Polycystic ovary syndrome (PCOS) affects up to 20 percent of women in their reproductive years. Most women with PCOS will ultimately seek medical care related to four common complaints: irregular periods, acne, facial hair growth or thinning hair on the scalp, or infertility. However, conventional treatment of this complex condition often leaves women feeling frustrated and dissatisfied.
In this article, we’ll review our PCOS functional medicine approach and explain how this method is more effective than traditional treatments.
Conventional Treatments for PCOS
Conventional treatment of PCOS is a symptom-centered approach and typically fits into three treatment categories: androgen-related symptoms, period irregularities, and infertility. A conventional healthcare provider may prescribe spironolactone to reduce acne breakouts, the birth control pill to treat heavy periods, or Clomid for infertility.
Unfortunately, conventional medicine usually fails to treat the root cause of PCOS and leaves most women feeling frustrated and stuck inside the vicious cycle of managing symptoms and side effects.
In fact, one study found nearly 57 percent of patients with PCOS were dissatisfied with their care (1).
Furthermore, while these medications can often reduce symptoms of PCOS, most women experience a rebound of symptoms once they stop taking them.
Functional Medicine for PCOS
On the other hand, functional medicine for PCOS is a patient-centered approach that involves a collaborative, in-depth assessment to determine the root causes of your PCOS symptoms. Unlike the conventional model, our functional medicine doctors can spend upwards of one hour with you for every appointment. This gives you time and space to tell your whole health story.
Functional medicine is an individualized approach. For people with PCOS, we usually order a blood test
to evaluate your fasting insulin, fasting blood glucose, hemoglobin A1c, vitamin B12, vitamin D, zinc
, omega-3 index, testosterone, and DHEA-S. These labs, combined with your health history, symptoms, and lifestyle, help us to determine your specific type of PCOS, which then allows us to treat your root causes.
Types of PCOS
PCOS is a complex condition with a variety of root causes. However, we generally see four main subcategories:
- Insulin resistance: the most common type of PCOS, typical symptoms include sugar cravings, difficulty losing weight, and unwanted hair growth or loss. Will have elevated fasting insulin and blood sugar levels. May have elevated hemoglobin a1c and testosterone.
- Adrenal: due an abnormal stress response that increases cortisol and DHEA-S levels, common symptoms may include insomnia, anxiety, and acne.
- Post-Pill: usually shows up about one to two months after stopping the birth control pill, acne and unwanted hair growth/loss is common.
- Inflammatory: symptoms due to chronic inflammation (high CRP on lab work), can often overlap with other types of PCOS and present with various symptoms.
Treating the Root Cause
Once we know more about your type of PCOS, our doctors and dietitians collaborate with you to form a realistic and effective treatment plan to treat the root causes of your symptoms. Let’s review a few common interventions we may recommend in a functional medicine plan for PCOS.
Blood sugar balance
Balancing your blood sugar is essential no matter which kind of PCOS you may have. When your blood sugar is chronically high or sporadic throughout the day, your hormones cannot do their job effectively. To encourage blood sugar balance, we recommend using the PFC meal planning method and referencing The Root Plate
™. This method ensures you have a protein, fat, and fiber-rich carbohydrate with each meal and snack. These three macronutrients work in symphony to provide your body with the energy it needs while promoting optimal blood sugar levels, gut health, and sustainable diet changes.
We see excellent results when our clients use the PFC Root Plate® method, and will often recommend Ovasitol for PCOS
as well. This supplement can lower insulin and glucose levels, restore ovulation, and lower testosterone.
Realistic and sustainable diet changes
Your overall diet—as in the foods you eat—is a powerful tool to find healing for your PCOS. However, we also recognize diet culture particularly targets women who suffer from ongoing health conditions. Especially in functional medicine, people often feel like they need to restrict or eliminate multiple food groups to find success. In our practice, we believe in realistic and sustainable diet changes that do not involve unnecessary restriction. Our Root dietitians will collaborate with you to help you implement these changes to support healing in your PCOS journey.
Improving gut health
Dysbiosis, or an imbalance of gut bacteria, is one suspected root cause of PCOS. This gut imbalance can then cause insulin resistance, high androgens (like testosterone), and inflammation (2
). This is why we address gut health in all women with PCOS in our functional medicine membership program.
Optimizing your lifestyle
Chronic stress is toxic to the body. While we can’t usually remove all stressors from life, we can change how we respond to them. Managing stress is particularly crucial for individuals with adrenal PCOS
. These people generally present with high levels of stress hormones, like cortisol and DHEA-S, that interfere with hormone balance and can have similar effects as testosterone. Effective ways to manage stress and lower stress hormones include yoga or tai chi, meditation, deep breathing, therapy, and journaling. We may also recommend supplements to support a healthy stress response like ashwagandha
to balance cortisol levels or resveratrol
to lower DHEA-S.
In our assessment, we also help you implement other lifestyle changes like optimizing sleep hygiene and implementing daily movement.
Our functional medicine plan for PCOS is a collaborative approach that treats the root cause of PCOS by using personalized lab testing, in-depth assessments, realistic diet and lifestyle recommendations, and tailored supplements.