Polycystic Ovary Syndrome (PCOS) is a common and complex hormonal condition affecting up to 13% of females of reproductive age in Australia, with a higher proportion of Asian, African, and Indigenous Peoples living with the condition1.
Often associated with symptoms such as irregular or missed periods, acne, weight gain, excessive hair growth, and reduced fertility (side note: to make things more complicated, PCOS looks different on everyone. But more on that below), PCOS is a long-term condition that requires long-term management of its associated symptoms. Click here for more information on PCOS, including its causes and symptoms.
A key pillar to successfully managing your PCOS symptoms and regulating your hormones is to find a method of treatment that works for you, your lifestyle, and your needs. Because symptoms (and the severity of each symptom) can vary so greatly from person to person, there is no one-size-fits-all approach to treatment when it comes to PCOS.
Buuuut, we’d be remiss if we didn’t acknowledge the elephant in the (doctor’s) room that’s often not so gently pushed as the best way to resolve just about every problem a person with PCOS can experience.
From infrequent periods to hormonal acne, weight gain to mood swings, and everything in between, if there’s one thing menstruating folk can agree on, it’s that we’ve all walked into a doctor’s office for one thing, and walked out with a script for The Pill instead.
From a young age, many of us were presented with the idea of The Pill as the magic solution to all of our problems…with absolutely no strings attached. Introduced to us as the secret to clear skin, the quick fix for irregular periods, and the solution to unpredictable mood swings, who would turn down something that was recommended to us by the very people who we were supposed to entrust with our care?
Almost sounds too good to be true, right?
Right.
Only years later, when many of us began to embark on our own research, did the truth finally come to light:
The Pill isn’t as magic as it once seemed after all.
In a fight to help you reclaim your bodily autonomy and break free from default, cookie-cutter treatment options, we’re here to help you remove the rose-coloured glasses that idolise The Pill. And in exchange? Explore alternative methods for managing your PCOS symptoms – in a way that serves you best. Because you deserve to have a say in your own treatment.
While conventional treatments (such as hormonal birth control aka The Pill) are available to help treat some of the most common symptoms of PCOS, not everyone wants to be on hormonal birth control - and we shouldn’t feel like it’s our only option, because it’s not. Everybody is different – so if hormonal birth control isn’t working for you (or causing unwanted side effects - we’ll deep dive into this in another article), or you’d like to explore other options, there are other treatment options available to you.
Wait, The Pill Does What?
Since its injection into society in the 1950s, the popularity of The Pill has skyrocketed2. The oral contraceptive pill has been so influential since its conception (if you’ll pardon the pun) that even in a world full of medications, it quickly earned itself the name of simply, The Pill. Despite being found in the bathroom vanity of just about every household, in the almost 70 years since we were first introduced to The Pill, we haven’t actually learned that much about it.
Barbara Seaman’s 1969 book, The Doctors’ Case Against The Pill, raised important questions about the safety and reliability of birth control pills, and public trust in The Pill began to falter for the first time2.
With the take-off of the feminist movement in the 1970s, word of the once-hushed side effects and non-consensual trials of The Pill began to spread like wildfire. Some of the more serious adverse effects of The Pill that we often don’t hear about are the increased risk of cervical, breast, and liver cancers and bone mineral density loss that it brings3.
The effects of The Pill aren’t just physical.
The use of The Pill during adolescence has been shown to increase the risk of developing depression later in life, whilst adult individuals have an increased risk of developing depression within the first two years of consistent use4. Studies have also shown the link between long-term exposure to The Pill and its association with anxiety and sleep issues in patients without a history of either condition5.
A study published in The American Journal of Psychiatry reported that the prevalence of suicide attempts was nearly doubled and suicide rates were nearly tripled among women taking hormonal contraception compared to patients who had never used hormonal contraception6.
So yes, The Pill does ensure your ‘period’ comes once every 28 days, and yes, The Pill does provide an aspect of reproductive freedom…but at what cost?
If you’re as angry as we are about these life-threatening statistics being left out of conversations in the exam room, read on for more ways you can successfully manage your PCOS symptoms – without putting your health and well-being at risk.
Managing PCOS Symptoms with Natural Therapies
We know what you’re probably thinking; natural therapy, schmerapy. But before you turn your nose up at this form of alternative treatment, over 70% of Australian women living with PCOS have reported that they use natural therapies such as medical cannabis or herbal supplements to help successfully manage their symptoms7.
Generally speaking, women with PCOS are more at risk of experiencing difficulties sleeping, poor sleep quality, and sleep disorders when compared to women living without the condition. Poor sleep quality is closely linked to fatigue, and women with PCOS are more likely to experience fatigue than women without PCOS8.
