Polycystic Ovarian Syndrome (PCOS)
- Dr. Aidanne
- Feb 21
- 3 min read
Polycystic Ovarian Syndrome (PCOS) is one of the most common hormonal disorders affecting women of reproductive age. It is the leading cause of female infertility, as it impacts an average of 6-13% of women in the United States (1). Beyond infertility, PCOS also significantly increases the risk of type 2 diabetes, metabolic syndrome, and cardiovascular disease.
How do I know if I have PCOS?
Diagnosis is based on a combination of clinical symptoms, hormone testing, and imaging. The Rotterdam Criteria is the most widely used diagnostic tool and requires the presence of at least two of the following:
Hyperandrogenism – Elevated hormone levels (ie. Testosterone, DHT, DHEA-s, Estradiol), or symptoms such as acne, hirsutism, or hair thinning.
Irregular or absent menstrual cycles – A key sign of ovulatory dysfunction.
Polycystic ovaries on ultrasound – Multiple small follicles or a "string of pearls" visible on one or both ovaries.
Symptoms of PCOS
Hormonal imbalances in PCOS lead to a variety of symptoms, including:
Irregular or absent periods
Weight gain or difficulty losing weight
Excess facial or body hair (hirsutism)
Scalp hair thinning or male-pattern baldness
Acne along the jawline and chin
Insulin resistance and increased diabetes risk
Mood disturbances such as anxiety or depression
What Causes PCOS?
PCOS is believed to be driven by a combination of genetics, environmental factors, and metabolic dysfunction. Insulin resistance plays a key role, as elevated insulin levels stimulate excess androgen production, exacerbating symptoms. Lifestyle factors, including dietary choices and stress, also influence PCOS severity.
What is Insulin Resistance?
Think of glucose (sugar) as a package that needs to be delivered to the door step (receptors) of your cells for energy. Insulin is the mail carrier responsible for making sure the package gets to the door, and the pancreas is the boss overseeing the whole operation.
Normally, when insulin knocks, the cell doors open, and glucose is delivered smoothly. But in insulin resistance, which is common in PCOS, the cells stop responding to insulin’s knock. The packages (glucose) start piling up in the bloodstream, so the boss (pancreas) tells the mail carriers (insulin) to work overtime, sending out more and more workers to carry out these deliveries. This leads to high insulin levels, which can stimulate the ovaries to produce excess androgens (like testosterone), leading to symptoms such as irregular periods, acne, and hair growth.
See my article on blood sugar balance to learn more about this process!
Conventional Approaches to PCOS
Standard treatments focus on symptom management and may include:
Hormonal contraceptives – To regulate cycles and reduce androgenic symptoms.
Metformin – To improve insulin sensitivity and lower blood sugar levels.
Anti-androgen medications – Such as spironolactone to block testosterone conversion to DHT, and reduce excessive hair growth.
Ovulation-inducing medications – Such as letrozole or clomiphene for fertility support.
Regular physical activity – Both strength training and aerobic exercise improve insulin sensitivity.
Naturopathic Management of PCOS
Naturopathic medicine emphasizes dietary changes, lifestyle interventions, and targeted supplementation to address the root causes of PCOS. Here are a few of my favorite "go-to" means to support someone living with PCOS (not an exhaustive list!):
Diet & Lifestyle Strategies
Reduce refined carbohydrates and added sugars
Increase fiber intake – Supports hormone detoxification and gut health.
Incorporate healthy fats and lean protein – Essential for hormone production and satiety.
Stress reduction techniques – Yoga, mindfulness, and breathwork can help lower cortisol levels, which impact hormone balance.
Botanicals for PCOS
Spearmint tea – May help reduce excess androgens and improve acne.
Berberine – A natural insulin-sensitizing compound with similar effects to metformin.
Vitex (Chaste Tree Berry) – Supports progesterone production and cycle regulation.
Cinnamon – Helps regulate blood sugar and support metabolic function.
Saw Palmetto – May reduce androgen-related symptoms such as hirsutism.
Nutritional Supplements for PCOS
Inositol (Myo- and D-Chiro) – Supports insulin sensitivity and ovarian function.
Vitamin D – Often deficient in women with PCOS and is crucial for hormone balance & ovarian function.
N-Acetyl Cysteine (NAC) – A powerful antioxidant that improves ovulation and reduces inflammation.
Chromium – Supports blood sugar metabolism and insulin regulation.
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