By Dr. Samina Mitha, ND
What is PCOS?
PCOS or Polycystic Ovarian Syndrome is one of the leading causes of infertility. PCOS is largely an endocrine disorder that can affect hormones, metabolism and the immune system. Since PCOS is known as a syndrome it can become very complex to determine what is truly going on. It has been recently suggested that the name should be changed since having cysts on the ovaries is not necessary to diagnose the syndrome.
One of the major symptoms of PCOS is infertility due to hormone imbalances, but there are many other symptoms such as:
- Irregular or absent periods
- Weight gain
- Excess hair growth
- Thinning scalp hair
- Ovarian cysts
Testosterone is generally high in PCOS patients which can end up blocking estrogen’s role in building a follicle and successfully carrying out ovulation. Treatment using Naturopathic Medicine is very individualized. Each patient will receive a different protocol based on their presentation of the syndrome. One of my favourite modalities is botanical medicine to help women get pregnant with PCOS.
Let’s learn more…
What is Botanical Medicine?
Botanical medicine has been practiced for centuries. It is also known as herbal medicine and is a medical system based on using plants or plant extracts that may be consumed. Many traditional drugs have been derived from plants such as aspirin which was originally created from willow bark and meadowsweet. Botanical medicine is a great modality to help balance hormones, support PCOS symptoms, and help women get pregnant with PCOS.
Below are my top 5 botanical herbs for PCOS.
1) Glycyrrhiza glabra (aka Licorice) and 2) Paeonia lactiflora (aka white peony)
The combination of these two herbs have been shown in small studies to lower testosterone and induce ovulation in women trying to get pregnant with PCOS. High doses of licorice have been shown to inhibit the conversion of androstenedione (a precursor hormone) to testosterone. Be sure to check with your health care practitioner before taking licorice, as it can raise blood pressure.
3) Serenoa rapens (aka Saw Palmetto)
Saw palmetto is known for its anti-androgenic properties. It has the ability to inhibit the enzyme 5-alpha reductase which converts testosterone –> dihydrotestosterone/DHT (a very potent testosterone). It is useful for testosterone related hair loss and acne associated with PCOS. And remember, the less testosterone, the more estrogen can shine and help carry out ovulation!
4) Cimicifuga racemose (aka Black Cohosh)
Black cohosh is typically categorized as a phytoestrogen (aka plant derived estrogen). A randomized control trial done in Eygpt in 2013 with 100 PCOS women, compared black cohosh to clomiphene. The group receiving black cohosh started on day 2 of their cycle for 10 days and the clomiphene group for 5 days. The participants were followed for 3 consecutive cycles. They found that both groups had a decrease in LH and LH/FSH ratio, however the black cohosh group had a greater decrease in LH and LH/FSH ratio (To learn more about labs click here). The black cohosh group also had higher progesterone levels and endometrial thickening. Additionally, the black cohosh group had more pregnancies (7 vs. 4).
5) Vitex agnus-castus (aka Chaste Tree)
Chaste tree is a very interesting herb and is often thought of first when it comes to hormone imbalances. However, it should only be used in certain cases. The research with Chaste tree and PCOS is limited and is known to act on the pituitary gland in the brain to help decrease prolactin. It is a great herb to use after menstruation has stopped after the use of the oral contraceptive pill. Additionally, its ability to decrease testosterone is conflicting in the research.
Be sure to talk to your Naturopathic Doctor or herbalist before taking any of the botanical herbs mentioned in this article.
Eur J Obstet Gynecol Reprod Biol. 2013 May;168(1):60-3. doi: 10.1016/j.ejogrb.2012.12.025. Epub 2013 Jan 21.
Gilbert, C. (2015). The essential guide to women’s herbal medicine. Toronto, Ontario: Robert Rose Inc.