On top of that, as many as 27% of women diagnosed with PCOS are reported to be affected by depression and 50% report anxiety symptoms and experience high stress, panic attacks, and trouble sleeping as a result9.
But don’t worry, it’s not all doom and gloom. If natural therapies sound a bit more your vibe than The Pill, then check out these green alternatives:
Medicinal Cannabis
Whilst medicinal cannabis is not a cure for PCOS, it can be used to help treat some of its associated symptoms. For some patients with anxiety, medical cannabis has been shown to produce a calming, anti-anxiety effect. Medicinal cannabis can also be used to reduce the prevalence of sleep disturbances, disruptive sleep, chronic pain, and depression10. Accessing medicinal cannabis treatments in Australia requires a valid prescription from a qualified doctor. To speak with a doctor who specialises in PCOS and natural therapies, join Hazel and find out if medicinal cannabis is right for you.
Naturopathy
When working with a naturopath for PCOS, your practitioner will work closely with you to identify your symptoms and create a holistic treatment plan that can improve your general well-being, reduce the symptoms of the disorder, and promote positive lifestyle behaviours.
Naturopathic modalities for PCOS symptom management include:
- Herbal medicine.
- Dietary advice.
- Lifestyle advice and coaching.
- Nutritional advice.
With a core focus on treating underlying causes, naturopathy can help to support the reproductive and metabolic symptoms of PCOS11 and assist in the following:
- Improved fertility.
- Improved body composition.
- Reduced risk of chronic health conditions (such as diabetes and obesity).
- Treat hormonal acne.
- Controlled hair growth or loss.
- Regulated periods.
Pssst, naturopathy services are coming to Hazel soon. Join the waitlist to be the first to know when we launch.
Managing PCOS Symptoms with Lifestyle Modifications
Reported to be one of the key components to successful PCOS management12, a recent study concluded that lifestyle modifications (yep, we’re talking about consuming a balanced diet and moving regularly) had the ability to alleviate several symptoms commonly associated with PCOS13.
The bonus? Making these lifestyle modifications can also have an overall positive effect on your general health and well-being.
Win-win.
Regular Movement
Regular movement plays a vital role in managing PCOS symptoms. Getting more activity into your routine can assist in decreasing insulin sensitivity, promote weight management, and boost serotonin levels.
Notice how we say ‘movement’ and not ‘exercise’. Movement doesn’t have to be hours of aggressive HIIT-style training (unless that’s what you love, we’re not here to yuck your yum) – movement for you could be a 30-minute walk, a yoga class, or a couple of laps at the pool.
There’s never been a better time for you to live your best pilates-girl life or jump on the hot-girl-walk bandwagon.
An increase in movement among those with PCOS has also been shown to successfully reduce insulin resistance, improve ovulation, and positively impact fertility14.
Regardless of the activity, find a way to move that works for you (bonus points if you get to wear a cute outfit and have fun doing it) and make it a point to incorporate more movement into your everyday life.
Eating a Balanced Diet
Remember what they used to say about how we should try to “eat a rainbow” with every meal? Turns out your primary school PE teacher was right; bringing colour to your plate is (you guessed it) another great way to reduce symptoms of PCOS.
While we can’t force you to eat your fruits and veg, we can take it upon ourselves to remind you that opting for meals and snacks rich in protein, fibre and healthy fats not only keep you satiated for longer, but they also have the power to regulate blood sugar and boost your mood (without the addition of a million extra hormones)15.
We guess that’s why they call them superfoods, hey?
Ready to up your nutritional intake? Give these PCOS-friendly foods a try:
- Berries.
- Apples.
- Melons.
- Leafy greens.
- Avocados.
- Nuts and seeds.
- Poultry.
- Fish.
Effectively Manage Your Stress Levels
Okay, we know you’ve probably heard this a lot (from your doctor, mum, friends and literally everyone else), but stress plays a major role in the manifestation of a number of diseases and conditions – and yep, PCOS is included.
A 2018 study has highlighted the critical link between stress and PCOS16. Stress is a common cause of reproductive dysfunction and stress-induced anovulation in women with PCOS17.
If your ears are burning reading this and you know you’re guilty of carrying the weight of the world on your shoulders (you don’t need to, we promise), try out some of our favourite stress-combatting strategies:
- Meditation.
- Yoga.
- Journalling.
- Pilates.
- Going for a walk.
- Mindfulness.
- Taking a bath.
- Naturopathy.
Most importantly, remember to breathe. You’ve got this.
Get Enough Sleep
Another crucial lifestyle factor (and yep, we’re sure you’ve heard of this one too) is sleep. But just because you’ve heard it all before doesn’t mean it’s any less important.
