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From Symptoms to Solutions: Your Ultimate Guide to Conquering PCOS

October 14, 2024

If you—or someone you care about—is struggling with Polycystic Ovary Syndrome (PCOS), you know just how frustrating and demoralizing it can be. 

PCOS is often viewed as just a gynecologic issue, but it's so much more than that.  

While many people associate PCOS with irregular periods and fertility struggles, it’s actually a lifelong condition that impacts your entire body—from how your cells respond to insulin to your mental health.

Though weight gain, hormonal acne, and difficulty getting pregnant are some of the better-known symptoms, what’s less talked about are the ways PCOS can show up in women of all shapes and sizes. Some women with PCOS don’t even have cysts on their ovaries, and many who are lean still battle the same hormone imbalances.

PCOS is deeply connected to insulin resistance, elevated androgen levels, and even gut health. But here’s the tricky part: Conventional medicine often focuses on treating symptoms, rather than addressing the root causes that make PCOS such a complex, whole-body condition. 

What works for one woman may not work for another, which can make managing it feel like a puzzle.

If you or someone close to you is navigating PCOS, you know how overwhelming it can be. So let’s dive in, break down what’s really happening in your body, and explore how you can take practical steps to feel better—beyond the typical advice.

Understanding the Hidden Driver of PCOS

At the heart of PCOS is a metabolic issue that doesn’t get enough attention: insulin resistance. Many women with PCOS have cells that don’t respond properly to insulin, a hormone that helps regulate blood sugar. This resistance means their bodies need to produce even more insulin to keep blood sugar levels in check.

But why does this happen?

Newer research suggests that in some women with PCOS, this could be due to beta cells—the ones that produce insulin in the pancreas—reacting too strongly or working harder than they should in response to our Westernized lifestyle.¹ For others, altered insulin metabolism—where your body doesn’t get rid of insulin efficiently after it’s been used—might be to blame. 

We still don’t know why this happens, but many doctors and researchers agree that PCOS is a highly complex condition influenced by genetic factors, environmental toxins, and a person’s lifestyle choices that may predispose some women to these issues with insulin production and metabolism.

How Elevated Insulin Fuels Hormonal Imbalances in PCOS

High insulin sets off a hormonal domino effect throughout the body. In the ovaries, insulin works together with another hormone called luteinizing hormone (LH) to boost the production of hormones like DHEA and testosterone. These hormones, known as androgens, are typically higher in men, but when women produce too much—as is common in PCOS—it can lead to hormonal imbalances.

These imbalances can predispose women to: 

• Disrupted ovulation and irregular or absent periods 
• Heavy periods 
• Weight gain (especially around the abdomen)
• Acne 
• Loss of scalp hair (male-patterned hair loss)
• Growth of body and facial hair (where you don’t want it)
• Mental health symptoms like anxiety and depression² 

If left unchecked, insulin resistance in PCOS can also contribute to developing lifelong conditions like fatty liver disease, high blood pressure, and/or type 2 diabetes, and other cardiovascular complications.

Additional Factors that Contribute to PCOS 

► The Role of Thyroid Hormone

Your thyroid, a gland that produces hormones crucial for regulating metabolism, reproduction, and mood, plays a significant role but can be overlooked in PCOS. 

Research shows that women with PCOS are more likely to have thyroid disorders, particularly subclinical hypothyroidism and autoimmune thyroid diseases like Hashimoto’s thyroiditis.³ A recent study from Denmark reported that the likelihood of developing thyroid disease is 2.5 times greater in women with PCOS compared to those without the condition.⁴

These thyroid issues don’t just coexist with PCOS—they can actually make its symptoms worse.

Subclinical hypothyroidism is a condition when thyroid hormone levels are slightly low but not enough to cause obvious symptoms. It’s more common in women with PCOS and can worsen insulin resistance. 

In fact, clinical research shows that subclinical hypothyroidism is significantly more prevalent in women with PCOS (43.5%) compared to those without the condition (20.5%).⁵ The study also showed that women with PCOS and subclinical hypothyroidism had notably higher weight and BMI than participants without PCOS.  

Plus, thyroid hormones help regulate reproductive function. Hypothyroidism can lead to irregular periods, ovulation issues, and even infertility, compounding the reproductive challenges many women with PCOS face. 

