If you are one of the 5 million women with polycystic ovary syndrome (known as PCOS), you know how tormenting the symptoms can be — we're talking weight gain, acne and excess facial hair. Additionally, PCOS is typically marked by a lack of ovulation, which can make getting pregnant difficult.
The only thing that rivals how distressing the physical traits are is how limited the treatments for PCOS can be. PCOS sufferers usually have higher levels of a hormone group called androgens, so doctors often prescribe birth control pills to correct this imbalance. But according to Felice Gersh, MD, a board-certified OB-GYN and integrative medicine provider, birth control pills don’t truly manage hormonal imbalances — they just ameliorate the symptoms.
Since hormones are out of whack, PCOS is also tied to insulin resistance, which forces the pancreas to make more. This overdrive causes an increase in blood sugar levels, which in turn can lead to the development of type 2 diabetes. Knowing that, doctors often prescribe Metformin, a diabetes medication that works to control blood sugar levels. Again, addressing the issue, but not the root cause.
No wonder so many women with PCOS feel hopeless. But according to experts who take a holistic approach to treatment, there are natural ways to soothe unpleasant symptoms and help regulate hormones. It’s best to discuss options with a medical professional before embarking on a course of action since fully treating the condition requires a careful, integrative treatment plan that may include medications as well as changes to lifestyle habits.
Here's what the experts have to say about how to treat PCOS symptoms holistically.
1. Eat Balanced Meals
Balancing blood sugar levels is fundamental to treating PCOS, so assessing your diet is essential. Functional nutrition and women's hormone expert Alisa Vitti, author of WomanCode and In the FLO, says it’s important not to start your day off on the wrong foot with an imbalanced breakfast, whether that’s skipping the meal altogether or only drinking a sugary smoothie or coffee. “This can really affect the glucose level and the level of insulin in your body, which is going to put you on a blood sugar and insulin roller coaster throughout the day,” says Vitti. In turn, this imbalance will throw off your endocrine system, and your body will start secreting more ghrelin (also known as “the hunger hormone”) to make you crave more sugar and simple carbs.
According to Vitti, many with PCOS tend to cut calories too low in an effort to lose weight, but this can backfire. Your body needs proper fuel to balance blood sugar levels and regulate hormones throughout the day. Instead, eat foods rich in protein, fiber and healthy fats to keep you satiated and regulate your blood sugar. Focus on leafy greens and high-fiber vegetables, low-sugar fruits (berries, apples, melons, etc.), healthy fats (nuts, seeds and avocados for example) and lean protein like skinless poultry and wild fish.
Dr. Gersh also recommends cutting out ultra-processed foods or those with added sugars, eating plenty of fermented foods instead.
2. Opt for Low-Impact Workouts
Those with PCOS may try to lose weight by burning as many calories as possible through vigorous exercise, but certain workouts could actually make things worse. HIIT and intense cardio can elevate cortisol levels, the body’s main stress hormone, which comes from the adrenal glands. Those with PCOS are already more likely to produce excess adrenal hormones, including cortisol, which can lead to symptoms such as excess belly fat, fatigue and anxiety.
Instead, try low-impact workouts like yoga, Pilates and walking to keep cortisol levels low and manage stress. Danielle Desroche, MD, also recommends strength training, which helps your cells respond to insulin and can improve blood sugar levels. Strength training also increases lean muscle mass, and the more muscle mass you have, the more calories your body burns at rest. Dr. Gersh recommends working with a certified trainer to maximize results and prevent injury.
3. Get Enough Sleep
We know you’ve already heard this one before, but it bears repeating: Adequate sleep is essential for your overall health. All of the experts we spoke to recommend getting seven to eight hours of sleep a night, which falls in line with CDC recommendations. Getting that level of proper sleep can be difficult when you are struggling with stress, anxiety or insomnia, so if you’re struggling to get some rest, try breathing exercises, turn off all electronics at least an hour before bed, invest in quality bedding and keep your room cool.