A key component in reducing stress levels and promoting cognitive health is to get enough sleep18. Poor sleep quality is closely linked to fatigue, and women with PCOS are more likely to experience fatigue than women without PCOS19.
Getting enough sleep by powering off devices, maintaining a good bedtime routine, and avoiding caffeine throughout the evening are all pivotal in ensuring a peaceful night’s sleep.
So stop doom-scrolling TikTok, give up on stalking your situationship’s family holiday pics, put a ban on intrusive work thoughts once you’re out of the office, and treat yourself to the good night’s sleep you deserve.
Future you will thank you for it.
Managing PCOS Symptoms with Supplements
Certain supplements have been reported to address specific symptoms associated with PCOS. Some of the most common forms of supplements used to manage PCOS symptoms include:
Magnesium
Magnesium is crucial for the maintenance of healthy muscles, nerves, and sugar levels. This super-nutrient is a pretty big deal; playing an integral role in making protein, bone, and our DNA. Magnesium supplements can help to:
- Improve insulin resistance.
- Improve lipid profiles.
- Lower cholesterol.
- Decrease high-density lipoprotein15.
Inositol
Inositol is a vitamin-like substance that can assist with cellular insulin signalling. When used in conjunction with a healthy lifestyle, Inositol can help to:
- Improve insulin sensitivity.
- Improve ovulation rates.
- Regulate menstrual cycles.
- Improve egg quality prior to fertility treatments.
- Support weight loss20.
Vitamin D
Vitamin D deficiency is not uncommon in women with PCOS, with as many as 87% of women with PCOS suffering from the deficiency21. And a few minutes of sunlight each day isn’t going to cut it. In fact, studies show that most people would need 8-10 minutes of body exposure (that means getting your arms, chest, and legs out too – with SPF, of course!) each day to get their recommended vitamin D intake22. By supplementing with a good quality Vitamin D, those with PCOS can experience:
- Lower inflammation.
- Improved insulin resistance.
- More regular menstrual cycles23.
Omega-3 Fatty Acids
Another supplement with a lot of clinical research behind it….As a result of their anti-inflammatory properties, Omega-3 is particularly helpful when it comes to improving:
- Overall fertility.
- Inflammation levels.
- Ovarian reserve and ovulation24.
As with all alternative treatment methods, before attempting to manage your PCOS symptoms with supplements, it is crucial that you speak to a healthcare provider or expert in PCOS. Your provider will help you to find supplements that effectively address and alleviate your own individual symptoms safely.
Remember, everyone has a different PCOS experience; what works for someone else may not necessarily work for you.
Managing PCOS Symptoms with Acupuncture
If you’re a yes-woman who’s always down to try something new and exciting, allow us to present you with this game-changer that you likely hadn’t thought of before.
A part of the ancient practice of Traditional Chinese Medicine (aka TCM), Acupuncture is the practice of penetrating the skin with thin, solid, metallic needles which a practitioner activates through a series of gentle and specific movements and techniques25.
Evidence suggests that when used to manage PCOS symptoms, acupuncture can influence ovulation by affecting levels of various hormones, such as oestrogen26.
Studies have also shown that when used for the management of PCOS symptoms, acupuncture was found to improve ovarian production, increase ovulation frequency, reduce androgen levels, and reverse insulin resistance. One particular study showed that over a 3-month treatment period with acupuncture, ovulation rates jumped from 15%-66%27.
Other Symptoms of Polycystic Ovary Syndrome
If your PCOS symptoms look different from your bestie’s, your sister’s, or your mother’s, it isn’t always a cause for concern – we promise.
Why? Because PCOS looks different on every single body, with symptoms ranging from mild to severe. Symptoms can present themselves as early as puberty (yep, we’re looking at you hormonal, teenage acne), but the onset can also begin in a woman’s 20s and 30s. While some symptoms can last for the entire duration of a woman’s life, other symptoms can stop at perimenopause and menopause.
We’ve already touched on weight gain, acne, and reduced fertility, but those aren’t the only symptoms someone with PCOS could experience.
Some other common symptoms of PCOS include:
- Pelvic pain.
- Fatigue and sleeping difficulties.
- Irregular (or missed) periods.
- Excessive hair growth on the face, body, or both.
- Mood swings.
- Hair thinning.
- Insulin resistance.
- Polycystic ovaries28.
Long-Term Risks Associated with PCOS
Those living with PCOS are at higher risk of developing the following associated conditions:
- Obesity.
- Type 2 Diabetes.
- High cholesterol.
- Dyslipidemia
- High Insulin resistance.
