Polycystic Ovary Syndrome (PCOS): What It Is [+ Holistic Remedies]

Highlights

Polycystic ovary syndrome (PCOS) is a common hormonal disorder.
The most common symptom of PCOS is missed, irregular, or prolonged periods.
PCOS can also cause excess hair growth, acne, hair loss, infertility, weight gain, and other complications.
Treatment for PCOS is largely based on whether or not a woman wishes to become pregnant.
The first line of treatment for PCOS is lifestyle changes.
Traditional treatment options include prescription medications.
Complementary treatment options include acupuncture, nutritional therapy, and herbalism.

If you’re one of the 1 in 10 women of childbearing age who has polycystic ovary syndrome (PCOS), you know that it’s a sometimes-debilitating endocrine disorder that can take a toll on your quality of life. PCOS is the most common endocrine disorder for women of reproductive age. Fortunately, there are plenty of treatment options to help you manage your condition and get on with living a happier and healthier life.

What is polycystic ovary syndrome (PCOS)?

Polycystic ovary syndrome (PCOS) is a common hormonal disorder that causes problems in the ovaries. With PCOS, these hormonal imbalances may cause metabolism changes, irregular or missed periods, and other problems that affect your overall health and appearance. PCOS commonly starts in adolescence but may not be diagnosed until your mid-twenties or later.

The term polycystic ovary syndrome means “many cysts” and describes the small cysts that can form in or on the ovaries with the condition. However, not all women with PCOS develop these cysts. Women with PCOS often have higher levels of androgens (male sex hormones). This can keep your ovaries from developing or releasing an egg during your menstrual cycle.

PCOS can affect your health throughout your lifespan, making it important that you identify and manage it as early as possible.

What are the symptoms of PCOS?

PCOS symptoms often appear around the time of your first menstrual period but can also develop later in adolescence or adulthood. Some women develop PCOS later in life, after other health conditions arise or in response to substantial weight gain. PCOS symptoms can go unnoticed or be mistaken for other conditions.

You will likely be diagnosed with PCOS if you experience at least two of the three key PCOS symptoms. These symptoms are:

Excess androgens. Having elevated or high levels of androgens (male sex hormones) can cause excess facial and body hair, acne, or female pattern baldness. There is a strong connection between hair loss and PCOS.
Irregular periods. Having irregular, infrequent, or prolonged periods is the most common sign of PCOS. A common example is having fewer than nine periods per year. You might also experience heavier periods when you have them.
Polycystic ovaries. You might ovulate less or not at all. This is more common if your ovaries are enlarged and contain follicles (small collections of fluid) that fail to release eggs. Some women have cystic ovaries but do not have PCOS. Some women have PCOS but do not have cystic ovaries.

PCOS can also present in other ways. You might also notice:

Dark or thick skin patches on your neck, armpits, or under your breasts
Infertility
Mood changes
Oily skin
Pelvic pain
Sleep problems
Skin tags (small pieces of excess skin on your neck or armpits)
Weight gain around your abdomen

What are the risk factors of PCOS?

The exact cause of PCOS is unknown. However, there are several conditions that can put you at greater risk for both PCOS and its complications. For example, insulin resistance and obesity are common in women with PCOS, and they can make your PCOS symptoms worse.

Things that might increase your risk for PCOS include:

Excess androgens. Having abnormally high androgen levels, which is also one of the major symptoms of PCOS.
Excess insulin. Many women with insulin resistance have PCOS. If your body can’t use insulin effectively, it can cause insulin to store in your body. Excess insulin can also cause your body to produce excess androgens, which cause issues with hormonal balance and ovulation.
Heredity. Research shows that certain genes could be linked to PCOS risk or expression. It’s common for close relatives, such as mother and daughter, to have PCOS.
Inflammation. Women with PCOS often have increased inflammation throughout their bodies. Specifically, research has shown that low-grade inflammation stimulates the ovaries to produce androgens, which can contribute to PCOS and other health conditions.
Obesity. Obesity is linked to PCOS. Obesity can also increase your insulin levels, which can make your PCOS symptoms worse.

When should I see a doctor about PCOS?

It’s important to speak to your doctor if you have concerns about your period, infertility, or other signs of hormonal imbalance. You should seek medical care if you notice missed or irregular periods accompanied by hair growth, acne, hair loss, or weight gain.