This makes it crucial to monitor thyroid function in women with PCOS, as treating thyroid imbalances can help improve some of the metabolic and reproductive symptoms associated with the condition.

► PCOS and Gut Dysbiosis 

The link between gut health and PCOS is becoming a key area of research. Your gut microbiota, the trillions of microorganisms living in your digestive tract, play a major role in regulating metabolism, hormones, and inflammation. 

For women with PCOS, the composition of their gut microbiota is often imbalanced, a condition known as gut dysbiosis.⁶

Studies show that women with PCOS tend to have less microbial diversity and an altered gut microbiome compared to women without the condition.⁷ This imbalance can lead to increased inflammation, insulin resistance, and heightened levels of androgens, which are already problematic in PCOS. Research even suggests that gut dysbiosis might contribute to the development of PCOS by affecting hormone levels, the integrity of the intestinal barrier, and metabolic processes.

Restoring a healthy balance in the gut can help improve insulin sensitivity, reduce inflammation, and regulate hormone production. Some promising strategies include incorporating probiotics and prebiotics into your diet and increasing your fiber intake.

These approaches aim to support a healthy microbiome, which may alleviate some of the metabolic challenges associated with PCOS.

► Environmental Pollutants and PCOS

Emerging research shows that environmental pollutants like heavy metals, insecticides, and endocrine-disrupting chemicals may play a role in the development of PCOS. 

Studies have found that women with PCOS, especially those with higher androgen levels, tend to have higher levels of pollutants such as BPA (found in plastics) in their blood.⁸ Other chemicals, like perfluorooctane sulfonate (used in stain repellents) and phthalates (used in plastics and cosmetics), have also been linked to PCOS, potentially worsening hormonal imbalances and metabolic issues.⁹

How to Balance Hormones Naturally Through Diet, Exercise, and Lifestyle

The primary goal in managing PCOS is to reduce insulin levels, which in turn helps lower androgen levels.¹⁰ 

The good news is that there are effective ways to balance your hormones and ease disruptive symptoms through a comprehensive approach involving diet, exercise, and lifestyle adjustments. 

These strategies have transformed the lives of many of my patients, helping them regain control over their hormones and experience lasting relief from PCOS.

What you eat plays a fundamental role in hormone regulation. By focusing on nutrient-dense, whole foods, you can support your body’s natural hormone balance.

In fact, if you make one major change to your diet, this one will provide the biggest benefits: eliminate ultra-processed foods. 

The reason: For one, ultra-processed foods are generally loaded with fast-digesting carbohydrates that spike your blood sugar. But they’re also engineered to be hyper-palatable. That means they’re so delicious they’ve very hard to stop eating. This exacerbates their effect because they drive you to eat even more of the sugar and starch they contain, creating the kind of “metabolic mayhem” that PCOS feeds on. 

By eating whole foods instead, you’ll dramatically lower your intake of fast-digesting carbs, be satisfied with far less food, and get your blood sugar under control. 

Especially emphasize low-starch vegetables, high-quality protein, and healthy fats. That probably sounds complicated, but here’s a simple but incredibly effective guideline: Seventy-five percent of your plate should be vegetables, and the other 25 percent should be made up of high-quality protein and healthy fat. 

Here are a few key strategies to help you make these changes:

• Add in healthy fats: Fats from sources like avocados, olive oil, and nuts are essential for hormone production and help reduce inflammation. Wild-caught fish (salmon, mackerel, or sardines) is another great source of healthy fats. 
  
  
• Consider adding an omega-3 supplement to make sure you’re getting enough healthy anti-inflammatory fats in your diet.
  
  
• Increase your fiber intake: Fiber aids in the elimination of excess hormones and nourishes your gut microbiome. Incorporate fiber-rich organic fruits, vegetables, and whole grains.
  
  
• Don’t forget a high-quality probiotic to enhance the balance of beneficial bacteria in your gut, which can further aid in hormone regulation.
  
  
• Prioritize high-quality protein: Opt for organic, free range, and grass-fed meat.
  
  
• Add phytonutrient-rich foods, which provide essential antioxidants:
  
  
• Leafy greens: 2-3 servings (one serving is about 1 cup of raw greens or 1/2 cup of cooked greens).
  
  
• Berries: 1-2 servings per day (one serving is about 1/2 cup).
  
