Women with PCOS often struggle with irregular menstrual cycles. Taking herbs following a biphasic cycle, which mimics a normal menstrual cycle, may help the body to recognize and create a regular menstrual cycle over time.
In women with PCOS the menstrual cycle begins with irregular production and release of hormones. The hypothalamus releases GnRH in a higher than normal pulsatile frequency in women with PCOS. This allows for increased LH and decreased FSH, this in turn leads to excessive production of the androgens androstenedione and testosterone. This causes the follicle to only mature some, but not enough to achieve full maturity. This also allows for continued increase of estrogen, primarily estrone. The higher levels of androgens and estrogen create a chronic state of low to very low progesterone. Classic polycystic ovaries are a result of chronic anovulation. Endocrine function is imbalanced from the very beginning of the cycle causing mild to severe hormonal imbalance, depending on the individual.
Fortunately there are specific herbs that can help women with PCOS to achieve hormonal balance, promote proper insulin levels, reduce side effects due to hormonal balance and promote a regular menstrual cycle. The following combination of herbs is intended to harmonize the body systems in women with PCOS, with the intention of achieving healthy fertility.
Biphasic Use of Herbs for PCOS
One blend of specific herbs can be taken during the first half of the menstrual cycle and then another during the second half. Taking herbs in a biphasic cycle may help the body recognize and “remember” how to create a regular menstrual cycle, as it normally should.
The first half of the menstrual cycle is known as the follicular phase. The second half is known as the luteal phase. The average menstrual cycle is about 28-30 days long. Specific herbs can be taken together in a specialized blend during either the follicular or luteal phase, to help promote a regular menstrual cycle. You may notice some of the herbs are part of both biphasic blends; these herbs have supportive actions for the entire menstrual cycle.
Key benefits of biphasic herbal blends for PCOS:
- Promote proper estrogen metabolism
- Reduce pelvic congestion
- Reduce cravings for sweets
- Aid the body in balanced insulin levels
- Promote hormonal balance overall
- Reduce elevated levels of androgens
- Promote regular ovulation
- Support the body in increasing progesterone
- Support proper formation and function of the uterus
- Support proper endocrine system function
Follicular Phase 1
First half of the menstrual cycle, approximately day 1-14 in the cycle (up to ovulation).
The herbs in this phase are specific to supporting release of the hormones responsible for promoting ovulation, reduction of androgens, and proper formation of the uterine lining in preparation for ovulation.
- Tribulus (Tribulus terrestris)
This herb promotes regular ovulation. It supports hormonal balance overall. This herb has been found to be wonderful in aiding women with menstrual irregularities; improving timing of the entire menstrual cycle. Tribulus has also been found to be a nourishing tonic for the female reproductive system as a whole, especially concerning the ovaries. Studies have shown that it may reduce ovarian cysts and stimulate ovulation in women who are not ovulating.
Vitex also known as Chaste tree berry (Vitex agnus-castus)
Vitex works to balance the hormonal feedback loop, promote ovulation and regular cycles. Vitex has a regulating effect upon the pituitary gland, which supports regular function of the entire menstrual cycle. During the follicular phase it supports proper timing and release of LH in preparation for ovulation, and FSH for stimulating ovulation.
Saw Palmetto berry (Serenoa repens)
Saw Palmetto has been found to inhibit DHT production by reducing 5 alpha-reductase production, which may help prevent hirsutism in women with PCOS. This herb also helps to reduce endometrial hyperplasia and hormonal acne symptoms. It is extremely nutritive and supports proper immune and stress response in the body.
White Peony Root (Paeonia officinalis)
White Peony promotes circulation to the reproductive organs which helps to reduce uterine stagnation, ovarian cysts and painful menstruation. Studies have shown that when White peony is combined with with Licorice Rt. (Glycyrrhiza glabra), it performs better, especially for relaxing muscles, reducing painful menstruation, as well as lowering serum and free testosterone levels in women with PCOS.
Dong Quai root (Angelica sinensis)
Dong Quai works by promoting blood flow to the pelvis where it will stimulate an absent or scanty period. It also nourishes the blood because it is rich in iron. One of the best uses is it helps women who are not menstruating to invite there menstruation back. The increased circulation also helps to strengthen and balance the uterus. Working to strengthen the uterus is vital for women with PCOS, since irregular cycles are common, which may cause the uterine muscles to become weak.
Gymnema (Gymnema sylvestre)
Gymnema has been used for hundreds of years to reduce high blood sugar. This herb has a “sugar blocking” action on taste buds and the small intestine. Gymnema blocks the typical paths that sugar molecules take during digestion, delaying the absorption of sugar. It works by stimulating the regeneration of pancreatic cells that produce insulin, which aids in more insulin production; in turn stimulating production of enzymes that help with the uptake of glucose into cells; and then prevents stimulation of the liver to produce more glucose. Resistance to insulin increases the body’s insulin levels which affects normal ovulation by preventing the body from ovulating or limiting the maturation process of the released egg. Gymnema also appears to have a lipid-lowering effect, which aids in weight loss.
