Polycystic Ovarian Syndrome (PCOS)

 Emily is a degree qualified naturopath, medical herbalist and nutritionist based in Auckland who specialises in the natural treatment of PCOS. Emily works one-on-one with clients to help regulate their menstrual cycle, support fertility and reverse PCOS symptoms such as acne, excess hair growth and hair thinning naturally, without the use of synthetic hormones such as the pill or other medications.

Appointments are held at Emily’s clinic in Remuera or over Zoom for those based outside of Auckland. Your initial appointment includes a 60-90 minute consultation where we cover your full health and medical history, current diet and lifestyle, plus review past blood work or other diagnostic tests. You will receive a personalised health plan in which recommendations may include nutrition and lifestyle changes, prescribed herbal medicine and supplementation. Book a consultation online now, or find out more about our services and pricing.

What is Polycystic Ovarian Syndrome (PCOS)?

PCOS is a complex condition related to an imbalance of hormones, particularly elevated levels of androgens (‘male-like’ hormones), which can cause irregular periods as well as symptoms such as acne, excess hair growth, hair thinning, weight gain and difficulty conceiving. In many cases, ultrasounds may show a “cyst-like” appearance on the ovaries, which is caused by an increased number of follicles.

What causes PCOS?

The exact cause of PCOS may differ from person to person. While there is thought to be a genetic component involved, insulin resistance, stress and inflammation are all thought to contribute to excess levels of androgens in the body, leading to issues with ovulation, regular periods and other symptoms.

What are the symptoms of PCOS?

Common symptoms and signs of PCOS include:

• Irregular periods or no period

• Acne, particularly on the chin, cheeks, jawline and/or neck

• Excess hair growth on the face, chest, nipples and/or stomach (known as hirsutism)

• Hair thinning on top of the head

• Weight gain and stubborn weight loss, especially around the middle

• Darkened skin patches

• Infertility or difficulty falling pregnant

It’s important to know that not everyone with PCOS will have all of these symptoms.

How is PCOS diagnosed?

PCOS is typically diagnosed when you meet two out of three of the following criteria:

• High levels of androgens as shown on a blood test, or through symptoms like excess facial or body hair and acne

• Irregular or absent menstrual cycles

• Polycystic ovary appearance on ultrasound

While there is no single test available to diagnose PCOS, a doctor or specialist will assess your full health history and symptoms as well as carry out additional testing which may include:

• Blood tests of reproductive hormones including testosterone, LH and FSH, prolactin, as well as measuring blood glucose, insulin and cholesterol

• A pelvic examination to assess if the ovaries are enlarged

• An ultrasound scan of the ovaries to assess size and follicle number

The problem with using ultrasounds as part of this diagnostic criteria

It can be quite worrying to hear that your ovaries are covered in cysts, however when it comes to PCOS, this is really not the case. These ‘cysts’ shown on an ultrasound are actually showing an increased number of follicles, driven by an imbalance of hormones. This can often be normal in people even without PCOS, especially younger women. In fact, some people with PCOS can have a completely clear and normal ultrasound, yet still have other hormonal symptoms, which is why PCOS cannot be diagnosed by ultrasound alone. While it is possible to get ovarian cysts that can rupture, this is something entirely different to what is seen in PCOS.

What are the risks of PCOS?

PCOS is associated with a number of other health concerns, including:

• Fertility issues - Due to the hormonal imbalances and irregular ovulation seen in PCOS, many women may struggle to conceive. It’s important to know however that having PCOS does not mean that you can't get pregnant. While PCOS is one of the most common causes of infertility, it is also highly treatable. In clinic, Emily has worked with a number of women with PCOS to help them conceive naturally or through natural support alongside other fertility treatments.

• Metabolic syndrome - Insulin resistance in PCOS often results in weight gain and/or obesity. This can lead to a number of health issues, increasing the risk of high cholesterol levels, high blood pressure and blood sugar imbalances. If left untreated, this can increase the risk of developing more serious issues like type 2 diabetes and heart disease.

• Sleep apnoea - Sleep apnoea is a common condition where breathing can temporarily stop during sleep. It is much more common in women who are both overweight and have PCOS.

• Anxiety & depression - Hormonal changes in PCOS and the unwanted physical symptoms that come along with it can affect emotional wellbeing, resulting in mood changes such as anxiety and depression in some people.

• Endometrial hyperplasia or cancer - In a normal cycle, the uterine lining is shed each month. This is known as your menstrual period. In PCOS, due to a lack of ovulation and missed cycles, the uterine lining and build and thicken, which can increase the risk of endometrial cancer.

How is PCOS treated?

Doctors or specialists will often advise taking the pill (often Ginet) or another form of hormonal birth control like the Mirena to “regulate” the menstrual cycle and help manage symptoms like acne and excess hair growth. Unfortunately, this does not treat the root cause of the issue, and so when people come off these drugs they are faced with the same symptoms. This is particularly problematic when women want to come off the pill and try for a family naturally.

Other types of medications such as spironolactone, metformin, clomiphene or letrozole are also often suggested to further help with issues such as excess hair, acne, weight gain, and to help stimulate ovulation and support fertility.

Natural treatment for PCOS

It is possible to completely reverse PCOS symptoms naturally. Through specific diet and lifestyle changes, we can work to improve insulin sensitivity and reduce excess androgens to improve physical symptoms as well as support a regular menstrual cycle and restore fertility. Often, supplementation and herbal medicine is prescribed to help balance hormones, regulate periods naturally and further improve symptoms such as hormonal acne, hair thinning and facial hair.

I think I might have PCOS. Where should I start?

PCOS is an extremely complex condition. If you’re suffering with the symptoms of PCOS or have recently been diagnosed, the best place to start would be booking an appointment with Emily. Emily will be able to help you identify if you have PCOS as well as what type of PCOS you have, and address the root cause related to the symptoms you are experiencing. Book a consultation online now or contact Emily for more information.

How can a nutritionist / naturopath help my PCOS?

Emily uses a holistic approach to address the core issues of PCOS. You will receive a completely personalised health plan targeted at managing symptoms through specific nutrition and lifestyle changes, as well as prescribed supplementation and tailored herbal medicine. By working with Emily, you will gain a deeper understanding of what is causing your PCOS symptoms, and will get the tools needed to reverse PCOS naturally and long term.

Ready to get started?