- Endometrial cancer.
- Cardiovascular disease.
- Anxiety and depression.
- Sleep Apnoea.
Your diagnosis does not define you, and it is not the end of the world. In fact, it’s quite the opposite. With the help of a strong support network, you can make choices regarding your treatment that help manage your symptoms in a way that serves you best.
No more miserable doctor visits, no more feeling helpless in the waiting room, and no more feeling like you have no choice but to manage your symptoms with The Pill.
What to Do if You Think You Have Polycystic Ovary Syndrome
Difficult to diagnose does not mean impossible to diagnose. Unfortunately, it is estimated that almost 75% of women living with PCOS remain undiagnosed29.
If you’re experiencing any of the above symptoms and suspect that you may have PCOS, know that there are answers, experts, and resources available to help you navigate your way through this condition.
Remember, PCOS does not look the same on any two people – meaning that treatment options that work for one individual may not work for you, and vice versa. With that being said, it’s important to seek support from an expert in PCOS who can provide you with a personalised care plan that not only works for you, but one that also aligns with your lifestyle.
If you’re interested in exploring additional avenues to PCOS symptom management (outside of hormonal birth control), book a consultation with our experts in female health and Polycystic Ovary Syndrome to start receiving the answers and care and answers that you’ve always deserved.
- The State of Queensland; Queensland Health. “7 Signs You Might Have Polycystic Ovarian Syndrome.” Www.health.qld.gov.au, Queensland Government , 5 Oct. 2021, www.health.qld.gov.au/news-events/news/7-signs-you-might-have-polycystic-ovarian-syndrome.
- Liao, Pamela Verma, and Janet Dollin. “Half a century of the oral contraceptive pill: historical review and view to the future.” Canadian family physician Medecin de famille canadien vol. 58,12 (2012): e757-60.
- Cibula D, Gompel A, Mueck AO, La Vecchia C, Hannaford PC, Skouby SO, et al. Hormonal contraception and risk of cancer. Hum Reprod Update. 2010;16(6):631–50. Epub 2010 Jun 12.
- Johansson, T., et al. “Population-Based Cohort Study of Oral Contraceptive Use and Risk of Depression.” Epidemiology and Psychiatric Sciences, vol. 32, 2023, p. e39., doi:10.1017/S2045796023000525.
- Slattery, J., Morales, D., Pinheiro, L. et al. Cohort Study of Psychiatric Adverse Events Following Exposure to Levonorgestrel-Containing Intrauterine Devices in UK General Practice. Drug Saf 41, 951–958 (2018). https://doi.org/10.1007/s40264-018-0683-x
- Skovlund, Charlotte Wessel, et al. “Association of Hormonal Contraception with Suicide Attempts and Suicides.” American Journal of Psychiatry, vol. 175, no. 4, Apr. 2018, pp. 336–342, https://doi.org/10.1176/appi.ajp.2017.17060616.
- Arentz S, Smith CA, Abbott JA, Bensoussan A. A survey of the use of complementary medicine by a self-selected community group of Australian women with polycystic ovary syndrome, BMC Complement Altern Med. 2014;14:472.
- Hollinrake E, Abreu A, Maifeld M, Van Voorhis BJ, Dokras A. Increased risk of depressive disorders in women with polycystic ovary syndrome. Fertil Steril. 2007;87(6):1369–76
- Damone, Anna L., et al. “Depression, Anxiety and Perceived Stress in Women with and without PCOS: a Community-Based Study.” Psychological Medicine, vol. 49, no. 9, 2019, pp. 1510–1520., doi:10.1017/S0033291718002076.
- Breus, Michael. “Does Marijuana Affect REM Sleep?” Sleep Doctor, 13 Dec. 2022, sleepdoctor.com/cannabis-and-sleep/does-marijuana-affect-rem-sleep/.
- Ratnakumari, M Ezhil et al. “Study to Evaluate the Changes in Polycystic Ovarian Morphology after Naturopathic and Yogic Interventions.” International journal of yoga vol. 11,2 (2018): 139-147. doi:10.4103/ijoy.IJOY_62_16
- Ee, C., Pirotta, S., Mousa, A. et al. Providing lifestyle advice to women with PCOS: an overview of practical issues affecting success. BMC Endocr Disord 21, 234 (2021). https://doi.org/10.1186/s12902-021-00890-8
- Daniella D.G. Curi, Angela Maggio Fonseca, José Antônio M. Marcondes, José Alcione M. Almeida, Vicente R. Bagnoli, José Maria Soares Jr & Edmund Chada Baracat (2012) Metformin versus lifestyle changes in treating women with polycystic ovary syndrome, Gynecological Endocrinology, 28:3, 182-185, DOI: 10.3109/09513590.2011.583957
- Norman, Robert J., et al. “The Role of Lifestyle Modification in Polycystic Ovary Syndrome.” Trends in Endocrinology and Metabolism: TEM, vol. 13, no. 6, 1 Aug. 2002, pp. 251–257, pubmed.ncbi.nlm.nih.gov/12128286/#:~:text=Current%20conservative%20treatment%20should%20emphasize, https://doi.org/10.1016/s1043-2760(02)00612-4.
