There are a lot of classifications of PCOS, but I found this helpful article that simplified it into two types. From what I gather if you have Type 1 (like me) are overweight, and particularly if you tend to accumulate your weight around your tummy/waist area, you may be able to reverse your PCOS trough a low Gi or the Insulin Resistance diet and regular exercise without the intervention of medications like Metformin or the pernicious pill.
I see a lot of cysters on online forums that are ttc with fertility treatments without first considering the weight loss option. I have stopped peddling my 'loose weight' mantra because I get the feeling women with PCOS are tired of being told to loose weight. But it is in fact the best, easiest, natural and most healthy way to effective deal with symptoms on a long term basis!
Fertility treatments are not very effective for women that are overweight. I was put on clomid 2 years ago to help with ovulation. Unfortunately at that point I was at my heaviest and reacted badly to it so I stopped after two rounds despite my doctors protests. I wanted a baby, but I just didn't feel I was getting anything out of it and I also knew there was a number of times one can use it before one has to stop. I didn't want to ruin my future chances.
If you are a 'slim cyster' there are dietary and lifestyle changes that you can still implement to improve your condition. Either ways PCOS is not a 'death sentence' and while each person is different, I believe in the natural approach first before resorting to drugs/medication as a final resort. Help your body help itself, :)
Two Types of PCOS.
One of the reasons that there is so much confusion about PCOS is that it is not one condition. PCOS can be divided into 2 main types. This is important, because each requires a different treatment. What type are you?
Type 1 PCOS: Insulin-resistant
Classic PCOS has the symptoms of weight gain, failure to ovulate, infrequent periods, infertility, facial hair, acne, hair loss and a predisposition to diabetes. They key feature is high testosterone on blood test.
The high testosterone is actually the side effect, rather than the cause. In type 1 PCOS, The real underlying issue is insulin resistance. It is insulin that inhibits ovulation and causes the ovaries to produce testosterone. It is insulin that is the main cause of weight gain. The symptoms of excessive testosterone, such as acne and facial hair will improve when insulin sensitivity improves.
Insulin resistance is caused by:
- too many carbohydrates in the diet (about 30% of the population cannot cope with a "normal" amount of bread and sugar)
- damaged vegetable oils called trans fat (see below)
- smoking
- environmental toxins such as BPA (see above)
- birth control pill
The correct treatment for Type 1 PCOS is to improve insulin sensitivity.
An endocrinologist will prescribe weight loss with a low GI diet and exercise, as well as a blood sugar lowering drug such as Metformin. This is approximately the correct approach, but metformin does have side effects such as nausea, diarrhoea and abdominal bloating. Fortunately, there are natural alternatives to metformin. In my experience, the natural supplements lower blood sugar as well, if not better, than Metformin.
TREATMENT SUMMARY FOR TYPE 1 PCOS.
Diet - When the body is insulin resistant, it simply does not remember how to use carbohydrates for energy. It can only store them as fat. At the same time, an insulin resistant body does not have the ability to burn fat stores for energy. The solution is to restrict carbohydrates for six weeks to "remind" the body how to use them for energy. You may need to go down to 30 or 40 grams of carbohydrate per day, but you still must eat vegetables for their fibre and nutrition. Your best source of calories during this time is fat, not protein. Protein puts a stress on the kidneys, and is also converted easily into sugar, whereas fat is simply burned for energy.
- Eliminate refined sugar from the diet
- Magnesium and chromium - Minerals to improve sensitivity of the insulin receptor
- Gymnema, Fenugreek - Herbs to improve sensitivity of the insulin receptor
- Homoeopathic Insulin & Leptin (See Insulin article)
- Peony & Licorice herbal formula to lower testosterone, which will alleviate acne and facial hair.
- Indole-3-carbinol to assist with oestrogen metabolism and clearance
- Detoxify environmental toxins such as BPA that may be interfering with the insulin receptor
- The Pill is absolutely not an appropriate treatment (see above).
Type 2 PCOS: Non-insulin-resistant
What if you have confirmed PCOS, but your insulin and blood sugar are normal?
The ultrasound may show multiple, undeveloped follicles. LH may be elevated, and periods do not occur regularly. Testosterone may be high or normal. If testosterone is normal, the acne and facial hair exist because oestrogen is too low (compared to testosteorne). Body weight can be normal.
In insulin-resistant Type 1 PCOS, the ovaries were prevented from ovulating because of insulin. In type 2 PCOS, the ovaries are prevented from ovulating because of something else. But what?
Here are some possibilities:
- History of the birth control pill (see above)
- Vitamin D deficiency
- Hormone disruptors are environmental chemicals that mimic oestrogen (see Sensible News 27)
- Trans-fat (see below)
- Adrenal stress which disrupts ovulation (see Stress article, Low Blood Pressure article, and Sleep article)
- Thyroid disease
- Low fat intake
- Leptin imbalance. (Leptin is a hormone secreted by fat stores, and can be deficient, especially if there is a history of an eating disorder. See see Sensible News 40 and 42.)
Metformin is not a treatment for Type 2 PCOS. Nor is the Pill. The Pill will induce monthly bleed this is not actually a treatment. For those women whose PCOS has been caused by the pill, continued use will only worsen the problem.
TREATMENT SUMMARY FOR TYPE 2 PCOS.
- Do not take the birth control pill
- Correct vitamin D deficiency
- Reduce exposure to hormone disrupting chemicals.
- Detoxify to repair any hormone damage
- Avoid cow's milk to reduce inflammation and clear acne
- Herbal medicine to normalise adrenal hormones
- Homoeopathic folliculinum to induce ovulation
- Peony & Licorice herbal formula to lower testosterone, bring on the periods, and alleviate acne and facial hair.
- The herbal medine Vitex (Chaste tree) can be used with caution. It can aggravate PCOS symptoms in some patients.
- Indole-3-carbinol to assist with oestrogen metabolism and clearance
- Homoeopathic leptin
- Natural Progesterone to suppress LH secretion (from the pituitary) and allow ovulation to occur. For this purpose, a low dose progesterone cream (1%) should be used intermittently. Consult with one of our Naturopaths for more information.
- Bowen therapy or acupuncture to induce ovulation
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