PCOS: A Functional Doctor Explains What You Really Need To Know

In my practice, Parsley Health, it seems every week I meet a patient who has been told by her gynecologist that she has PCOS.

PCOS, or polycystic ovarian syndrome, is a group of symptoms resulting from a hormonal imbalance. It's the number one cause of fertility issues in the U.S. An estimated 5 to 10 percent of women of childbearing age have PCOS, while at least 30 percent of all women have some symptoms of PCOS. And as with most chronic diseases and conditions, the prevalence of PCOS is increasing around the world.

Most of the women who come to me with PCOS have been told by their doctor that they must take a birth control pill in order to "stop it." Unfortunately, the Pill does not actually fix or “stop” PCOS. It only masks its symptoms while the syndrome continues unhindered under the surface.

The link between these seemingly unrelated and random set of symptoms? It's suspected that insulin, body fat, and metabolism are the underlying causes of this constellation.

Many women are anovulatory (they fail to ovulate) because of a variety of other factors. In today’s high-stress, high-inflammatory world, I see this frequently and it’s usually as a result of a suppressed HPG (hypothalamus, pituitary, gonadal) communication pathway.

In reality, the birth control pill does nothing to cure, prevent, or fix PCOS or any other hormone disorder. It can be helpful as a management tool for symptoms, but ultimately it just masks the problem.

I consider this to be the most "bustable" of all the myths about PCOS. I've had many women balance testosterone levels, lose body fat, resolve acne and facial hair growth, and regain their menstrual cycles through a mixture of diet, supplements, and lifestyle changes including stress reduction and better sleep.

This brings us to the deeper question on PCOS: What can we do about it?

What I often see causing PCOS is a potent mixture of chronic stress that increases testosterone levels, and a diet high in refined carbs, sugar, processed foods, and alcohol, which increases insulin, thereby increasing testosterone.

Weight gain, especially visceral fat — the kind that’s underneath the muscle of your belly, not on top of it — is also a culprit. This fat is inherently insulin resistant, inflammatory, and estrogen producing. The increased estrogen suppresses LH and FSH from the brain, the hormones you need to get a menstrual cycle.

I find that the solution for many women is therefore real stress reduction, not the kind you pay lip service to by going to yoga once a month, but real, daily stress management. (I teach this in my mindbodygreen stress course.) It also means following a very low-glycemic, plant-based, Paleo-style eating plan.

I also tell my patients that supplements can be helpful, specifically myo-inositol and d-chiro-inositol to lower testosterone and balance insulin; curcumin and other herbal compounds to lower inflammation; a combination of cinnamon, EGCG from green tea, and chromium to balance blood sugar; and long-chain omega-3 fatty acids to lower the production of inflammatory messengers.

Remember to use supplements with the support of a trusted provider, such as a functional medicine practitioner, who knows you and your life story, and who can do regular testing to be sure that the effects of these supplements are getting the results you want. After all, it’s not fun to play with your hormones and get it wrong.