PCOS: Are Birth Control Pills and Metformin the Only Treatment?

That depends on who you ask.  If you ask a medical doctor, gynecologist or endocrinologist, the answer will be yes or possibly a drug called spironolactone and Accutane for the acne.  If you ask a naturopathic doctor, the answer will be “not by a long shot!”.  There are numerous natural treatments for PCOS that can not only ease the symptoms, but also address the underlying cause of the condition and build up your body at the same time. Why the disparity in answers?  Because Medical Doctors are not trained in and have little or no knowledge of naturopathic medicine.  If you are looking for an alternative to drugs for PCOS, the best person to ask is not the person who is only trained in the drugs.  It’s like asking your mechanic “what is the best dog food?”  He or she may offer up an opinion on what to feed Rover, but it’s not coming from an expert on the subject. The best person to consult regarding natural remedies or alternatives to drugs for PCOS is a licensed naturopathic doctor who specializes in women’s health and PCOS.

3 Common Misconceptions about PCOS

  1. All women with PCOS are overweight or obese – this is not true, up to 40% of women with PCOS are thin.
  2. Women with PCOS are infertile – possibly if they don’t address the root of the problem, but I’ve helped many women with PCOS conceive and have healthy, natural pregnancies.
  3. All women with PCOS have high testosterone levels.  Nope!  Many do, but others have different reasons why they’re not ovulating regularly such as high prolactin, high DHEAs, high androstenedione etc.

 

Low Carb Diet

From:

Why a Low-Carb Diet Should Be the First Approach in Diabetes Treatment

http://www.diabetesincontrol.com/articles/53-diabetes-news/17323-why-a-low-carb-diet-should-be-the-first-approach-in-diabetes-treatment#unused

  • Dietary carbohydrate restriction has the greatest effect on decreasing blood glucose levels.
  • During the epidemic of obesity and type 2 diabetes, caloric increases have been due almost entirely to increased carbohydrates.
  • Benefits of dietary carbohydrate restriction do not require weight loss.
  • Studies show that carbohydrate restriction is the best intervention for weight loss.
  • Adherence to a low-carb diet in people with type 2 diabetics is at least as good as adherence to any other dietary interventions and is frequently significantly better.
  • Replacement of carbohydrate with protein is generally beneficial.
  • Dietary total and saturated fat do not correlate with risk of cardiovascular disease.
  • Plasma saturated fatty acids are controlled by dietary carbohydrates more than dietary lipids.
  • The best predictor of microvascular and to a lesser extent, macrovascular complications in patients with type 2 diabetes, is glycemic control (HbA1c).
  • Dietary carbohydrate restriction is the most effective method of reducing serum triglycerides and increasing HDL.
  • Patients with type 2 diabetes on carbohydrate restricted diets reduce and frequently eliminate medication and type 1 diabetics require less insulin.
  • Intensive glucose lowering by dietary carbohydrate restriction has no side effects comparable to the effects of intensive pharmacologic treatment.

It makes sense that if carbs are creating lots of insulin, and that’s leading to weight gain, heart disease and diabetes, you want to correct the source of the problem by reducing the carbs. This approach should also apply to anyone with Polycystic Ovarian Syndrome, metabolic syndrome, high cholesterol, high triglycerides and hypertension.  Beware of studies that claim that low carb diets don’t work, they do and the well designed studies show that.  Poorly designed studies that consider 150-200 grams per day of carbohydrate “low carb” will not show a benefit because there’s nothing “low” about 150-200 grams of carbohydrate per day.  Low carb is 60-80 grams of carbohydrate per day.

Feinman RD, Pogozelski WK, Astrup A, et al. Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base. Nutrition. 2015;31(1):1-13. Abstract

Polycystic Ovarian Syndrome Theories

Some of the prevailing theories as to what is going on with women with PCOS include:

1.  A defect in insulin action and secretion that leads to higher blood insulin levels and insulin resistance.
2.  A defect in the nervous and endocrine systems leading to an exaggerated LH (luteinizing hormone) pulse frequency and amplitude
3.  A defect of androgen (male hormone) production that results in enhanced ovarian testosterone, DHEAs and/or androstenedione production
4. An alteration in cortisol metabolism resulting in enhanced adrenal androgen production (Tasoula et al, Clin Endocrinol, 2004)
5. Intrinsic theca (ovarian) cell hypersensitivity to LH stimulation that results from defective inhibition by FSH that may involve inhibin-B signalling. (Hirshfeld-Cytron et al, J Clin Endocrinol Metab, 2009)

In any case, improvement is usually seen through measures that lower insulin such as low glycemic index, low glycemic load diet, stress reduction and daily exercise. Additional support from insulin sensitizing agents like inositol, NAC, zinc, and cinnamon is also helpful.