PCOS

Background

Polycystic Ovarian Syndrome (PCOS) reflects elevated testosterone and DHEA (which turns into testosterone in the body) hormone levels. This often comes from insulin resistance, often caused by excess sugar in the diet. As in men, high levels of testosterone trigger facial hair growth in women as well. The high testosterone is the most common cause of excess facial hair in women. The high testosterone can also trigger other problems including acne, irregular periods, weight gain, infertility, and ovarian cysts (although many people with PCOS do not have ovarian cysts).
Some common triggers for the elevated testosterone include:

  • Excess sugar in the diet.
  • Adrenal fatigue.
  • Menopause (causes an increase in the ratio of estrogen to testosterone, which controls facial hair growth).
  • Supplementation with testosterone or DHEA.

Treatments

Treatment often helps in many ways, including restoration of fertility.  To start, be sure you are not taking any supplements with DHEA or testosterone, and cut out the excess sweets/sugar in your diet, especially sodas and fruit juices.

Natural Treatments

Eliminate sweets

Sweets worsen the insulin resistance. Stevia is OK. See my book Beat Sugar Addiction NOW! for help with this.

D-chiro inositol

The supplement D-chiro inositol (e.g., Chiral Balance DCI), 600 mg 1 to 2 times a day lowered elevated testosterone levels by over 70% in one study.

Chromium

Take chromium 200 to 1,000 µg daily (it has a modest effect).

Weight loss and exercise

The weight loss is easier after you do the above. Also address any thyroid hormone deficiencies.

Medications

Metformin

Metformin (prescription) 500-1,000 mg 2x day. This is a very helpful and safe medication, and is so wonderful and safe I think it should be classified as an honorary natural supplement! The main concern is that it will cause B12 deficiency if not taking B12 along with it. In addition to helping the overall process, it very often restores fertility (and is both safe and healthy to take during the pregnancy). Start with a low dose and work up if it upsets your stomach. If needed, the medication Clomid can also be added to induce ovulation.

Cortef 

Cortef  (prescription) up to 15 mg a day if symptoms/labs are present suggesting the need for adrenal support (e.g., irritable when hungry). Adrenal expert Professor William Jefferies routinely recommends ultra low-dose Cortef  for PCOS. Half of a woman’s testosterone is made by the adrenal gland, and taking the Cortef decreases stimulation of the adrenal. Using a natural adrenal support product may also help and is especially worth considering if the ACTH blood test is in the upper half of the normal range.

Spironolactone (not recommended in CFS/FMS)

Though the medication Spironolactone can help decrease excess facial hair growth in general in PCOS, this medication can severely flare symptoms in CFS/fibromyalgia patients, so I do not recommend it in this population.

Birth control pills

Birth control pills can help the menstrual irregularity if it persists despite the above. The progestin component of the pill should be cyproterone acetate (not available in the US) or drospirenone (Yasmin or Yaz in the US), as these inhibit testosterone.
For more information, see Hirsutism.

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