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 pharma 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 to age-old remedies used by our grandmothers from across the globe. The following PCOS series unpacks allopathic offerings for irregular periods and natural remedies to complement or as an alternative for natural conception and/or pain-free regular periods.
Have you struggled with regular periods? Or maybe painful periods, acne, energy, and hair loss? Are you unsure what the signs of ovulation are or if you’re ovulating? Likely, if you’re reading this you have been to a doctor about this and you’re not quite sure if the answers you received are the complete picture. You landed on the right page.
Almost all first consultations bring me to tears. I hear these stories weekly: that everything is normal, or that it is just in your head, or that birth control is handed out instead of a proper workup to see what is really going on.
1 in 12 women in childbearing years has Polycystic Ovarian Syndrome (PCOS). PCOS is not a disease, it is a collection of symptoms and all treatments are tailored toward managing symptoms. There is no cure for this, though I will say, I see symptoms reversed within just a couple of months of herbal and lifestyle-applied suggestions. The fact that we do not have more answers in standard American medicine floors me.
The truth is, we need a serious reformation here in reproductive justice. Women are treated as if our health is superfluous unless we are heading into baby-making. And it’s not the Doctor’s fault. Funding research (yes, usually from pharma) changes patient care algorithms, not Physicians.
The amount of self-advocacy that it takes to find answers on women’s hormones is exhausting. In the wellness industry, information is delivered in a diluted fashion with “cure-alls.” And in the medical-industrial complex, the information is delivered that there are few options with very little education: Birth Control or Clomid or Letrozole as step one for trying to conceive, and other pharmaceuticals. Not one of these answers are helping you get to the root of imbalances. First, you need to understand if you have PCOS.
The gut microbiome is a community of trillions of “bug” variants that regulate almost everything in our body. In fact, the human genome project revealed an ounce of medicine whereas the microbiome genetic sequencing is revealing a universe of medical knowledge. The microbiome regulates everything from nutritional status, immune function, emotional health, endocrine (hormone) health, and metabolic health.
The microbiome helps hold down the mucosal barrier and when out of balance, it can lead to a “leaky gut.” The mucosal barrier screens for who gets to stay in the gut and who gets to leave into the bloodstream. Nutrients from our food can pass through the mucosal layer into the submucosa. When protein food particles, bacterial and viral fragments begin to leak into the submucosa instead of being passed through our digestive system, inflammation is triggered.
Not only can these particles cause the body to develop antibodies to particular foods (food intolerances), but also antibodies to the body’s own tissues. In fact, 70% of the body’s immune tissue is developed in the gut. Dysbiosis or misgrowth of gut microbiota can lead to more inflammatory cells such as tumor necrosis factor (TNF), interleukin 6 (IL-6), and nuclear factor-kappa B (NF-KB), while promoting anti-inflammatory cytokines like interleukin-10 (IL-10). And it only takes three days of eating a standard American diet to cause an imbalance in gut bacteria!
There is actually new research emerging that shows that there is a direct cross-talk between the hypothalamus and pituitary hormones that regulate your hormone health and the proteins and hormones in the gut. The trickster here is that you may not even have gut symptoms if you have dysbiosis or insidious parasitic infections.
Direct PCOS/Gut Connection
Studies have shown that women with PCOS have a dysbiotic gut more so than women without PCOS. In fact, the literature has leaned so far into this correlation, that in the future, we may find that there is a CAUSATIVE link between dysbiosis and PCOS + its complications (androgen excess, metabolic syndrome, insulin resistance, inflammation).
Insulin Resistance and the gut connection. 70% of women with PCOS may develop Insulin resistance. Though there is a genetic and lifestyle component, we know that those with insulin resistance. Bacteria shells or outer membranes have a signal that stimulates innate immunity and helps regulate nutrient absorption. When this shell is less active due to dysbiosis (overgrowth of other bacteria that can lead to inflammation), then it can lead to insulin resistance. Furthermore, this shell helps short-chain fatty acids such as butyric acid be created which helps strengthen the mucosal barrier.
Obesity / Metabolic Syndrome is more prevalent in women with PCOS. There are particular microbes that are imbalanced in mice that struggle with obesity and when given a poo-transplant, the mice lose weight without a lifestyle change. This has also translated to the human experience. For instance, when Akkermancia muciniphila is reduced, obesity is more common, but when Akk. is replenished obesity and insulin resistance scores improve.
Inflammation. Recall the Inflammatory Markers Above?
The story behind this is because those shells or outer membrane of the bacteria🦠 (aka lipopolysaccharides “LPS”) can break through the submucosal barrier into the gut lymphatic system. These guys are meant to be passed through the gut. When the lymphatic tissue begins to receive this information, it flags it to the immune system as an invader and begins to mount an immune response, leading to food intolerances, fatigue, autoimmune responses, and more. This can be a slow process that happens over time. Almost daily, I receive the question: “I was fine before this, what tipped it?” That I have never been the same since ____ is such a common story. Rather it’s trauma, stress, medications, food, or a combination of all that triggered the inflammatory response to give you symptoms that are no longer able to be put aside, it doesn’t matter. What matters is getting back to health.
Mood. The gut-brain axis is now undeniable. In fact, 80% of our serotonin is produced in the gut. And the microbes have the ability to travel up the vagus nerve into the brain! Wow. Studies show that taking probiotics and eating fermented foods improve depression and anxiety in women with PCOS. Depression and anxiety are more prevalent experiences in women with PCOS and infertility than women who have a healthy hormone balance.
Hormone Imbalance + Elevated Androgens
There is a clear link here: beta-glucuronidase is an enzyme produced by healthy bacteria that helps break down hormones. Without ample healthy bacteria, we simply cannot have a healthy hormone balance.
Studies show that improving gut health can improve PCOS symptoms in as little as two weeks. Remember, each little step is a major move toward long-term health. It is arguably the most important to be as gentle with yourself as you are your best friend during your healing journey.
- Stress reduction, regular sleep, and a Mediterranean diet are key.
- Dr. Ohhira’s Probiotics are the only probiotics that I know that have short-chain fatty acids + post-biotics that are now well researched to help heal the mucosal barrier.
- A PCR gut analysis from Genova or GI Map will give you a sneak peek at what you need to heal.
- The steps to gut health are detoxification + removing (toxins, infections, and inflammatory foods), replenishing, and restoring the mucosal barrier. It can take as long as a year for complete restoration but your symptoms of leaky gut can begin to resolve in as little as 10 days.