PCOS or polycystic ovary syndrome is a very difficult fertility disorder to treat. In fact, there are no FDA-approved or accepted treatments for the disease, which is why researchers are working so hard to find something that works. Researchers in Spain have looked into a possible treatment for adolescent girls with PCOS and have found some interesting results.
PCOS Study Findings
A research study, presented at ENDO 2017, an annual conference on endocrine disorders, says that treating adolescent girls who have PCOS so that their abdominal or belly fat and fat around the liver is normalized can help to restore ovulation. This is important because one of the big problems with fertility in PCOS is that the woman doesn’t ovulate and has infrequent or absent periods.
Many women are treated with birth control pills, even if they aren’t sexually active. It treats some of the symptoms of PCOS but, of course, doesn’t restore fertility. The Spanish researchers used a drug containing a combination of an anti-androgen and two insulin sensitizers instead to treat these girls. The idea was to direct treatment at some of the underlying factors seen in PCOS and not just to restore periods.
The girls they treated did not have obesity but had irregular periods and excessive body hair—two common things seen in PCOS. They were treated with spironolactone/pioglitazone/metformin and were encouraged to exercise and eat a Mediterranean diet. This diet is believed to be heart-healthy and doesn’t promote weight gain. The number of ovulations the girls had while on treatment were measured.
Each of these girls had more visceral/belly fat and liver fat, and higher levels of both male hormones and insulin compared to girls who didn’t have PCOS. Those who took the drug combination improved in each of these areas after just a year of therapy. They also had more than double the ovulation rate after they were treated. No one knows if this type of treatment will restore their future fertility, but the results were certainly promising.
What is PCOS?
PCOS is a generalized hormonal or endocrine disorder of young women, leading some to have many symptoms. These symptoms include excess body fat, high levels of male hormones, symptoms of androgen excess (like excessive hair growth in the facial area), cysts on the ovaries, infrequent or absent periods, irregular ovulation, and low fertility. As time goes on, these women can develop insulin resistance, type 2 diabetes, and increased risk for heart disease.
PCOS seems to begin at the time of puberty but some women don’t know they have it until many years later. If you have irregular or infrequent periods, excess facial or body hair, male pattern baldness, and/or acne, you want to inquire with your doctor about having PCOS. It’s important to know you have it because of the increased diabetes risk and heart disease risk, even if you aren’t trying to conceive.
Possible Causes behind PCOS
Doctors know that many women have elevated insulin levels and insulin resistance, which is a precursor to type 2 diabetes. Some researchers speculate that this could lead to increased male hormone levels and ovulation issues. Many women with PCOS also have a metabolic disorder. There is often low-grade inflammation going on, which can stimulate cysts to develop on the ovaries and increase ovarian androgen production. Some of this may be hereditary because it does seem to run in families.
Early Treatment of PCOS
With PCOS, many practitioners of differing modalities believe it’s important to support your body in re-learning balance by promoting healthy hormonal balance, a healthy uterine lining, regular ovulation, improved estrogen metabolism, reduced cravings for sweets and improved digestion. In fact, a 2017 National Institute of Complementary Medicine study shows diet, lifestyle and herbs are key to managing PCOS.
There are things you can do if you have PCOS and are trying to manage the symptoms you have:
1. Change your diet
There is evidence that diet and exercise can turn around the insulin resistance and may restore your periods. Women who are overweight have a bigger problem with insulin resistance and type 2 diabetes compared with women who aren’t overweight. It makes sense that eating to regain a healthy weight might help the underlying metabolic problems seen in PCOS.
- Stick to a diet that is high in vegetable fiber, such as whole broccoli, cauliflower, lettuce, kale, and spinach.
- Choose lean proteins like lean meats and fish.
- Eat anti-inflammatory foods, like olive oil, almonds and walnuts, and spices like turmeric.
- Eat plenty of beans, lentils, and whole berries.
- Avoid sugary sodas and anything sweetened with high-fructose corn syrup, refined carbohydrates such as those in white bread and traditional pasta, cookies, cakes and muffins, avoid white potatoes.
- Limit inflammatory processed foods and fatty red meats.
Remember that “sugar” comes with many different names, such as high-fructose corn syrup, glucose syrup, sucrose, and dextrose. Juices may sound healthy but they contain more sugar in them than they do fruit fiber so these should be avoided.
2. Exercise more
Besides a healthy low-sugar diet, you need to start a healthy exercise program. Just make sure you move more on a regular basis and find an activity you can enjoy that gets your heart rate up so you can potentially lose some belly fat.
- Exercise for about 150 minutes every week—that’s just 30 minutes a day, five days a week.
- Walking, swimming, leisurely bike riding, Zumba, Pilates, at-home workout programs, or creating a program specific to your current skill level with a trainer are all great ideas.
3. Manage stress
PCOS can also be worsened by stress. Yoga, Tai Chi and meditation can reduce your experience of stress. Here too are other tools to explore;
- PCOS Support: Tools To Help You Stay Positive
- PCOS Infertility: Using Positive Visualizations On Your Journey to Pregnancy
4. Learn about herbs, nutritional supplements and natural therapies
When diet and lifestyle changes are made, the body is better able to respond to herbs, nutritional supplements and natural therapies.
The Bottom Line
There are no solid answers as to the underlying problem or treatment for PCOS yet, but there are some potential clues. Women and adolescents who get into a bad cycle of insulin resistance, excess belly fat, and androgen excess often have trouble conceiving a child. It makes sense that early treatment of PCOS and using what we know about reversing these problems is the best option for potentially restoring your fertility.
Note: The drugs researchers used in the study to treat adolescents with PCOS are available, but they haven’t been studied in combination with PCOS in any large study. In this research study, only 32 girls were treated. Also, only adolescents were treated so it isn’t clear if these drugs would restore ovulation in older women with PCOS, although they are commonly used.
- Treating polycystic ovary syndrome early may help prevent later drop in fertility. (6 April 2017). Endocrine Society Adapted Media Release. Retrieved from https://www.medicalnewstoday.com/releases/316786.php
- Polycystic ovary syndrome (PCOS). (Aug. 29, 2017). Retrieved from https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439
- Whelan, C. (n.d.). Can My Diet Relieve Symptoms of Polycystic Ovary Syndrome (PCOS)?. Medically reviewed by Deborah Weatherspoon, PhD, RN, CRNA on November 2, 2018. Retrieved from https://www.healthline.com/health/pcos-diet