How to treat PCOS with a naturopathic, holistic approach. Learn about natural ways of treatment for polycystic ovary syndrome.

Living with PCOS (Polycystic Ovary Syndrome) can be devastating. On top of the symptoms of excess/loss of hair, weight gain, acne, and irregular periods, women often face self-esteem battles, anxiety, depression, and medical trauma. If you go to a conventional medical doctor for PCOS, the treatments are often limited and with many side effects. 

There is a time and space for all medicines. At times simply getting your symptoms alleviated is enough for you at this moment. And medications often have side effects that can worsen conditions. For instance, Birth Control can lead to worsening anxiety or depression, or blood sugar dysregulation.  

And it can be a battle to even get the proper workup to get diagnosed with PCOS. You can read more about PCOS diagnosis here.

In today’s reproductive political environment, it is more pertinent now more than ever to get in touch with the medicines that Earth provides.  As we turn to fight for abortions and voting rights, I cannot fathom that endocrinology pharmaceutical studies are going to magically begin investing more into women’s health.  There is so much knowledge to be gleaned from modern science today. 

And it gets particularly sexy when we get to apply that knowledge into age-old remedies used by our grandmothers from across the globe.  The following PCOS suggestions help you find the correct natural remedies to complement your care plan, preserve fertility, obtain pain-free regular periods, and avoid diseases associated with PCOS. 

The issue with managing PCOS using the conventional medical system is the sequelae of unmanaged hormones that can lead to chronic diseases and a lower quality of life. Our insurance-based system is modeled after Medicare which directly states “Care that seeks to prevent disease, promote health, and prolong and enhance the quality of life, is not considered medically necessary, and therefore not payable.” (MCM 2251.3 reference)

Reduce Toxic Burden 

If you see me for PCOS, we assess the toxic load in your body to determine whether or not to do a detox. Many plastics, bisphenols, air pollutants, water, and your cosmetics could be the root cause of your hormonal dysregulation. Many of these toxins can block essential nutrients that help balance your hormones. For more specific methods to reduce toxic exposures in your day-to-day life, please see the Ebook, house plants and naturopathic guide to reducing toxic loads in your home for weight loss.  (Ebook provided in assets on house plants + reducing the toxic load in your home.)

Acne

Another major symptom of PCOS is acne. For treatment, you may be prescribed Spironolactone, Accutane, or other acne medication. This makes very little sense to me, as many acne medications are endocrine or hormone disruptors. Herbal and nutritional detoxification (aka eating cleaner) helps with acne. Detoxing decreases androgens which helps testosterone convert to estrogen. 

A regular skin-care routine with clean products, dietary shifts, hormone help, and some TLC can definitely decrease acne. Acne caused by PCOS has always seemed to take the longest to address. Skin treatment usually follows after balancing hormone cycles and regulating blood sugar. If you are feeling a bit impatient about your cystic acne, you can check into micro-needling and dermabrasion.  My two trusted skin care companies include Lifestyle Physicians for micro-needling services and Boketto Wellness for products and facials. 

Reduce Testosterone Dominance 

Some doctors will offer 5 alpha-reductase (5AR) inhibitors. It’s a mouthful to say, but an important player in reducing androgen and boosting healthy estrogen. With the range of side effects from these medications, I prefer to use herbal remedies that work on the 5AR pathway which also helps build healthy thyroid function, brain health, and adrenal function. Herbs that I find to be most effective with PCOS hormone regulation include saw palmetto, nettle root, vitex, licorice, Chinese peony, and schizandra.  

Control Blood Sugar and Insulin

The only medication that I see truly helps my clients with PCOS insulin is Metformin.  This medication not only helps with controlling blood sugar, but also helps with weight gain that can be associated with PCOS/ metabolic syndrome.  Metformin does not come without side effects. Other considerations for blood sugar regulation are weight management, exercise, food as medicine, inositol, and berberine.

Weight management + Gut Health + Exercise

These 3 are key for reversing symptoms of PCOS. You can read more about food as medicine here.

Top Herbs to Consider

Every herbal regimen must-have herbs that target the pituitary, hypothalamus, and ovaries.  If you skimp on any level of the endocrine system, you risk worsening your hormone imbalance or just simply doing a half-ass job at helping your system out.  

Peony and Licorice

This is a classic combination for PCOS that has been used in Chinese Medicine for years.  

Licorice, or Glycyrrhiza Glabra

This is used in culinary and herbal medicine in almost all cultures.  The medicinal action of licorice is on the entire HPA + O Axis; meaning that it works on the brain, ovarian, and adrenal levels of the body to balance hormones.  Licorice has a mild estrogenic effect on tissues and can prolong progesterone metabolism.  Licorice also has a steroidal-like action and can help maintain cortisone in the body, which helps keep your energy level feeling normal during periods of cortisol dips, which looks something like afternoon and morning fatigue.  Lately, I have been seeing reactivation of current mono infections (EBV) in many clients that are struggling with fatigue.  Licorice also happens to have a strong anti-viral effect, which makes this a lovely herb if you are struggling with fatigue, PCOS, and viral infections.  I often use licorice in combination with Saw Palmetto, Vitex, and Chinese Peony for PCOS.  Licorice is a mild estrogenic and anti-androgenic, and when combined with saw palmetto or Serenoa repens, it’s a mild anti-androgenic and a prime choice for PCOS treatments. 

