Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders in young women. The main characteristics include obesity, cycle irregularities, insulin resistance, blemished skin and infertility. There are numerous natural measures that can improve PCOS.

Polycystic ovary syndrome

Polycystic ovarian syndrome (PCOS) was first described in the medical world in 1921, when scientists Achard and Thiers imagined a bearded woman with diabetes. She had PCOS.

Today, PCOS is one of the most common hormonal disorders in women of childbearing age, affecting 10 to 25 percent of all women of childbearing age.

The term “polycystic ovary syndrome already points to the problem: The ovaries (ovaries) of the affected women are enlarged and an unusually large number of (poly) immature egg cells can be detected there in ultrasound. Since the egg cells are present in vesicles and vesicles are called cysts in medical terminology (from the Greek word “kystis”), the term poly-cystic results.

Nowadays, affected women are usually closely monitored by their gynecologists and treated immediately with hormone preparations at the first signs of PCOS, even if the diagnosis is not yet certain. ( 29 )

PCOS – The Symptoms

The possible symptoms of hormonal disorders associated with polycystic ovary syndrome are the following (31) (33):

Chronic absence of ovulation and therefore:

• Menstrual cycle disorders (prolonged cycle, therefore infrequent or no menstruation at all or intermenstrual bleeding)
• Infertility or a tendency to miscarriage during pregnancy
• Overweight
• Acne
• Insulin resistance with a high risk that it will later develop into diabetes if no measures are taken
• Hair loss or hair growth according to the male pattern, i.e. hair loss on the head with excessive hair growth on the rest of the body at the same time = hirsutism
• Psychological problems up to depression
• Long-term increased risk of cardiovascular disease

However, not all symptoms have to occur at the same time in all those affected. Obesity, for example, is said to affect about 50 to 80 percent of PCOS women. Half suffer from prolonged cycles, only a third from intermenstrual bleeding.

But how do these symptoms occur in PCOS? And where exactly are the hormonal imbalances?

PCOS – How do the symptoms occur?

The hormonal balance is known to be a finely sophisticated system in which each hormone is in some way connected to the other hormones: Hormones influence each other, inhibit each other or promote the release of other hormones. If all this works out – wonderful!

However, if there is an error in the system at any point, then this error – like a domino effect – affects many other hormones and noticeable symptoms inevitably occur, depending on which hormones are most affected. In PCOS, the hormonal situation now looks like this:

Too much LH, too little FSH

In PCOS, the pituitary gland releases more LH (luteinizing hormone), but less FSH (follicle-stimulating hormone).

The LH is actually responsible for ovulation, while the FSH is responsible for egg maturation. No wonder that many immature egg cells now accumulate in the ovary if there is too little FSH in relation to the LH.

At the same time, ovulation does not occur, as an egg never really matures and would be “ready to jump” ( 10 ). Ovulation calculators do not show ovulation in this case either.

Too many male hormones (hyperandrogenemia)

The LH-FSH imbalance in PCOS now leads to the ovaries producing too many male hormones (androgens). The male hormones, in turn, can convert into estrogen – preferably in adipose tissue.

So the more obesity there is, the more fatty tissue there is and the more estrogen can be produced – which shows how being overweight has a negative effect on PCOS or how good it would be if the affected woman lost weight.

Too high estrogen levels (estrogen dominance)

Now a vicious circle begins, as a high estrogen level further promotes LH release and inhibits FSH release even further.

Even more male hormones are now produced in the ovaries and the chance of a maturing egg cell becomes less and less. Infertility is the result. ( 36 ) ( 41 )

Insulin levels that are too high (hyperinsulinemia)

At the same time, an increased insulin level can be observed in PCOS (hyperinsulinemia). However, a high insulin concentration in the blood promotes both fat storage and thus an increase in obesity and the formation of male hormones in the ovary. ( 30 ) ( 34 )

Conclusion: The dominance of estrogen (too much estrogen compared to progesterone), the excess of male hormones (hyperandrogenemia) and hyperinsulinemia are now jointly responsible for the development of the above-mentioned PCOS-typical symptoms. (14)

PCOS – What does conventional medicine do?

From the point of view of conventional medicine, there is hardly any other solution for PCOS than to prescribe hormones (the pill). Depending on the symptoms that occur, cortisone preparations are also given, which are intended to reduce the production of male hormones in the adrenal glands, as well as – in the case of insulin resistance – typical diabetes medications such as metformin.