Early diagnosis and treatment can help to improve your long-term health outcomes. It can also help to reduce your risk of additional complications, such as type 2 diabetes.

How is PCOS diagnosed?

The process for diagnosing PCOS is relatively simple. Your healthcare provider will take a medical history, ask you about your symptoms, and complete a physical exam. They will likely complete a pelvic exam and may order diagnostic tests to confirm your diagnosis.

If you have at least two of the three key PCOS symptoms, you may be diagnosed without additional tests. Many PCOS symptoms can be caused by — or mistaken for — other health problems. You might need additional confirmation through:

Blood tests. Your provider may order blood tests to check for high levels of androgens, glucose, or other hormones. They may also want to check your cholesterol and triglyceride levels, as these tend to be higher in women with PCOS.
Ultrasound. This test is used to look at your ovaries to check for inflammation and cysts. They might also check the thickness of your uterine lining (endometrium).

What are the complications of PCOS?

Woman holding her side, complications of PCOS.

Women with PCOS are at a greater risk for developing certain health problems. The most common health problems linked to PCOS include type 2 diabetes, cardiovascular disease or high blood pressure, fertility problems, mood disorders, and uterine cancer. PCOS can also complicate existing conditions and reduce women’s overall quality of life.

Potential complications of PCOS include:

Chronic conditions. Women with PCOS are more likely to develop or have insulin resistance, hypertension, or type 2 diabetes. Women with PCOS are more likely to have — or to develop — metabolic syndrome. Metabolic syndrome increases the risk of diabetes, stroke, and heart disease.
Endometriosis. There is a strong link between endometriosis and PCOS. Research shows that women with PCOS are more likely to be diagnosed with endometriosis than women without PCOS.
Fertility and pregnancy problems. Infertility is common in women with PCOS. Women with PCOS may also be at higher risk for high-risk pregnancy, gestational diabetes, pregnancy-induced high blood pressure, premature birth, and miscarriage.
Metabolic syndrome. Close to 80 percent of women living with PCOS are overweight or obese. Obesity and PCOS increase the risk of high blood pressure, high blood sugar, and cholesterol problems. This is known as metabolic syndrome.
Mood disorders. Hormonal imbalance can worsen existing mood disorders, such as anxiety or depression. PCOS has also been linked to an increased risk for developing eating disorders.
Sleep apnea. Research shows that women with PCOS and obesity are at a greater risk for sleep apnea than women without either condition.
Other complications. Additional complications reported include abnormal uterine bleeding, endometrial cancer, and liver inflammation.

What Western treatment options are available for PCOS?

There is no cure for PCOS, but you can manage the symptoms and any related health complications. Your treatment will depend on your symptoms, existing health conditions or health risks, and whether or not you plan to have children. Many women benefit from a combination of treatment methods, including medical intervention and lifestyle changes.

PCOS can complicate fertility and pregnancy. Your treatment options will vary depending on whether or not you plan to have children.

PCOS treatment for women who plan to become pregnant in the near future

If you are actively trying to become pregnant — or plan to become pregnant in the future —your treatment could include:

Lifestyle changes. You can better manage PCOS with diet, exercise, and other lifestyle changes. This is the first-line treatment for PCOS treatment that providers recommend. Becoming more active, eating a well-balanced diet, and losing weight can help to reduce your symptoms. They can also help to lower your risk for complications and related health conditions. For example, it can help you to use insulin more efficiently, maintain your blood sugar, and even improve your chances at ovulating.
Medications for fertility and ovulation. You will likely need additional treatment to help you ovulate. Some fertility and ovulation medications carry additional health risks, such as contributing to hormonal imbalance. They may also cause bloating and pelvic pain. Your provider can work with you to determine the best medication(s) for your condition.
Surgery. If you continue to struggle with fertility after other treatments, your doctor may recommend surgery. Ovarian drilling is a technique used to break through the thickened outer layer of the ovaries and promote the release of eggs during your menstrual cycle. This treatment is typically effective for six to eight months. In some cases, providers may recommend bariatric surgery.