Licorice also modulates inflammation via inhibition of the cox-2 pathway and dual 5-lipoxygenase, which makes it amazing for those who have PCOS with autoimmune components or cardiovascular risks. In rat studies, oral licorice extract reduced sorbitol levels in red blood cells of diabetic rats. 

Peony

“A woman who consumes the root of the peony every day becomes as beautiful as the Peony flower itself” – inner beauty 

Peony is estrogen-modulating, meaning it makes estrogen raise or lower. A term we use in herbalism for herbs that can help you swing both ways is amphoteric, like an amphibian, but pertaining to body health rather than legs vs fins.  

Peony bypasses the liver to build blood and is also used to help quell your nervous system When used with Dong Quai, she can help promote bleeding and is also used with motherwort to help inhibit fibroids. The traditional Chinese medicine use for Peony is indicated for autoimmune conditions associated with pain in the joints. It is important to know these specifics with herbs in order to nail your own custom health formula. You can see my Cyclical Living course for graphs and handouts to help build your own medicinal apothecary. (Link to Cyclical Living course)

I personally love Tulsi as an all-around adaptogen or balancer of cortisol.  Tulsi, or Holy Basil, is one of my go-to stress-balancing herbs.  Not only can it help you bear the weight of the world with more grace, but also helps insulin sensitivity and it can lower blood sugar if you are having issues with blood sugar regulation.  

Dong Quai is also a classic Chinese medicine plant that is included in formulas to tonify the uterus and brings blood flow.  This is particularly useful if you have scanty bleeds or missed periods.  

Saw Palmetto is a large palm plant that isnative to Florida and is widely used as a type of tree of life… providing roofing, fibers, and food for the Seminoles and other native Floridians.  Most modern herbalists and supplements simply use the berry for its steroidal saponins and ability to be a 5@reductase inhibitor, decreasing the production of DHT (dihydrotestosterone).  Specifically for PCOS, Saw Palmetto is used to deter DHEA from converting to DHT. At the same time, it is a mild estrogenic, which when used alongside a licorice and peony classical formula, can help in the production of estrogen.  Saw Palmetto is also recommended for weakness or atony of the urinary system due to aging.  Also, it is known to help with kidney stones. RF Weiss of Germany mentions Seronoa as being used to improve urinary atony and dysfunction that is nervous in origin, including sphincter and detrusor muscle dysfunction. Weiss believed that Saw Palmetto improved the urinary autonomic system. 

Vitex is an ace-in-the-hole for almost every woman suffering from a hormone imbalance.  You can learn more about vitex in my Cyclical Living course, as we cover her fully. 

Biphasic Blends as a Remedy

There is a method to prescribing herbs in a biphasic way that often can lead to a more regular period.  I quite prefer this method, as it isn’t just the luteal phase preparing for the bleed that needs attention.  In the follicular phase, or the first half of your cycle, your follicles grow.  Granulosa cells rest between the follicles in the ovary and they convert testosterone to estradiol (this can be aided by the peony and licorice blend listed above). Estradiol helps the follicles grow plump and juicy.  As your cycle progresses, one follicle becomes the “lead” follicle, or the larger one.  This is generally the follicle that drops an egg for ovulation.  Once the egg is released into your fallopian tubes, the empty follicle or eggshell remains and begins secreting progesterone.  The healthier the follicle, the more progesterone is secreted.  If the egg goes unfertilized by sperm, then as progesterone drops and estrogen remains, you begin to shed your uterine lining (aka have your period).  You can learn more about biphasic blends in any of my hormone health courses.

Other Remedies

Sometimes, heat packs (I prefer hot water bottles) and castor oil can help promote a bleed.  I also quite appreciate mugwort tincture for this. If a client goes more than two cycles after initiating a PCOS care plan with me, I will suggest a progesterone challenge, which can force a bleed if the client is not in ovarian failure.  This is a process in which you take a loaded dose or progesterone over a period of time, stop, and wait for a bleed. Some doctors use progestin, and I prefer natural progesterone, for a number of reasons. After a successful bleed, we go back to the biphasic blends; and generally, a natural period happens in the next cycle.  

There are low-dose herbs that can stimulate ovulation that can be used if prescribed safely by a Doctor that knows your health history. 

Top Supplements to Consider 

Inositol helps regulate blood sugar and make your ovaries more sensitive. This is a must for all women with PCOS. 

NAC makes your ovaries more sensitive to all the herbs and supplements you are taking. 

CoQ10 is a top antioxidant for ovarian health. 

Berberine, Oregon grape, or Barberry to help with gut health and blood sugar regulation. 

A high-quality prenatal to replenish lost nutrients or necessary nutrients for total body health. 

In Closing

Many of the prescription drugs used to relieve PCOS symptoms often produce negative side-effects such as depression or blood-sugar dysregulation. Furthermore, these treatments do not address the underlying issues at the root of PCOS symptoms. As an integrative healthcare provider, I help you to examine how your environmental toxins may be contributing to your PCOS-related hormonal imbalance that is causing your symptoms. After thorough testing, I can direct you to herbal medicines that heal acne and reduce testosterone dominance. In addition to herbs, I emphasize that the key treatment for PCOS is a commitment to a lifestyle change that focuses on a healthy diet and enjoyable exercise. I offer you my informed guidance and compassionate support as you take steps to reverse your PCOS symptoms for good. To learn more about PCOS signs and symptoms, read here.