However, metformin can lead to gastrointestinal complaints (nausea, abdominal pain, diarrhea, etc.), to changes in taste and even loss of appetite. The side effects of the pill are well known, as are those of cortisone: water retention, obesity, high blood pressure and increased blood sugar levels.

If all else fails, women can have their ovaries pierced in an operation. The ovary is pierced 15 times – 2 mm deep each time. The aim is to reduce its testosterone production capacity.

None of this sounds very body-friendly. And Dr. Keri Marshall took a similar view in 2001, emphasizing in her review that PCOS is in urgent need of therapy, but that this can also be done by naturopathy. This is just as effective as conventional medical therapy – only without its side effects. ( 1 )

And although Keri Marshall announced this 20 years ago, hardly any gynecologist passes on the relevant information to the often desperate and help-seeking patients. We would like to close this gap with the following summary of the holistic and naturopathic measures that can be considered for PCOS.

However, before you implement measures, have your thyroid levels checked – if you have not already done so. Hypothyroidism is often the cause of PCOS-like symptoms. If the underactive thyroid gland is corrected, the PCOS symptoms often also disappeare.

Holistic measures for PCOS

The natural measures presented below can help you to significantly alleviate your PCOS problem or even eliminate it completely:

Lose excess weight

In a British study with 153 subjects with polycystic ovary syndrome, it was found that a third of them suffered from abnormal eating behavior. The researchers stated that it makes sense for those affected to seek psychological treatment in order to be able to get a grip on the respective eating problems – and consequently also PCOS – more easily. ( 55 )

If PCOS is overweight, then weight reduction alone in conjunction with a change in diet can bring about a significant improvement in the symptoms, as the reduced body weight has a positive effect on all values and complaints associated with hormone fluctuations. This is already the case with an average weight loss of just 5 percent. ( 32 ) ( 38 ) ( 48 ) ( 54 )

A study caused a particular stir in which 82 percent of the participants showed a noticeable improvement in fertility as a result of weight loss and even 5 new pregnancies occurred in women who had previously been infertile for a long time. ( 49 )

Further studies on obese women with menstrual irregularities have shown that menstruation can often return to normal and fertility also regenerates once weight is successfully lost. ( 46 )

The best way to reduce excess weight is with the help of a suitable change in diet, e.g. with a moderate low-carb diet, which, by the way, does not necessarily have to consist of a lot of meat and other animal products – as one might think – but can also be vegan. If spices such as cinnamon are incorporated into the diet, obesity can also be counteracted. ( 7 )

Change your diet

The typical Western diet, which is rich in refined carbohydrates (sugar, white flour, baked goods and pasta) but provides very little fiber and vital substances, is considered a major trigger for insulin resistance and at the same time contributes to the development of obesity and cardiovascular diseases. ( 40 ) ( 43 ) ( 50 ) ( 52 )

Therefore, in order to remedy both problems, the diet should be changed to a diet rich in vital substances and excess alkaline.

Such a diet consists of plenty of vegetables, fruits, high-quality proteins, as well as moderate amounts of carbohydrates in the form of fiber-rich, complex carbohydrates (e.g., whole grains, legumes, oilseeds, and nuts). (44)

A 2013 study summarized the effect of a low-carb diet on PCOS as follows (2):

“Lowering insulin levels through an appropriate diet is an attractive non-pharmaceutical therapy for women with PCOS, whose increased insulin levels stimulate testosterone synthesis and thus increase PCOS symptoms.”

30 women with PCOS took part in the said study. The low-carbohydrate diet led to lower insulin, cholesterol and testosterone levels in the participants as well as to increasing insulin sensitivity (i.e. a decrease in insulin resistance).

Seven years earlier, a similar study had been conducted with similarly successful results. After just 16 days of moderate low-carb nutrition (43 percent of the daily calorie intake still came from carbohydrates), the insulin levels of the participants dropped, which – according to the scientists – will also lead to an improvement in sex hormone levels in the long term. ( 3 )

Read how changing her diet help beat PCOS for one of our readers

Try Seed Cycling

Seed cycling is a very uncomplicated measure (a kind of hormone diet) that can be integrated into almost any nutritional concept. It involves eating two specific seeds in the first half of the cycle (flaxseed and pumpkin seeds) and then eating two other seeds (sesame seeds and sunflower seeds) in the second half of the cycle (5)

The oil seeds are said to help regulate the hormonal balance so that hormone-related complaints – whether PCOS, menopausal symptoms or premenstrual complaints – can be alleviated.

