PCOS is a syndrome - not a disease. Treat the ‘root cause’ of your symptoms to correct your cycle with natural medicine, herbs & nutrient interventions.

A syndrome is a recognisable complex of symptoms and physical findings which indicate a specific condition for which a direct cause is not necessarily understood.

Once medical science identifies a causative agent or process with a fairly high degree of certainty, physicians may then refer to the process as a disease, not a syndrome. (2)

“I have been diagnosed with PCOS - what does this mean?”

The diagnosis of PCOS seems lifelong - but I have seen countless women who have been able to identify their underlying drivers, and have corrected their ovarian function and reduced their symptoms. Polycystic ovarian SYNDROME is a collection of symptoms from an unknown driver. However, “unknown” is something that I disagree with. We know a lot about PCOS now, and the different types of ‘drivers’ in the body that are unique to each individual (see ‘root cause’ section below).

It generally takes an average of 17 years for research findings to be applied in clinical practice, a gap known as the "knowledge-to-practice" or "research-to-practice" gap. (3)

How is PCOS diagnosed?

According to the Rotterdam criteria, PCOS is diagnosed when at least two of the following are present:

  • hyperandrogenism - elevated androgens on a blood test OR signs and symptoms of androgen excess (acne, hirsuitism, head hair loss),

  • ovulatory dysfunction, and

  • polycystic ovarian morphology (1).

So you are diagnosed, but was your root cause investigated?

“Drivers” of PCOS:

  1. Inflammation

  2. Insulin resistance

  3. Stress and adrenal issues

  4. Androgen excess

  5. Hormonal imbalances - anovulation and/or estrogen imbalance

  6. Thyroid issues

  7. Environmental issues - toxins, moulds etc

  8. Dietary imbalance

So how do you know what type of driver you have? Check out my blog post on this, which includes questionnaires relating to the different underlying drivers!

The truth is, most people will have multiple drivers due to the synergistic relationship of the body.

Natural treatment of PCOS:

You will not have to use every nutrient, herb or diet recommendation in the list below - it will depend on your individual driver which can be determined by blood or functional testing. PCOS should be treated under the guidance of a professional, who will help you choose a way of eating that suits your lifestyle and budget, and who can make recommendations for SHORT TERM nutrients and herbs to get your body back on track. Herbal and nutrient prescriptions need to be reviewed each month to determine if you still need to stay on that product. If you need some expert advice, please book in to see me, either for a free discovery call, or an initial appointment online or face to face at my clinic in Stafford Heights.

Key recommendations:

  • DIET intervention:

    • Wholefood eating, minimised refined sugars, alcohol and carbohydrates long term (1).

    • If inflammation is severe, or there is an autoimmune thyroid issue happening also, a short term anti-inflammatory diet is often used.

    • If there is a metabolic picture, macro balanced eating focussing on protein is often used.

    • If there is a cortisol/stress picture, caffeine may need to be reduced or eliminated.

  • NUTRIENT intervention:

    • Antioxidants and anti-inflammatories like selenium, quercetin, resveratrol, bromelian, a good quality fish oil and vitamin D (based off blood test results) (1).

    • Ovarian nourishing nutrients like zinc and B6.

    • Insulin support using myo/chiro inositol & chromium.

    • Stress/nervous system support using magnesium and activated Bs.

    • Fertility support if required using COQ10.

    • Liver supporting nutrients: Taurine.

    • Thyroid supportive nutrients if required such as iodine, selenium & tyrosine.

  • HERBAL intervention:

    • Not all herbs will be required, the type of herb will be chosen based off your individual presentation and constitution and the knowledge base of your practitioner. Just because a herb is indicated for insulin resistance, that you have, does not mean that herb is right for you -

    • this is because HERBS also have individual profiles - some may be ‘hot’ or ‘cold’ in nature, and you might be a ‘hot’ constitution so adding in another ‘hot’ herb will not make you feel good, or some might not be good to use when you have elevated liver enzymes, which you might have, or some might not be safe to use in early pregnancy, and you’re trying to fall pregnant - this is why I cannot stress enough the role your practitioner plays in ensuring your plan is safe for you.

