Functional Medicine Approach to PCOS

Polycystic ovarian syndrome (PCOS) affects as many as 1.4 million Canadian women. Although PCOS is the most common endocrine disorder in women of reproductive age, it is commonly underdiagnosed and poorly managed, leading to many women suffering without a comprehensive plan of action.

PCOS can affect multiple systems and there are 4 different PCOS phenotypes, therefore, it can look very different in each person.

Functional medicine uses an individualized, patient-centered approach that targets specific manifestations of a disease, so that patients can feel balanced and happy in their own body once the symptoms are reversed.

How Is PCOS Diagnosed?

Classic PCOS comes with a set of symptoms, such as irregular or absent periods, high androgens (excess hair growth, thinning hair, acne), overweight or obesity, and multiple small cysts on the ovaries.

To be diagnosed with classic PCOS, you will have at least 2 of the following signs or symptoms;

1. chronic anovulation
2. clinical (acne, hirsutism) and/or biochemical signs of hyperandrogenism
3. polycystic ovaries on ultrasound

What Is the Underlying Pathophysiology of PCOS?

– Abnormal ratios of the pituitary hormones LH to FSH
– Elevated secretions of androgens from the ovaries and/or adrenal gland
– Failure of the follicle to mature in the ovaries
– Insulin resistance (likely genetic)
– Inflammation
– Fatty tissue dysfunction (lipotoxicity)

What Does a PCOS Assessment Entail?

– A thorough intake, focusing on your health history and individual presentation of symptoms.
– General health assessment labs: fasting insulin and glucose (HOMA-IR will show level of insulin resistance), lipids (cholesterol makes hormones), thyroid, inflammatory markers (CRP, ESR, ferritin, homocysteine).
– Comprehensive hormone panel: serum testing can only provide a snapshot of your hormones at a particular time, which is helpful as part of an initial screening. For more comprehensive hormone testing, a urine test (DUTCH) can be used.
– Vitamin D test: associated with insulin resistance, thyroid function and inflammation.
– Comprehensive stool test: gut health can impact inflammation, hormone balance and insulin resistance.
– Trans-vaginal ultrasound (referral from your GP).

What Does A Functional Medicine Treatment Plan for PCOS Look Like?

The treatment will depend on your specific PCOS phenotype, the systems that are out of balance and what your specific goals are (fertility, hair loss, acne, weight management, hirsutism, etc.).

What Are Common PCOS Goals

1. Lower androgens
2. Inhibit the conversion of testosterone to DHT
3. Induce regular ovulation
4. Modify insulin resistance
5. Restore fertility, if desired, and reduce risks for pregnancy complications (i.e. gestational diabetes)
6. Reduce risk of associated health conditions: diabetes type 2, depression, anxiety, cardiovascular disease and endometrial cancer.

Treatment Plan Options

1. Diet and exercise – important to address weight and insulin resistance.
2. Stress management and optimizing adrenal function – PEMPH, reflexology, neural acupuncture, intravenous therapy, HRV are some of the in-clinic options.
3. Intravenous therapy or injections therapy can help optimize nutrient deficiencies and support broken systems.
4. Herbal medicine, nutraceuticals, homeopathics and bioidentical hormones – to bring your hormones back into balance.

How Long Will It Take for Me to Feel a Difference?

Results are patient specific. It is important to note that it can take at least 3-6 months to balance hormones, if the patient is fully compliant with the treatment plan. However, some start to feel better within the first month.

If you are ready to start the journey towards a healthier happy life, get in touch with us or get a free 15 minutes consultation today!