Increase the amount of fiber

The health benefits of dietary fiber, among other things for reducing the risk of chronic diseases, have long been scientifically recognized. ( 45 ) ( 63 ) ( 64 )

Fiber sometimes ensures that carbohydrates enter the bloodstream more slowly, which indirectly lowers insulin levels. Further studies have shown that even insulin sensitivity increases and body weight decreases when the test subjects eat high-fiber foods. ( 62 ) ( 65 ) ( 66 )

Dietary fiber thus influences at least two factors that promote PCOS or increase the severity of PCOS symptoms, namely obesity and insulin resistance.

Very good sources of fiber are, for example, chia seeds, konjac powder (which is taken specifically for weight loss), coconut flour, oat bran or the already mentioned flaxseed. Or try a fiber-rich great tasting powder.

Take flaxseed

Flaxseeds not only provide fiber, but are also one of the best food sources for plant lignans, which in turn belong to the phytoestrogens. ( 51 )

Phytoestrogens are a class of plant substances that have been shown to have both estrogenic and anti-estrogenic properties. ( 53 )

The consumption of flaxseed also proved to stimulate SHBG synthesis and, conveniently, to inhibit growth on various tumors. ( 58 ) ( 67) ( 69 )

SHBG is a transporter protein that binds hormones to itself and transports them throughout the body. High insulin levels – such as those present in PCOS – inhibit SHBG formation.

If the SHBG levels are increased by lignans in flaxseed, more estrogen can be bound, which reduces the amount of free (= effective) estrogen and thus also the estrogen dominance present in PCOS. ( 11 ) ( 68 )

Flaxseeds can be crushed and added to muesli or whole meal baked goods. Flaxseed can also be used to prepare delicious crackers in raw food quality.

Ideally, flaxseed also has a very beneficial influence on intestinal health – and this also seems to be crucial for alleviating PCOS (as explained below).

Rehabilitate your intestinal flora

In 2012, Australian scientists presented a new thesis in the journal Medical Hypotheses: PCOS is known to be associated with chronic inflammation and often insulin resistance. What exactly leads to these two aspects is uncertain. ( 4 )

The researchers now suspect that it is the intestinal flora that could not only be involved in the development of PCOS, but may also trigger it in the first place. In the link below, we have reported on the connections between the intestinal flora and PCOS.

Dysbiosis (intestinal flora disorder), which occurs as a result of an unfavorable diet, increases the permeability of the intestinal mucosa. As a result, increased amounts of so-called lipopolysaccharides (LPS) can enter the bloodstream.

LPS are substances that are normally found in the cell membrane of bacteria and thus also in the cell membrane of intestinal bacteria. When bacteria decay – which happens all the time – the LPS are released. They have a toxic effect and are therefore referred to as endotoxins.

If the intestinal mucosa is intact, the toxins can be excreted in the stool. However, if it is no longer intact due to the increased permeability described above, these toxins enter the blood and immediately alert the immune system.

However, this can now hinder the function of insulin receptors, which causes insulin levels to skyrocket, which in turn drives testosterone production in the ovaries, disrupts normal egg cell development and promotes chronic inflammatory processes. PCOS is here.

In order to reverse this situation, i.e. the permeability of the intestinal mucosa, the intestinal mucosa needs time and opportunity to regenerate and heal. The healing of the intestinal mucosa can be supported with the right diet and a rehabilitation of the intestinal flora with high-quality probiotics (e.g. Super-Pro).

Because only a healthy intestinal flora can protect the intestinal mucosa and promote its healing processes. At the same time, other mucosal regenerating measures can be used, such as taking the following preparations:

• Mucilage (psyllium husks)
• Zeolite (which binds the lipopolysaccharides and excretes them in the stool before they can enter the bloodstream through the still permeable intestinal mucosa)
• Preparations such as Super-Biome
• Omega-3 fatty acids, which can make a decisive contribution to the regeneration of the intestinal mucosa and at the same time have an anti-inflammatory effect (see point 6)

Probiotics, zeolite and psyllium husk powder are taken as part of intestinal cleansing programs, intestinal cleansing to build up the intestinal flora. You can find more about the practical implementation here: How does a colon cleanse work?

