Polycystic Ovary Syndrome (PCOS) affects up to 10% of women of reproductive age, making it one of the most common hormonal and metabolic disorders. Yet despite its prevalence, many women struggle for years with symptoms before receiving a proper diagnosis. Management of PCOS is aimed at easing symptoms and reducing risks associated with PCOS. This can be accomplished through a combination of conventional and integrative treatments.
September is PCOS Awareness Month, so let’s discuss what PCOS is and explore some options for management.
What Is PCOS and How Is It Diagnosed?
We do not fully understand what causes PCOS and there is not a single test to diagnose it. This is one of the reasons why obtaining a definitive diagnosis can be tricky and delayed. It is thought that abnormal levels of luteinizing hormone (LH) and high levels of male hormones (androgens) interfere with normal function of the ovaries. PCOS is also associated with metabolic risk factors including high blood pressure, high cholesterol, and insulin resistance. It is thought that triggers for PCOS are genetic, environmental, or a combination of both.
We base the diagnosis of PCOS on a collection of symptoms. Common symptoms include irregular or absent periods, excessive hair growth, acne, weight gain (particularly around the midsection), scalp hair loss, and difficulty conceiving. We sometimes test hormone levels and sometimes use ultrasound to determine if there are more than the usual number of follicles or “cysts” on the ovaries. However, lab work and imaging are not always necessary for diagnosis. A diagnosis can be made based on symptoms alone.
Each woman’s experience with these symptoms can be different. Some may have more symptoms than others and the severity of the symptoms can fluctuate over time. This can add another layer of difficulty in identifying PCOS as a diagnosis.
Understanding Treatment Approaches
There are clear goals for treatment for PCOS. These include regulating menstrual cycles, addressing metabolic health, and managing symptoms. Since each person with PCOS may have different symptoms, and/or varying degrees of symptom severity, each person’s treatment plan may look a little different.
A Personalized Treatment Plan
Medication When Needed: Conventional medicine offers valuable tools including medications to regulate menstrual cycles, multiple different medications for metabolic health, spironolactone for acne and body hair growth, and fertility medications when pregnancy is desired. These interventions can be important and may be exactly what some women need at certain points in their journey.
Integrative and supportive measures: The following integrative and lifestyle measures can help support hormonal health and metabolic health. These can be used in combination with medications discussed above.
Stress Management: Emphasize stress reduction techniques such as mindfulness practices, yoga, adequate sleep, and nervous system regulation.
Movement and Exercise: Find enjoyable forms of movement that support metabolic health without causing additional stress to the body. This often includes a combination of strength training, walking, and stress-reducing activities like yoga or swimming.
Strategic Supplementation: Common evidence based supplements include inositol and berberine for insulin sensitivity.
Targeted Eating Strategy: Rather than generic dietary advice, create a personalized eating strategy based on your individual metabolic patterns, food sensitivities, and lifestyle factors. This might include a Mediterranean-style anti-inflammatory diet or specific carbohydrate cycling.
Your Journey to Wellness
If you’re struggling with PCOS, know that there are ways to help manage your symptoms and reduce risks associated with PCOS. The key is working with your provider to find what works best for your unique situation and health goals.
This blog post was written by Jen Schirner, PA-C, a medical provider at Integrative Family Medicine of Asheville. You can read more about Jen in her bio.