Being one of the most complicated gynecological conditions, PCOS requires a proper evaluation of etiology. Some cases are due to high androgens and some to high estrogen levels. When estrogen is too high for prolonged periods of time, it results in a wide range of symptoms including an increase in follicle formation – this produces excessively heavy periods. At other times, when testosterone is high, there may be a prolonged absence of menstruation as the release of eggs becomes irregular. It also affects fertility and can result in obesity, facial hair and more.

Symptoms:

– Menstrual irregularities
– Heavy periods
– Scanty periods
– Obesity
– Hyperinsulinemia
– Infertility
– Acne
– Hair Loss
– Abnormal hair growth (facial hair)
– Deepening of voice

Causes:

1. High Androgens
This tends to be the result of the inhibition of an enzyme called “Aromatase”. This enzyme is what converts androgens (testosterone) into estrogen. The main reason for this is liver problems and excessive consumption of foods or herbs that inhibit aromatase such as mushrooms and stinging nettle.

2. Insulin resistance
When insulin is excessively high, it causes an increase in insulin-like growth factor, which is connected to such growths in the body. Most doctors argue that this is the main association with PCOS and should be the target of treatment as well. While in some cases this may be true, the treatment for it is not ever a permanent solution as pharmaceutical drugs only suppress it rather than reverse it.

3. High Estrogen
A common cause of many female reproductive problems is estrogen dominance. This occurs when the body is producing too much estrogen as a result of certain nutritional deficiencies, excessive consumption of estrogenic foods, and genetics.

Treatment:

Please read the following paragraph carefully

Before you start treatment, you need to know whether your condition is caused by high androgens, insulin resistance, stress, or high estrogen. Blood tests must be done to assess which hormones are irregular in order to correctly treat this condition. Do not attempt to do this blindly – always work with a well-versed physician who is familiar with this condition in this depth (most doctors are not, and will just put you on birth control or drugs like metformin). Use your intelligence and make sure you have proper guidance.

High Androgens 

This is due to a lack of the enzyme “aromatase” which converts testosterone to estrogen. This enzyme comes from the liver and ovaries. In order to correct this, liver function must be optimized and the ovaries should be supported with appropriate nutrition.

1. Inositol

Inositol is sometimes referred to as Vitamin B8. It plays an essential role in glucose metabolism as well as aromatization. In multiple clinical trials, Inositol has proven to be highly effective for treating various symptoms associated with polycystic ovary syndrome (see study). It is absolutely crucial that you use this nutrient under proper medical supervision as it has to be used in combination with other hormone-regulating herbs and supplements to prevent the development of heavy periods.

I usually recommend this one.

2. Pure Whey Protein

One of the most common issues with liver function is related to the development of a fatty liver. Hepatotoxicity can also be an issue in patients who use a lot of pharmaceutical drugs and alcohol. A clinical trial involving women with fatty liver disease showed that liver fat can be reduced by 21% by consuming 60 grams of whey protein daily for 4 weeks (see study). Whey protein also increases glutathione levels which helps reduce toxicity. It is best to use an unsweetened/naturally sweetened and unflavored/naturally flavored whey protein isolate supplement.

I usually recommend this one.

Insulin Resistance

The most common cause of insulin resistance is the depletion (and thus deficiency) of certain minerals such as vanadium, chromium, and potassium. Even other minerals such as selenium and zinc play a very important role in insulin and sugar metabolism.

1. Chromium & Vanadium

Both of these minerals play a vital role in correcting the way insulin interacts with cells. Chromium improves insulin sensitivity (see study) while Vanadium improves the way insulin itself works (see study). Supplementing these minerals helps with correcting this problem.

I usually recommend this brand.

2. Selenium & Zinc

In clinical studies, both of these minerals improved metabolic profiles in patients with PCOS (see study 1 & study 2) They also play a vital role in the development and conversion of various hormones within the body that may also play a role in the pathogenesis of PCOS. Note that if your problem stems from high androgens, then you should avoid supplementing with Zinc as one of its functions is androgen production.

3. Amla

Also known as Indian Gooseberry, this fruit can be used as a supplement for improving sugar metabolism and reducing insulin. Amla has actually outperformed pharmaceutical drugs when compared for their efficacy in reducing blood sugar (see study). DO NOT use standardized extracts of this fruit. In my clinical experience, the whole herb supplements are more effective.

The most effective form of Amla that I have used is this one.

High Estrogen

High estrogen is caused by several factors including low calcium levels, low iodine, and the increase in consumption of foods that are full of soy, and other phyto-estrogen rich substances. Even plastic has estrogenic qualities.

1. Consume Cruciferous Vegetables

This includes Cabbage, Kale, Cauliflower, Brussel sprouts, and Broccoli. These vegetables contain indole-3-carbinol, which is able to significantly reduce estrogen levels (see study). However, they should be steamed or cooked in order to avoid the toxic effect they have on the thyroid gland. Also, do not consume too much of them as they can deplete iodine. You can also use an indole-3-carbinol supplement under the supervision of a doctor.

2. Correct Calcium & Vitamin D

More so Vitamin D plays a very important role in estrogen metabolism and should be increased. This can be accomplished by increasing your vitamin D intake. Apart from increasing Vitamin D supplementation, it is important to make sure that the organs responsible for Vitamin metabolism are functioning well – this would be the liver and kidneys. I’ve mentioned a few liver detox tips above. The kidneys can be detoxed with Cilantro and chlorella.

Avoid

– Weight Lifting
– Excessive Dairy (If you live in the USA, UK, or Canada, avoid dairy as much as possible)
– Soy, Corn, Too much sugar
– Alcohol
– Processed food
– Stress

(Always use medicinal herbs under the supervision of a doctor)

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By Dr. Nishal Ramnunan B.A.M.S.
Copyright © 2017