Take advantage of omega-3 fatty acids

Fats play an important role in the holistic therapy of PCOS. Fatty acids influence not only the activity of hormone receptors, but also the expression of certain genes, such as those that are responsible for obesity and insulin resistance. ( 47 )

Omega-3 fatty acids (e.g. from fish oil or the purely vegetable algae oil) have been shown to improve insulin sensitivity and thus glucose uptake, which lowers blood sugar levels. They reduce fat storage and thus weight, and they lower blood lipid levels after meals.

All these properties seem to be made for the therapy of PCOS, which has already been shown in clinical studies:

In an Iranian study from 2012, for example, 64 overweight PCOS patients between the ages of 20 and 35 received four omega-3 capsules or four placebo capsules daily. Each omega-3 capsule contained 180 mg of EPA and 120 mg of DHA (for a total of 720 mg of EPA and 480 DHA daily). ( 5 )

In the omega-3 group, blood sugar levels, insulin levels, as well as total cholesterol and LDL cholesterol levels decreased. Insulin resistance decreased and adiponectin levels increased. Adiponectin is a hormone that is usually too low in overweight people. It increases the effect of insulin, which is therefore very useful in the fight against insulin resistance.

You should therefore always carefully check your omega-3 fatty acid supply and optimize it if necessary. Hemp oil and linseed oil are suitable for this, just like the chia seeds and flaxseeds already mentioned. Walnuts and their oil, as well as naturally fatty sea fish, also contain high-quality omega-3 fatty acids.

However, if you want to use omega-3 fatty acids therapeutically, the amounts ingested with food may be too low, especially if you don’t want to eat fish..

With capsules made from pure vegetable algae oil, you can take omega-3 fatty acids in a healthy way and in the desired doses.

In addition, make sure to reduce your consumption of omega-6 fatty acids, as these – if consumed in too much – can partially cancel out the effect of omega-3 fatty acids. Omega-6 fatty acids are found in particularly high quantities in sunflower oil, safflower oil and soybean oil, but also in many other vegetable oils. In olive oil and coconut oil, on the other hand, the omega-6 amounts are low.

Recommended: Dietary supplement with inositol

According to numerous studies, D-chiro-inositol or the very similar myo-inositol are considered highly interesting dietary supplements for women with PCOS. ( 13 ) ( 16 ) ( 17 ) ( 18 ) ( 21 ) ( 22 ) ( 23 ) The substance also occurs naturally in the human body and serves there as a messenger substance in signal transmission at the cell, which is why it also influences insulin effectiveness. ( 19 )

Based on some study results, it is now suspected that the PCOS symptoms of insulin resistance and hyperinsulinemia could indicate a deficiency of D-chiro-inositol – not least because the amount of inositol contained in the muscles is lower in type 2 diabetics than in healthy individuals. ( 9 ) ( 15 ) ( 24 ) ( 25) ( 26 )

A study by Dr. Nestler of Virginia Commonwealth University in Richmond, published in The New England Journal of Medicine, had shown that 1,200 mg of D-chiro-inositol per day (for 6 to 8 weeks) can have numerous beneficial effects in the treatment of PCOS. ( 20 )

Inositol not only increased insulin efficacy (i.e. reduced insulin resistance), but it also ovulated in 86 percent of women treated with D-chiro-inositol, compared to only 27 percent in the placebo group.

The androgen levels in the blood serum of the experimental group also decreased significantly. At the same time, both high blood pressure and excessive blood lipid levels decreased.

Inositol or its compounds are also contained in many foods, especially in cereal products with a high bran content (i.e. in whole grain products), also in nuts, legumes and fruits (especially in cantaloupe melons and oranges), so that a healthy whole food diet makes perfect sense in this context as well.

As a precaution, inositol should not be taken during pregnancy, as it could lead to uterine contractions in too high doses.

Chromium Supplementation

Chromium is known to be a helpful trace element when it comes to regulating blood sugar and insulin levels. Yes, a specific chromium deficiency is even said to be able to directly cause insulin resistance or type 2 diabetes.

Therefore, chromium is often used by diabetics as a dietary supplement. Chromium then increases the effectiveness of insulin. Chromium intake is therefore also conceivable in the treatment of PCOS.

Chromium is consumed particularly quickly during stress or high carbohydrate consumption – and usually in higher quantities than it can be replenished with food, which is why the additional intake of chromium could be useful under these conditions.

Studies at the Beltsville Human Nutrition Research Center ( 6 ) ( 12 ) ( 39 ) investigated the effects of chromium picolinate (the chromium form with the highest bioavailability) as the only therapeutic agent in type 2 diabetics. For this purpose, the patients were asked to eat “normally” during the treatment phase.

