Polycystic ovary syndrome, or PCOS for short, has recently made its way into our media headlines, thanks to a candid Instagram post that Star Wars actress Daisy Ridley released. In this post, she hinted at the difficulties of living with PCOS but more importantly about how some changes she made to her diet had a positive effect on her skin. This made me think that a blogpost is long overdue from me on the many ways in which women can help their symptoms of PCOS.
If you're undergoing a course of acupuncture or Chinese herbal medicine with me, you'll notice that I place a great deal of emphasis on things that you can do for yourself alongside our treatments. The integrated approach I take means that any advice I offer will always take into consideration what is currently going on with your conventional medical treatment, as well as the key areas of concern for you.
Although metformin and oral contraceptives can be helpful for various symptoms of PCOS, not everyone responds to them and it's these people who I tend to see in my practice. I also see a huge number of women trying to conceive (TTC) so the Pill is not an option for them. For these girls and women with PCOS, the three most common pieces of advice I've been offering over the last 16 years are as follows:
1. Make cinnamon part of your diet
Cinnamon is used alongside other herbs in Chinese herbal medicine for various symptoms of PCOS, but it is probably one of the most well-researched herbal medicines for PCOS. Cinnamon is being increasingly investigated for its insulin-sensitising properties and a pilot study in the US suggested that an 8-week course of cinnamon resulted in significant reductions in insulin resistance compared to placebo (Wang 2007). I tend to recommend cinnamon for women who have difficulties with post-meal energy dips, sugar cravings or a tendency to gain weight. Cinnamon in TCM is called Rou Gui and is pretty much in every herbal formula I give to PCOS patients.
Take a teaspoon of cinnamon a day by adding it to porridge or to a stir-fry. Higher doses than this are considered medicinal and should be prescribed by a qualified herbalist, and additional care should be taken if you're already being prescribed an insulin-sensitiser such as metformin, or are taking blood-thinners. In these circumstances, speak to somebody who's registered with AHPRA and make sure your GP or endocrinologist is aware of any supplements you're currently taking.
2. Activity is an important ally in PCOS
Before you roll your eyes at this recommendation, take a moment to hear me out on this one! The reason why I find activity to be so important for women with PCOS is not just because of its effects on weight, but also because of its potential effects on the sympathetic nervous system. The sympathetic nervous system regulates our 'fight or flight' response in response to stress and also has important functions in regulating cardiac function and blood pressure. Current medical thinking and research suggests that the sympathetic nervous system could be working overtime in women with PCOS compared to those without the condition (Lansdown 2012, Li 2014). Chronic overactivity of the sympathetic nervous system has been associated with PCOS, as well as other inflammatory conditions like endometriosis, cardiovascular disease and metabolic syndrome.
To my mind, anything that can address this imbalance has the potential to be of considerable benefit and increasing physical activity is one of the most effective ways to do this. This is why physical activity matters in all women with PCOS, regardless of whether they are overweight or not. (Incidentally, effects on the sympathetic nervous system may also be one of the ways in which acupuncture can help with symptoms of PCOS but more on this in another post!).
Increase physical activity gradually by finding opportunities in your daily life, such as going out for a walk at lunch, or taking the stairs instead of the escalators. However, you will need to work this up gradually to include activity that gets your heart rate going. If you're not (yet!) a sports enthusiast, try different exercises out - going with a friend or a partner can provide additional support or motivation, but use the time to find a pattern that works for you and that you're likely to keep to. I love yoga for its ability to strengthen my mind and body but I don't have a lot of spare time. I have found an app called Daily Yoga which is 30 mins per day that I can do in the privacy of my home at the time that suits me! Highly recommend.
3. Find out if cutting down on wheat & dairy is right for you
Dairy gets a lot of stick and I'm not sure it deserves it entirely. Whether or not to cut out dairy depends on many factors, including how you feel symptomatically after having dairy, what kind of dairy you tend to take in, and what your other sources of protein or calcium may be. The link between dairy and inflammation has additionally been of significant interest to the PCOS community partly because of the potential role of inflammation in PCOS (Duleba 2012). Although some studies suggest that dairy may be pro-inflammatory, other studies have contradicted this and my take on this is that the evidence isn't yet clear cut, not least because measuring inflammation is a pretty tricky process in itself, but also because the relationship between inflammation and disease processes is far from linear (Rajaeieh 2014, O Markey 2014, Pasin 2015, Kalergis 2013).
As Daisy Ridley has reported though, limiting dairy can been helpful for some women. If you're interested in seeing how this goes for your own symptoms, my advice would be to start off by cutting down firstly on cheese, butter, ice-cream and cream-based foods and sauces for around 4 weeks. These heavier dairy products can be the key culprits for some women. During these 4 weeks, you can keep having milk and yoghurt but stick to organic where possible.
Wheat however, has been repeatedly shown as hard on the digestive system so inflammatory in nature. Although wheat was only added to the human diet around 12,000 years ago, it has become a major dietary staple and is widely used in processed foods. One group of proteins found in wheat - amylase-trypsin inhibitors (ATIs) - has been shown to trigger an immune response in the gut that can spread to other tissues in the body.
I never thought I'd be quoting from Daisy Ridley in my blogposts, but her final remark in her Instagram post beautifully sums up the core approach that we always use in acupuncture and Chinese medicine:
'From your head to the tips of your toes we only have one body, let us all make sure ours are working in tip top condition.'
If you would like to know more about what we can do for you and your PCOS please click here or call 0352 228714 or you can book online
Hope you have a great day! Thanks for reading xx