal supplement, Berberine is a super effective method to improve insulin resistance in a similar way to metformin. Countless studies reinforce its effectiveness in treating insulin sensitivity as well as a host of other PCOS symptoms such as acne, anxiety, and excessive androgen production. As such Berberine is central to our holistic approach to treating PCOS effectively.
There you have it! The above approach alone is effective in reducing the majority of PCOS symptoms, however, it can be beneficial alongside orthodox treatment such as metformin, which can provide more immediate relief whilst the patient modifies diet/lifestyle for longer-term resolution. Natural progesterone therapy can also be beneficial for certain women but requires Dr oversight and monitoring. Fertility treatment outcomes are also greatly improved by weight and diet modifications. The monitoring blood sugar response to daily diet will allow for the patient to track how they are reacting to the foods consumed.
Get in touch to see how we can help you find a natural, effective and long-term solution to PCOS. firstname.lastname@example.org.