- LDN, Katherine D. McManus, MS, RD. “Phytonutrients: Paint Your Plate with the Colors of the Rainbow.” Harvard Health Blog, Harvard Health Publishing: Harvard Medical School, 25 Apr. 2019, www.health.harvard.edu/blog/phytonutrients-paint-your-plate-with-the-colors-of-the-rainbow-2019042516501.
- Basu, Barnali Ray et al. “Possible Link Between Stress-related Factors and Altered Body Composition in Women with Polycystic Ovarian Syndrome.” Journal of human reproductive sciences vol. 11,1 (2018): 10-18. doi:10.4103/jhrs.JHRS_78_17
- Patel A, Sharma PS, Narayan P, Binu VS, Dinesh N, Pai PJ, et al. Prevalence and predictors of infertility-specific stress in women diagnosed with primary infertility: A clinic-based study. J Hum Reprod Sci. 2016;9:28–34.
- B.S, Dr Nikitha Murthy. “Can Stress Cause PCOS? Let’s Find Out! - Ayu Health.” Ayu Health, 2 June 2023, ayu.health/blog/can-stress-cause-pcos/.
- Hollinrake E, Abreu A, Maifeld M, Van Voorhis BJ, Dokras A. Increased risk of depressive disorders in women with polycystic ovary syndrome. Fertil Steril. 2007;87(6):1369–76
- Zarezadeh, Meysam et al. “Inositol supplementation and body mass index: A systematic review and meta-analysis of randomized clinical trials.” Obesity science & practice vol. 8,3 387-397. 22 Oct. 2021, doi:10.1002/osp4.569
- Tran, Dorothy. “PCOS: Daily Dose of Vitamin D.” Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, 9 Dec. 2021, lewis.gsu.edu/2021/12/09/pcos-daily-dose-of-vitamin-d.
- Ashley, Dr. Robert. “Ask the Doctors - How Much Sunshine Do I Need for Enough Vitamin D?” Www.uclahealth.org, UCLA Health, 23 Mar. 2018, www.uclahealth.org/news/ask-the-doctors-round-sun-exposure-vital-to-vitamin-d-production.
- Lin, Ming-Wei, and Meng-Hsing Wu. “The role of vitamin D in polycystic ovary syndrome.” The Indian journal of medical research vol. 142,3 (2015): 238-40. doi:10.4103/0971-5916.166527
- Kiani, Aysha Karim et al. “Dietary supplements for polycystic ovary syndrome.” Journal of preventive medicine and hygiene vol. 63,2 Suppl 3 E206-E213. 17 Oct. 2022, doi:10.15167/2421-4248/jpmh2022.63.2S3.2762
- John Hopkins Medicine. “Acupuncture.” John Hopkins Medicine, Johns Hopkins Health System, 2019, www.hopkinsmedicine.org/health/wellness-and-prevention/acupuncture.
- Lim C, Ng R, Cheng N, Zhang G, Chen H. “Acupuncture for Polycystic Ovarian Syndrome.” Www.cochrane.org, The Cochrane Collaboration , 2 July 2019, www.cochrane.org/CD007689/MENSTR_acupuncture-polycystic-ovarian-syndrome.
- Feng, Yi, et al. “Hypothalamic Neuroendocrine Functions in Rats with Dihydrotestosterone-Induced Polycystic Ovary Syndrome: Effects of Low-Frequency Electro-Acupuncture.” PLoS ONE, vol. 4, no. 8, 14 Aug. 2009, p. e6638, https://doi.org/10.1371/journal.pone.0006638.
- Fletcher, Jenna. “PCOS Symptoms and Treatment: Why Are Some Symptoms More Severe?” Www.medicalnewstoday.com, Medical News Today, 26 Feb. 2021, www.medicalnewstoday.com/articles/pcos-symptoms#pcos-symptoms.
- Wolf, Wendy M et al. “Geographical Prevalence of Polycystic Ovary Syndrome as Determined by Region and Race/Ethnicity.” International journal of environmental research and public health vol. 15,11 2589. 20 Nov. 2018, doi:10.3390/ijerph15112589