Licorice Root (Glycyrrhiza glabra)
Helps to maintain proper hormone production and release through support of the endocrine system. It work to help balance estrogen levels in the body. It also supports healthy insulin levels and liver health for hormonal balance support. Licorice is excellent for proper immune, inflammation and stress response as well. Women with PCOS have been shown to benefit from reducing inflammation.
Luteal Phase 2
Second half of the menstrual cycle, after ovulation (about day 14), up to about day 28 or until the menstruation begins.
The herbs for the luteal phase are deeply nourishing for the endocrine system, supporting proper function of the glands that produce and release hormones. Some of the herbs here are the same as the follicular phase herbs, for prolonged, continued, balanced support of the hormones, insulin levels and reproductive organ health. The goal in the phase is to support the body in increasing and sustaining proper progesterone levels to help reduce estrogen dominance and prepare the uterus for implantation of the fertilized ova.
- American Ginseng Rt. (Panax quinquefolius)
American ginseng has been found to provide excellent immune support and strengthens the HPA (hypothalamus-pituitary-adrenal) axis. The HPA axis is vital to proper hormonal balance, stress management, and immune system strength. Supports proper digestion and absorption of nutrients from foods. This plant has also been shown to be helpful in supporting proper glucose levels; very important for women with PCOS.
Vitex also known as Chaste tree berry (Vitex agnus-castus)
In the second half of the cycle, vitex supports the body in sustaining and increasing progesterone levels in anticipation for implantation of the fertilized egg. Many women with PCOS have low levels of progesterone due to unopposed estrogen, vitex helps the body to balance estrogen and progesterone, for a healthy, regular menstrual cycle.
Saw Palmetto Berry (Serenoa repens)
In addition to the benefits already discussed, Saw Palmetto is strengthening for the body tissues, aiding in proper formation and function of the uterine cells. This is vital to preventing endometrial hyperplasia and preventing prolonged bleeding due to this common condition in women with PCOS.
White Peony Rt.(Paeonia officinalis)
Continued hormonal balance and reproductive function support for the luteal phase.
Gymnema (Gymnema sylvestre)
Continued support for balanced insulin levels throughout the cycle. Maintaining proper insulin levels throughout the cycle is vital to preventing miscarriage. Women who are insulin resistant are 4-5 times more likely to have a miscarriage. Imbalanced insulin levels due to PCOS make it difficult for the embryo to attach properly to the uterus. Reducing insulin resistance helps prevent type 2 diabetes.
Dong Quai Rt. (Angelica sinensis)
Continued hormonal balance support. Nourishing to the uterus, promoting healthy circulation to the uterus in preparation for implantation.
Schisandra Berry (Schisandra chinensis)
Supportive and protective of liver health, which is vital to hormonal balance. Shown to support immunity, endocrine and nervous system function. Aids stress related infertility.
Maca Root (Lepidium meyenii)
Maca supports healthy progesterone levels in the body. Maca is an adaptogen and an incredible fertility superfood. It helps to balance the hormones, but does not contain any hormones itself. It is able to do this by nourishing and balancing the endocrine system.
Biphasic Herbal Blend for PCOS Q&A
Q: When do I begin taking these herbs if I don’t have a regular menstrual cycle?
A: If you have a somewhat regular cycle, or you know you may start your period sometime in the near future, begin taking them at the beginning of your next cycle (day 1). If you do not know when you are going to begin your period, choose your own day 1 to begin. Count out the days for the follicular phase as if you have a regular cycle, continuing the blend until about day 12-14 in the cycle, then begin the luteal phase herbal blend and continue until you begin your period, or until about day 28-30 in the cycle. Keep utilizing the herbal blends like this; creating a biphasic cycle.
Q: Is it okay to take maca with these herbal blends?
A: Yes, maca is fine to continue. Be sure not to exceed dosage of 3000mg a day.
Q: Can I continue natural progesterone cream with these herbal blends?
A: If you are already using natural progesterone cream (NPC), then yes, it is fine to combine these herbs with NPC use. If you have not yet tried NPC, consider trying a biphasic herbal program for PCOS first. See how your body does over a 3-6 month period. If your progesterone levels are still not adequate, then consider adding the NPC. Note: It is always best to work with an herbalist, ND or a doctor skilled in the use of herbs when choosing to combine NPC and herbal preparations.
Q: Is it okay to use vitex with these biphasic herbal blends for PCOS?
A: No, we don’t recommend using vitex with these biphasic herbal blends, as they both already contain vitex.