Polycystic Ovarian Syndrome (PCOS)
words by Kristy Emmett

What is PCOS?

Polycystic Ovarian Syndrome (PCOS) is a common hormonal condition that affects 12-22% of women of reproductive age (1). It is characterised by higher than normal levels of male sex hormones or androgens, which lead to metabolic and reproductive system dysregulation. It is the leading cause of infertility in females, and unfortunately, 70% of cases go undiagnosed (1).


What are the signs & symptoms of PCOS?

  • Oligomenorrhoea (irregular and infrequent menstrual periods of less than 6-8 per year)

  • Amenorrhoea (an absence of menstrual periods)

  • Hirsutism (male-pattern hair growth to the face, chin, and body)

  • Hormonal acne on the face, chin or body

  • Weight gain or difficulty losing weight (but not in all cases)

  • Metabolic syndrome (insulin resistance, pre-diabetes, obesity, high cholesterol)

  • Fatigue

  • Difficulty falling pregnant

  • Anxiety or depression

What causes PCOS?

Insulin resistance is present in as many as 70% of PCOS cases, which is an underlying driver for the condition (2, 4). Elevated serum insulin disrupts metabolic signalling pathways, which leads to an overproduction of androgens by the theca cells of the ovaries (3). Higher than normal circulating androgens including testosterone, androstenedione, and dehydroepiandrosterone (DHEAS) disturb normal hormonal balance which impairs ovulation. Excess follicles develop on the ovaries in an attempt for the body to ovulate, however failure to do this results in anovulatory cycles and missed periods. Sub-fertility, infertility and an increased risk of miscarriage can occur due to this ovulatory dysfunction (1).

Excess androgens cause male-like characteristics of male-pattern hair growth, acne and male-pattern hair thinning, as well as further compound the issue of hyperinsulinaemia and insulin resistance (3). Women with PCOS have an increased risk of developing metabolic syndrome which encompasses obesity, pre-diabetes, and dyslipidaemia (1).

There are 4 main types of PCOS which are Insulin-resistant, Post-pill, Inflammatory and Adrenal PCOS, with each having a different mechanism in how the condition manifests (4).


How is PCOS diagnosed?

Diagnosis is based on the Rotterdam criteria, whereby 2 of the 3 of the following signs and symptoms must be present:

1) oligomenorrhoea/anovulation

2) hyperandrogenism:

  • hirsutism or male pattern alopecia, or

  • raised Free Androgen Index or free testosterone on a blood test.

3) polycystic ovaries on ultrasound:: >10 small antral follicles on both ovaries or one ovary.

The exclusion of other possible conditions is essential including adrenal gland disorders, tumours, thyroid dysfunction and hyperprolactinaemia.


How is PCOS medically treated?

Typical medical treatment of PCOS often involves prescribing the oral contraceptive pill to regulate the menstrual cycle and suppress ovarian androgen production. The pill, however, doesn’t actually regulate the menstrual cycle, rather it suppresses ovarian function and creates a pseudo period or “withdrawal bleed” which confuses women into thinking they have a normal 28-day cycle. This can further compound the issue of PCOS when the decision is made to come off the pill to try and conceive, whereby ovarian function remains suboptimal and symptoms related to excess androgens can quickly resurface.

Other medications may be prescribed by doctors including androgen blocking medications, and metformin for blood sugar control, but these medications can have side effects.