      • Antioxidants and anti-inflammatories like turmeric/curcumin and green tea.

      • Insulin sensitisers and blood sugar regulators like cinnamon, berberine containing herbs, gymnema, fenugreek, and bitters.

      • HPO regulators (for ovulation): peony, shatavari, chaste tree (if prolactin is high).

      • HPA regulators (for stress): withania, oats green, rhodiola, rehmannia, licorice.

      • Thyroid regulators: Withania, bacopa, Bladderwrack, Motherwort, Lemon balm, Bugleweed. These herbs are for both hypothyroid & hyperthyroid bodies so it will depend on the thyroid picture for what is recommended.

      • Anti-Androgenics: Sarsaparilla, peony + liquorice combination, saw palmetto, tribulus, spearmint.

      • Liver herbs to aid in detoxification of hormones & inflammatory toxins: Dandelion root, bupleurum, globe artichoke, st marys thistle.

      • Cyst management support: Thuja, immuno-modulating herbs.

      • Topical castor oil for cysts.

  • LIFESTYLE intervention:

    • Stress reducing strategies.

    • Optimising exercise routine - ensuring not ‘overexercising’ and incorporating a mix of cardio & strength, as well as relaxation like stretching and yoga.

    • Low tox strategies such as buying more plants, ditching plastic, vacuuming regularly.

    • Getting more sunlight.

    • Ensuring adequate hydration.

    • Lymphatic drainage support.

  • NATUROPATHIC tests to assist in determining the root cause:

    • Testing is recommended based off a thorough case history, but some common ones are:

  • Blood tests to assist in determining the root cause:

    • Again, not every test will be recommended, it will depend on your individual case history.

      • Inflammatory markers - ESR, CRP, ANA, vitamin D, homocysteine.

      • Fasting insulin, fasting glucose, HbA1c, oral glucose tolerance test.

      • Ovarian hormone panel

        • Day 3 of cycle - Estradiol, FSH, LH, SHBG, prolactin

        • Day 21 of cycle (if you have a normal 28 day cycle, if irregular, this day will be different) - Progesterone, DHEA, testosterone, free testosterone, estradiol, SHBG.

        • AMH levels (often increased).

      • Adrenal hormones

        • Fasting, morning cortisol 2 hours after waking naturally.

      • Other vitamins:

        • Magnesium, red cell zinc, b12, folate, iron studies.

    • It is important to note the optimal levels of these markers, and not go off the reference range in your blood tests. This reference range is an average, not an ‘optimal level’ of health. This range is based off a population and can be different ranges if you go through different labs, and different ranges if you are in a different area - i.e QLD vs WA, or QLD vs Rome in Italy. Many people do not understand this and are often told their blood tests are normal based off this reference range.

    • Vitamin D deficiency is more common in women with PCOS and is related to insulin resistance, ovulatory dysfunction, and infertility. Supplementation with vitamin D has been shown to improve insulin sensitivity, menstrual regularity, and fertility outcomes (1).

Citations:

  1. Muhammed Saeed AA, Noreen S, Awlqadr FH, Farooq MI, Qadeer M, Rai N, Farag HA, Saeed MN. Nutritional and herbal interventions for polycystic ovary syndrome (PCOS): a comprehensive review of dietary approaches, macronutrient impact, and herbal medicine in management. J Health Popul Nutr. 2025 May 2;44(1):143. doi: 10.1186/s41043-025-00899-y. PMID: 40317096; PMCID: PMC12049039.

  2. Calvo F, Karras BT, Phillips R, Kimball AM, Wolf F. Diagnoses, syndromes, and diseases: a knowledge representation problem. AMIA Annu Symp Proc. 2003;2003:802. PMID: 14728307; PMCID: PMC1480257.

  3. Rubin R. It Takes an Average of 17 Years for Evidence to Change Practice-the Burgeoning Field of Implementation Science Seeks to Speed Things Up. JAMA. 2023 Apr 25;329(16):1333-1336. doi: 10.1001/jama.2023.4387. PMID: 37018006.

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Understanding Thyroid Conditions: The Limitations of Thyroid Testing and Lab Reference Ranges in Australia