PCOS treatment for women who do not plan to become pregnant in the near future

If you don’t see a pregnancy in your future, your treatment plan could include lifestyle changes and:

Birth control. Hormonal birth control can help you to have a more regular menstrual cycle, lower your androgen levels, and help to clear up acne. They can also help you to have lighter periods and protect against endometrial cancer.
Diabetes medication. Certain diabetes medications can help to improve your insulin levels and reduce your risk for additional complications from PCOS. Some medications may also help to reduce your androgen levels, slow hair growth, and promote regular ovulation.
Other medications. You may be prescribed additional medication to manage other symptoms or conditions. For example, you may wish to take anti-androgen medication to maintain your androgen levels. However, these medications are not approved by the Food and Drug Administration (FDA) to treat PCOS.

What PCOS treatments are in the pipeline?

Researchers continue to search for the best ways to treat PCOS. There are many ongoing clinical trials aimed at studying the relationship between PCOS and factors like age, environment, race and ethnicity, and obesity. Recent evidence suggests that using medications for lowering insulin levels can also be effective in restoring menstruation for women with PCOS.

Lowering insulin levels can also help to reduce additional health risks related to PCOS. Medications like pioglitazone, rosiglitazone, and metformin are all FDA-approved for managing diabetes and could be approved in the future for managing PCOS.

You can learn more about ongoing research for PCOS treatment at the National Institutes of Health and ClinicalTrials.gov.

Complementary and holistic treatments for PCOS

Complementary medicine, also known as integrative medicine, includes a number of holistic treatments that are most often used alongside traditional Western treatment to improve the outcome for a patient.

Holistic therapies that are often used for PCOS include nutritional therapy, herbalism, and acupuncture.

How is acupuncture used for PCOS?

Acupuncture is increasingly widely used as treatment for things like pain management and fertility. Research regarding acupuncture’s role in PCOS management is limited, but some research suggests that acupuncture can help women with PCOS manage pain, reduce stress, and improve uterine blood flow.

If you are interested in trying acupuncture for your PCOS symptoms, look for a board-certified practitioner.

Can you use homeopathy for PCOS?

Homeopathy is an alternative system of medicine used to treat various health conditions, generally by using small doses of natural substances that are tailored to an individual. A recent case series of PCOS and homeopathic treatment demonstrated promising results within 12 months of treatment. Specifically, individualized homeopathic treatment plans were shown to regulate menstruation, reduce cysts, and relieve related PCOS symptoms.

Overall, however, there is very little research on the effectiveness of homeopathy. We recommend talking to your doctor or a nutritional therapist before starting any homeopathic regimen.

When you’re ready, we can help you find a reputable homeopath.

How is herbalism used for PCOS?

Herbs have been used to heal in Asia for hundreds of years. Like most complementary therapies, there’s not yet a lot of research in the Western world on their effectiveness, but the practice is gaining popularity and legitimacy among healthcare professionals in the US and elsewhere.

More study is needed on the effectiveness and safety of herbal treatments. But current research, including a 2019 clinical trial review, suggests that many herbs can be useful for treating symptoms related to menstrual health and PCOS, including obesity, insulin resistance, and excess androgen production.

Herbal remedies are often used in combination, mixed into formulas that are customized to treat a person holistically. In many cases, people use herbal therapy along with conventional medicine techniques to get results for their specific symptoms.

You should alway consult your doctor before beginning new treatments, especially if you are taking prescription medication.

Living with polycystic ovary syndrome (PCOS)

Lifestyle changes are the first step in managing PCOS, but you may also benefit from complementary treatment methods. In fact, a 2014 scientific review revealed that acupuncture, physical activity and lifestyle changes, and holistic remedies each had the potential to improve PCOS symptoms long term.

The relationship between weight loss and PCOS is complex and continues to be a topic of research. Many diet and exercise regimens can help you better manage your PCOS symptoms and risk for other health complications. You may also benefit from adopting a diet specifically designed to help with PCOS management. For example, you may benefit more from eating foods with a low glycemic index if you also have high insulin levels.

Consulting a nutritional therapist or dietitian would be the best way to get started on a PCOS-friendly diet.

Your doctor may recommend a combination of therapy methods to help you live a healthier and happier life with PCOS. This may include combining traditional Western treatment methods, like prescription medication, with lifestyle changes and complementary therapies. You should discuss your options with your provider before beginning any rigorous diet, exercise, or treatment program.

Choosing the right complementary practitioner may feel challenging. Let us be your ally on your way to better holistic health. Follow our blog for more information on complementary and alternative therapies, and visit our provider directory to find a practitioner near you.