Natural treatments for PCOS and endometriosis
It’s not uncommon for women to suffer from both PCOS (polycycstic ovarian syndrome) and endometriosis. In this article I’ll discuss the underlying causes of PCOS and natural treatments that help both endometriosis and PCOS.
Unlike endometriosis, PCOS doesn’t cause pain. This is because PCOS is a condition of hormonal imbalance (or androgen excess). PCOS is a complex condition to diagnose because there are many different symptoms and they can vary.
Endometriosis is a chronic inflammatory condition that is fuelled by estrogen.
What are the symptoms of PCOS?
PCOS can have a range of symptoms and associated conditions, including (1, 2):
Absent or irregular periods
Infertility
Acne
Excess facial hair
Scalp hair loss
Obesity (especially abdominal obesity)
High blood presssure
Metabolic syndrome
Type 2 diabetes
Dysbiosis (imbalanced microbiome)
Intestinal permeability (aka leaky gut)
Chronic inflammation
Anxiety and depression
How is PCOS diagnosed?
PCOS is diagnosed when at least two of the following are met:
Irregular or absent periods
Higher levels of androgens in the blood (androgens are male hormones) which are shown through a blood test or symptoms such as: acne, excess facial hair or hair loss from the scalp.
Polycystic ovaries on an ultrasound which means there are more than 20 follicles (which are partly developed eggs) on one or both ovaries or the size of one or both ovaries is increased
A ultrasound isn’t required if you meet criteria one and two. You don’t need to have multiple cysts on the ovaries to be diagnosed with PCOS.
What causes PCOS?
There is no exact cause of PCOS but the cause of excess androgen production is linked to family history, insulin resistance and inflammation. If you suspect PCOS it’s important to see a health professional who can diagnose you and rule out other conditions that have similar symptoms, such as hypothalamic amenorrhea.
If you have PCOS it’s 70% likely you have insulin resistance - a condition where your body doesn’t utilise insulin properly. Insulin resistance often causes high levels of insulin in the blood and causes excess androgen production, leading to PCOS (3).
Often when women come off the pill to treat PCOS, their symptoms are worse. In some cases coming off the pill can trigger PCOS, this type of PCOS isn’t necessarily due to insulin resistance but more to do with the change in hormones and an increase in androgens that can happen when stopping the pill.
The oral contraceptive pill doesn’t correct the underlying hormonal imbalance, it overrides your natural hormones with synthetic ones. In addition the pill can cause insulin resistance (4).
Natural treatments for PCOS and endometriosis
Diet, supplements and lifestyle are all supportive therapies for both PCOS and endometriosis, as they can help reduce inflammation and improve gut health which are important factors in both conditions.
When approaching treatment for both these conditions it’s important to understand the underlying cause of your hormonal inbalance. If you are one of the 70% of women with PCOS who have insulin resistance then consider:
A low glycemic / anti-inflammatory diet to help keep blood sugar stable and to lower inflammation
Removing refined carbohydrates such as sugar and flour
Increase fibre intake
Consider prebiotics / probiotics to support gut health
Regular exercise is important for those with insulin resistance, consider working with an exercise physiologist
Consider sleep and stress - chronic stress and poor sleep will negatively impact both conditions
Helpful supplements for insulin resistance include inositol, chromium and magnesium
Examples of supplements that help lower inflammation include curcumin and fish oil
If you’re looking for support with PCOS or endometriosis, I’m available for appointments in Brisbane or online / over the phone. Click here to book.
References
Rojas, J., Chávez, M., Olivar, L., Rojas, M., Morillo, J., Mejías, J., Calvo, M., & Bermúdez, V. (2014). Polycystic ovary syndrome, insulin resistance, and obesity: navigating the pathophysiologic labyrinth. International journal of reproductive medicine, 2014, 719050. https://doi.org/10.1155/2014/719050
Zhao, X., Jiang, Y., Xi, H., Chen, L., & Feng, X. (2020). Exploration of the Relationship Between Gut Microbiota and Polycystic Ovary Syndrome (PCOS): a Review. Geburtshilfe und Frauenheilkunde, 80(2), 161–171. https://doi.org/10.1055/a-1081-2036
Marshall, J. C., & Dunaif, A. (2012). Should all women with PCOS be treated for insulin resistance?. Fertility and sterility, 97(1), 18–22. https://doi.org/10.1016/j.fertnstert.2011.11.036
Evanthia Diamanti-Kandarakis, Jean-Patrice Baillargeon, Maria J. Iuorno, Daniela J. Jakubowicz, John E. Nestler, A Modern Medical Quandary: Polycystic Ovary Syndrome, Insulin Resistance, and Oral Contraceptive Pills, The Journal of Clinical Endocrinology & Metabolism, Volume 88, Issue 5, 1 May 2003, Pages 1927–1932, https://doi.org/10.1210/jc.2002-021528