  
• Cruciferous vegetables like broccoli, cauliflower, and kale not only provide phytonutrients, but can also help promote proper hormone metabolism (one serving is about 1 cup of raw vegetables or 1/2 cup of cooked vegetables).
  
  
• Incorporate GLP-1-boosting foods: Foods that stimulate the production of GLP-1, a hormone that helps regulate appetite and blood sugar levels, can be beneficial for women with PCOS. These foods can help improve insulin sensitivity, manage weight, and support overall metabolic health, making them a key part of a PCOS-friendly diet. 
  
  GLP-1-supporting foods include:
  
  
  • Bitter foods like arugula, dark leafy greens, bitter melon, green tea, yerba mate, coffee, and dark chocolate.
    
    
  • Fiber-rich foods like sunchokes, apples, and onions.
    
    
  • Phytonutrient-rich foods.
    
    
  • And of course, one of my personal favorites is Himalayan Tartary Buckwheat.
    
    
• Optimize glycemic control with targeted supplements: 
  
  
  • Berberine can help improve insulin sensitivity by regulating key signaling pathways, offering potential therapeutic benefits for managing PCOS.¹¹
    
    
  • Inositol can help improve insulin sensitivity and glucose metabolism in women with PCOS.¹²
    
    
  • Vitamin D deficiency is common in women with PCOS, affecting 67-85%, and may be a significant factor contributing to insulin resistance and metabolic syndrome.¹³ That’s why ensuring you’re getting enough vitamin D is crucial if you have PCOS. 
    

2. Exercise

Regular exercise supports hormone regulation and can help alleviate disruptive symptoms of imbalance.

• Moderate-intensity exercise: Activities like walking, cycling, or swimming improve cardiovascular health and reduce stress.
  
  Don’t know where to start? Take a look at this article for tips and tricks that might just work for you. 

• Strength training: Building lean muscle mass through weight training can improve insulin sensitivity and support a balanced metabolism.
  
  For a deeper dive, feel free to check out Dr. Gabrielle Lyon’s book Forever Strong.

3. Lifestyle

Your lifestyle choices, from how much sleep you get to how you manage stress, play a major role in your hormonal health.

• Avoid plastics, especially those with recycling codes 3, 6, and 7, as they are more likely to contain hormone-disrupting chemicals like BPA and phthalates.
  
  
• Check out the Environmental Working Group’s guides to clean living. 
  
  
• Manage stress: Elevated cortisol levels from chronic stress can worsen hormone imbalances. Incorporating stress-reducing practices like meditation or deep breathing can help keep cortisol levels in check. 
  
  
• Give diaphragmatic breathing a try.
  
  
• Consider nourishing your adrenal health: Adaptogenic herbs like ashwagandha or rhodiola can support your adrenal glands and help your body manage stress hormones.
  
  
• Prioritize sleep: Aim for 7-9 hours of sleep per night, as good-quality sleep is essential for proper hormone function. 
  
  
• Detox regularly: Help your body eliminate toxins that disrupt hormone levels by staying hydrated, eating organic foods, sweating, and reducing your exposure to xenoestrogens.

4. Testing 

If you’re experiencing significant symptoms of hormone imbalance, it’s important to get tested. Hormone testing can pinpoint specific issues, allowing for targeted treatment. 

• DHEA-S and testosterone: This test measures levels of androgens, hormones that contribute to PCOS.
  
  
• Insulin response test and hemoglobin A1c: These tests can provide crucial information about a patient’s insulin sensitivity and glucose metabolism.
  
  
• Prolactin test: This test helps rule out any issues, like a pituitary tumor that could mimic PCOS.
  
  
• Thyroid: Testing for TSH, T4, and T3 can help rule out problems, such as an underactive or overactive thyroid.
  
  
• Lipid profile: Measures cholesterol and triglyceride levels, helping to assess the risk of heart disease and other metabolic issues commonly seen in PCOS.
  
  
• Cortisol: To rule out Cushing syndrome.

Most of the needed tests (and many others) can be done with the company I co-founded, Function Health for $499 (over 110 biomarkers) by going to www.functionhealth.com/mark.

If you’re experiencing persistent symptoms that haven’t responded to conventional treatments, exploring a Functional Medicine approach with the guidance of a skilled practitioner could be beneficial. You can connect with my team at the UltraWellness Center, or find a Functional Medicine practitioner near you.

References

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