Nutritional treatment of PCOS

There are many proven nutritional and supplemental strategies for treating PCOS.
  1. Seek guidance from a natural health professional – It’s always recommended to seek guidance from a qualified professional such as a Clinical Nutritionist who can appropriately assess, test and treat your symptoms
  2. Address the driving cause – Identity which of 4 types of PCOS are present e.g. Insulin-resistant, Post-pill, Inflammatory and/or Adrenal PCOS. Each of these subtypes requires a different strategy in the treatment.
  3. Support ovulation – Nutritional and supplemental strategies can promote optimal hormonal balance and spontaneous ovulation
  4. Improve insulin sensitivity – Stabilise blood sugar levels
  5. Support liver detoxification – The liver inactivates and filters hormones from the blood via phase 2 liver detoxification pathways, including oestrogen, testosterone, DHEA and cortisol
  6. Support a healthy weight – 60% of women with PCOS struggle with excess weight, as weight gain can be accelerated due to unbalanced hormones and insulin resistance (1). Dietary and exercise strategies are an important part of the management of PCOS.
  7. Nourish the adrenal glands – Improving stress adaptation and resiliency of the adrenal glands is important in PCOS, due to the significant role that the adrenal glands play in hormone production and blood sugar regulation
  8. Nutrient support – Myo-Inositol, N-acetyl cysteine (NAC), magnesium, zinc, chromium, vitamin D, and essential fatty acids have shown benefits in PCOS


If you suspect you may have PCOS or have been diagnosed with the condition, I would love to help you rebalance your hormones through natural means. Reach out for a FREE Discovery Chat in our online clinic today.

Our wide selection of high-quality professional products is available as part of your free consultation and we express post products Australia-wide.


Click here for research sources

1) Boyle, J., & Teede, H. J. (2012). Polycystic ovary syndrome: An update, Australian Family Physician, 41 (10). https://www.racgp.org.au/afp/2012/october/polycystic-ovary-syndrome

2) Traub, M. L. (2011). Assessing and treating insulin resistance in women with polycystic ovarian syndrome. World Journal of Diabetes, 2 (3): 33-40. doi: 10.4239/wjd.v2.i3.33

3) Baptiste, C. G., Battista, A. T., Trottier, A., & Baillargeon, J. P. (2009). Insulin and hyperandrogenism in women with polycystic ovary syndrome. The journal of steroid biochemistry and molecular biology, 122 (1-3). doi. 10.1016/jsbmb.2009.12.010

4) Briden, L. (2017). Period repair manual (2nd ed.).

5) Javanmanesh, F., Kashanian, M., Rahimi, M., & Sheikhansari, N. A comparison between the effects of metformin and N-acetyl cysteine (NAC) on some metabolic and endocrine characteristics of women with polycystic ovary syndrome. Gynecol Endocrinol. 2016;32(4):285-9. doi: 10.3109/09513590.2015.1115974.

5) Pundir, J., Psaroudakis, D., Savnur, P., Bhide, P., Sabatini, L., Teede, H., Coomarasamy, A., & Thangaratinam, S. (2017). Inositol treatment of anovulation in women with polycystic ovary syndrome: A meta-analysis of randomised trials. BJOG : an international journal of obstetrics and gynaecology. 125. doi: 10.1111/1471-0528.14754.

6) Unfer, V., Facchinetti, F., Orrù, B., Giordani, B., & Nestler, J. (2017). Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocrine Connections, 6(8), 647–658. https://doi.org/10.1530/EC-17-0243

7) Thalamati, S. (2019). A comparative study of the combination of Myo-inositol and D-chiro- inositol versus Metformin in the management of polycystic ovary syndrome in obese women with infertility. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 8(3): 825-829. DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20190498

8) Gayatri, K., Jena, K. S., & Kumar, B. B. (2010). Metformin and N-acetyl Cysteine in Polycystic Ovarian Syndrome–-A Comparative Study. Indian Academy of Clinical Medicine (1):1-7. DOI: 10.1177/117739361000100002

9) Thakker, D., Raval, A., Patel, I., & Walia, R. (2015). N-Acetylcysteine for polycystic ovary syndrome: A systematic review and meta-analysis of Randomized Controlled Clinical Trials. Obstetrics and gynecology international, 2015, 817849. https://doi.org/10.1155/2015/817849

Words by Kristy Emmett

Words by Kristy Emmett

Kristy is a passionate nutritionist and nurse with extensive experience working in both modern and natural medicine industries. Her main interests lie in balancing gut, hormonal, weight, and autoimmune health issues. After experiencing many of her own personal health issues, Kristy turned to natural medicine for holistic solutions to persistent symptoms that were not being managed effectively using modern medicine treatments. In her spare time, Kristy enjoys going to the beach, painting and drawing, bushwalking, yoga, meditation, and travelling.