The participants were then divided into three experimental groups: either the placebo group, an experimental group that received 100 mcg of chromium picolinate twice a day, or an experimental group in which the subjects received 500 mcg twice a day.

Both the blood glucose levels on an empty stomach and the values two hours after food intake were significantly lower in both experimental groups, which suggests that an improvement in insulin sensitivity can be achieved through dietary supplementation with chromium.

In addition, studies show that supplementation with chromium picolinate can also contribute to noticeable fat loss (at 200 to 400 mcg daily), which is also desirable for PCOS. ( 28 )

Check your vitamin D levels

As with any chronic disease, the vitamin D level of PCOS should also be checked, as it is known that many PCOS patients have a vitamin D deficiency. If the deficiency is corrected, vitamin D contributes to the regulation of hormonal balance, harmonizes the menstrual cycle and promotes egg cell maturation.

Since PCOS can also cause depression in some cases and vitamin D can have an antidepressant effect (especially if there was previously a vitamin D deficiency), researchers examined a possible connection in 2014 and found that the more severe a vitamin D deficiency was, the more intensively the PCOS patients suffered from depression or depressive moods.

Dietary supplementation with DIM

DIM (diindolylmethane) is a cancer-hostile and anti-inflammatory substance that is produced during the metabolism of the plant substance indole-3-carbinol. ( 27 ) The latter, in turn, is contained in all cabbage vegetables and other cruciferous vegetables, e.g. in red cabbage, white cabbage, broccoli, broccoli sprouts, Brussels sprouts, cauliflower, but also in cress, mustard, arugula, etc.

However, DIM also has a positive effect on estrogen/testosterone metabolism. It is said to influence the liver in such a way that it can convert a higher estrogen rate into the inactive estrogen form, so that the body is freed from the tormenting estrogen dominance. The testosterone level is also corrected downwards under the influence of DIM.

Of course, DIM as well as maca should only be used as an accompaniment to all the other measures and should not be considered as the sole therapeutic agent. ( 8 )

Don’t forget to exercise

Of course, physical exercise – in combination with a healthy diet – should not be forgotten even with PCOS. It is an important factor in the prevention and treatment of insulin resistance – even if it occurs in the context of PCOS. (37) (56) (57)

For example, even a single training session can noticeably increase the overall rate of glucose breakdown throughout the body and reduce insulin resistance in skeletal muscle cells. (59) (60) (61)
In an observational study of young women with PCOS, Dutch researchers discovered a significant decrease in PCOS symptoms in those participants who exercised for at least 8 hours per week. (42)

Reduce your stress

PCOS also appears to have a low resistance to stress. Those affected do not cope so well with stress. If they are now confronted with permanent stress, this can intensify the symptoms. However, permanent stressful situations can also be among the triggers of PCOS.

Therefore, it makes sense to integrate good stress management into the holistic therapy of PCOS, e.g. Mindful Yoga, which was able to reduce PCOS-related increased testosterone levels and improve mental well-being in a 2020 study.

Other naturopathic measures for PCOS

Other options that could be considered for PCOS would be the following, which you should discuss with your holistic therapist just like those described above:

• Optimize your magnesium supply, as magnesium is involved in regulating blood sugar and insulin levels.
• Optimize your zinc supply. Zinc is also involved in blood sugar regulation as well as thyroid health.
• Improve your hormonal situation with natural hormones, e.g. with preparations made from Vitex Agnus Castus (monk’s pepper), which can alleviate the often existing estrogen dominance and is often used for infertility due to a progesterone deficiency (which is also the case with PCOS). Chasteberry is also said to normalize pituitary gland functions so that LH and FSH levels can settle down again.
• Mercury exposure can damage the hormonal system and throw it out of balance, which is why an appropriate check (whether there is a contamination) and, if necessary, mercury elimination may be indicated in the case of hormone disorders.
• A progesterone cream applied externally can also be helpful against estrogen dominance.
• Licorice root (e.g. as tea) reduces elevated testosterone levels and is said to be able to regulate the LH-FSH ratio.
• Saw palmetto might also be an option, as it can lower increased testosterone levels.
• If you have a high stress level, choose a natural remedy that has an adaptogenic effect, i.e. can increase your stress resistance so that you don’t have to suffer so much from the stress. In addition to the above-mentioned maca, the adaptogenic medicinal plants include, for example, ginseng or Rhodiola rosea.