4. Limit Alcohol Intake
Not only is alcohol a source of added calories and sugar, but it can also cause inflammation in the body. The CDC recommends one drink or less a day for women, and if you are going to have an alcoholic beverage, it’s better to choose red wine for the antioxidant benefits of resveratrol or another low-sugar, low-calorie option.
5. Tend to Your Gut Health
If your gut bacteria is out of whack, it can impact your immune system, mental health and heart health. This is particularly important for managing PCOS as there is some gut bacteria in our microbiome that metabolizes estrogen, explains Vitti. “We need our gut microbiome to keep inflammation down, which affects our cycle and could keep our estrogen levels where they should be,” adds Vitti.
Vitti recommends taking prebiotics and probiotics and eating lots of fiber to tend to your gut health, as well as fasting 12 hours between dinner and breakfast the next morning. Dr. Frank Lipman, Chief Medical Officer of THE WELL, also recommends this tip for supporting gut health.
6. Add in Natural Herbs and Supplements
According to experts, herbs and supplements can also aid in treating PCOS symptoms. Herbs and supplements can regulate blood sugar, fight inflammation and support health hormones. Dr. Desroche suggests nettles, saw palmetto, green tea and spearmint tea to help reduce the production of testosterone. She also recommends chromium, berberine and inositol for insulin resistance.
Vitti also recommends myo-inositol in order to regulate insulin and boost ovulation. A 2015 clinical trial found that 61.7 percent of those studied who were treated with myo-inositol experienced ovulation, while 38.3 percent were resistant to treatment. Even if you’re not actively trying to get pregnant, Vitti says myo-inositol can help restore your menstrual cycle. “[Myo-inositol] is so well-studied that medical centers are using it and recommending it,” adds Vitti.
Other supplements Vitti recommends include omega-3, vitamin D3 for fertility and immune support, an enterically-coated probiotic to get to your large intestine for your gut health, a B vitamin complex that includes B5 to support your adrenals and B6 to help with progesterone production.
7. Enjoy Orgasms
Have fun with this one. According to Vitti, orgasms, either with a partner or solo, may help improve hormonal balance, though there is still research to be done in this area. At the very least, having an orgasm releases tension and reduces stress, which is beneficial for those already dealing with heightened stress and cortisol levels. Making time for pleasure isn’t selfish — it’s an essential part of a healthy lifestyle.
8. Manage Your Stress
“Stress management is crucial to PCOS management and is, in my opinion, the missing piece in many approaches to managing PCOS,” explains Dr. Desroche. To start, she suggests unplugging from electronics for a few hours a day to be more present. “For others, it may mean learning to say no and setting boundaries with loved ones and social outings,” says Desroche. There are so many different ways to unwind and decrease stress, including meditation, warm baths, reading a book or going for a long walk.
9. Try Chinese Medicine and Acupuncture
An official PCOS diagnosis from your OB-GYN is the first step to treating the condition, and from there, Traditional Chinese Medicine (TCM) can also be a helpful course of action.
Jessica Sowards, MS, LAc, acupuncturist and traditional Chinese Medicine (TCM) practitioner, explains that there are five pillars of Chinese Medicine: Acupuncture, Chinese herbal prescriptions, dietary therapy, movement as meditation (Qi Gong or Tai Qi, which is similar to yoga) and Tui Na (medical massage). “Chinese Medicine aims to treat PCOS by finding the underlying mechanism which creates the conditions for PCOS to arise,” says Sowards. “This is called differential diagnosis.” She adds that in TCM, providers look for previously unnoticed signs and symptoms of a hormone imbalance and pinpoint patterns.
According to Sowards, a provider will focus on lifestyle and nutrition changes, such as eating clean to avoid inflammation, a specially chosen combination of herbs and cleaning up potential endocrine disruptors.
To treat PCOS specifically, acupuncture “clears excess dampness and phlegm from the uterus and other female reproductive organs,” explains Sowards. The treatment can also nourish the kidneys and invigorate the blood. Sowards adds that in addition to needles, patients can elect to use electric stimulation to help with ovulation.