Treating Polycystic Ovary Syndrome (PCOS)

Last week we talked about PCOS and today we’re looking at treatments.

When I first read the phrase “ovarian drilling using lasers,” for PCOS, I thought: Only a guy could come up with this concept (and I bet he wouldn’t want some woman doc drilling away on his outdoor plumbing). Then an image crossed my mind of some surgeon in a OR with a hardhat setting up his rig, rolling up his sleeves, lighting a Marlboro, and getting to work.

Now please don’t be irritated with me if you owe the existence of your bundle of joy to getting your own ovaries drilled. But surely women are entitled to know of simpler options for treating PCOS. (If you have no idea what ovarian drilling is, click here.)

According to published articles, which will always be biased in the direction of money flow–conventional and alternative therapies alike–there has been some success treating PCOS with ovarian drilling, and relatively few complications when performed in the hands of a good surgeon. (Of course, all surgeons think they’re good, so faith plays a large part in the outcome if you opt to go that route. Also, statistics show the number of procedures a surgeon performs contributes to mastery, so look for someone who’s done a lot of these.)

But let’s step back from the drilling rig for a moment and look at easier ways to manage your PCOS. In our experience, the best approach is a blend of conventional, nutritional, and Eastern medicines. Here are five steps I recommend:

1. Immediately start a weight reduction program centered on a low-glycemic diet (no sugar, simple carbs, high fructose corn syrup), with plenty of fresh fruit and veggies. You should go as organic as possible to detoxify yourself, but this needn’t be the $100-a-bag approach from Whole Foods. Many groceries now carry organically grown produce, and with the money you’ll be saving by not purchasing prepared foods and sugary and salty junk, trust me you’ll come out ahead. If you need help with all this—including very practical and eminently useable advice on how to shop your local grocery for best results–set up an appointment with our nutritionist Marla Feingold.

2. It’s essential you start a regular exercise program to burn off toxin-storing fat and strengthen your muscles. This isn’t a question of vanity–it’s a medical necessity. You can hire a trainer but you can easily start on your own. Look for a workout that combines cardio, strength training, and stretching. Click here for ways to get started.

3. Supplements. You need a good general multiple vitamin (like Multiplex with iron or, if you’re trying to conceive, a prenatal blend like Opti-Natal ). In addition, take the herb Vitex (also called chasteberry) once daily to balance your hormones; Milk Thistle , twice daily, for detoxification; and natural progesterone cream (Progonal ), ½ tsp applied to your skin daily from mid-cycle to flow (if you’re not menstruating, then two weeks on and two weeks off).

4. Have your doc prescribe one of these medications for Type 2 diabetes: metformin (Glucophage XR) or pioglitazone (Actos). Both reduce insulin resistance and lower insulin levels, and as a result lower your internal production of excess testosterone. Usually within two months women notice less facial and body hair, less acne, improved scalp hair, weight loss, and better blood pressure. After 4 to 6 months comes improved menstrual regularity. Many doctors also add spironolactone, a diuretic (water pill) that has the interesting side-effect of blocking testosterone. If you’re opposed to using prescription meds, you’ve tried them unsuccessfully, or had to stop because of side effects, work with the other four recommendations here.

5. Schedule an appointment with a practitioner of traditional Chinese medicine. PCOS is considered a “stagnation” issue and in the hands of an experienced acupuncturist/herbalist, you’ll likely see good results. Both Mari Stecker and Tanuja Jagernauth at WholeHealth Chicago have considerable experience with PCOS and infertility problems.

Or, you can get your ovaries drilled.