PCOS: Symptoms & Treatment

Perhaps you are curious if you might have PCOS? Maybe you already know that you do & would like to know what the treatment options are.


Let’s talk about ‘PCOS: Symptoms & Treatment’.


Hello, I am so thrilled to be here.

For those of you that don’t know me, my name is Michelle Cooke, Period & Hormone Naturopath, Natural Fertility Educator & Naturopathic Emotional Release (NER) Practitioner. I help women struggling with their menstrual cycles, have easy, pain-free periods, balanced hormones & emotional wellbeing. I’m the Founder and Director of Reproductive Wellness, a clinic located in Melbourne. I see patients online and face-to-face.


What is PCOS?


Polycystic Ovarian Syndrome is a syndrome which is a collection of symptoms. It is a metabolic condition & it is also multiglandular endocrine (hormone) disorder that affects more than just the ovaries. It is thought to be prevalent in 1 in 7 women. You don’t have to have Polycystic ovaries to have Polycystic ovarian syndrome. But if you do have polycystic ovaries this will generally cause the ovaries to become enlarged with a great number of cysts that are essentially underdeveloped or immature follicles.



How is PCOS diagnosed?


It is diagnosed commonly using the Rotterdam Criteria:


You need to present with TWO of the following THREE criteria =


  1. Oligo / anovulation – irregular or infrequent lack of ovulation

  2. Hyperandrogenism -symptoms or signs on pathology of high androgens (male type hormones)

  • Clinical (symptoms of it) = hirsutism (unwanted male pattern excess hair growth – chest, back, face, tummy etc) or male pattern alopecia – hair loss

  • Biochemical (found on pathology tests) – high free testosterone or raised FAI – free androgen index

  1. Polycystic ovaries found on pelvic ultrasound

Before this diagnosis is made, other conditions must be excluded: hyperprolactinaemia (over production of prolactin), thyroid dysfunction, Cushing Syndrome, Androgen secreting tumours, congenital adrenal hyperplasia (genetic disorder impacting the adrenal glands).



What are the types of PCOS?


There are 4 phenotype classifications:


Phenotype A (full blown): HA + OD + PCO

  • Hyperandrogenism (high androgens – symptoms or on blood tests) +

  • Ovulatory dysfunction (irregular or infrequent ovulation) +

  • Polycystic ovaries


Phenotype B (non-polycystic ovaries): HA + OD

  • Hyperandrogenism (high androgens – symptoms or on blood tests) +

  • Ovulatory dysfunction (irregular or infrequent ovulation)


Phenotype C (ovulatory PCOS): HA + PCO

  • Hyperandrogenism (high androgens – symptoms or on blood tests) +

  • Polycystic ovaries


Phenotype D (non-hyperandrogenic): OD + PCO

  • Ovulatory dysfunction (irregular or infrequent ovulation)

  • Polycystic ovaries


There are four different types of PCOS


  1. Insulin resistant PCOS – most common (insulin has gone on strike & is no longer able to keep glucose in check) results in high androgens.


FYI: Normally insulin will give glucose a piggy-back into the tissues where it is needed by the cell for energy production. In this type of PCOS, it stops doing this allowing glucose to increase in the blood.


  1. Adrenal PCOS – There is high DHEAS which is an adrenal hormone, but normal testosterone & androstendione (male hormones). Generally feel more stressed.


  1. Inflammatory PCOS: chronic low grade inflammation. This stimulates the ovaries to produce too much testosterone.


  1. Post pill PCOS: occurring after stopping the pill & is usually temporary



Symptoms & Signs of PCOS


This will vary according to what type of PCOS you have


  • Excess body or facial hair (hirsutism) – upper lip, chin, neck, chest, tummy etc. Generally dark & coarse in the male pattern areas.

  • Male pattern balding / alopecia

  • Irregular menstrual cycles

  • Long menstrual cycles

  • Irregular periods or periods that have stopped

  • Anovulatory cycles (ovulation won’t take place)

  • Heavy periods

  • Infertility

  • Emotional issues: depression, anxiety

  • Metabolic issues: diabetes, obesity (but not always, lean women can have PCOS too), dyslipidaemia (imbalance of fats such as the different types of cholesterol)

  • Acne

  • Oily skin

  • Enlarged ovaries with several small cysts (immature follicles) – but not always

  • Acanthosis nigricans – dark patches of discoloration in creases & body folds


 Natural treatment for PCOS


We need to remember that these suggestions are just going to help ease some of the symptoms that you may experience. But it not the complete solution & it is best to see a Naturopath that specialises in periods & hormones to help & guide you with an individualised treatment that addresses the underlying causes & issues for you. Plus they will be able to address the type of PCOS you have.  


  1. Avoid soft drinks

Soft drinks like coke, pepsi, lemonade etc. will contribute to high blood sugar levels, high insulin, insulin resistance & weight gain around the mid-section (contributes to hormone imbalance). Switch to kombucha instead (sweetened with stevia – doesn’t impact blood sugar levels).


Note: this includes the sugar free coke zero & pepsi max – these contain artificial sweeteners that actually have been shown to cause a rise in blood sugar levels. Because they are mistaken for glucose because of the sweet taste.



  1. Drink green tea or matcha

Having a green tea after meals can decrease the craving for sweet foods & it is also a great thermogenic (good for weight loss).


  1. Cutting down on saturated fats

Foods such as red meat should be minimised because these encourage the re-absorption of oestrogen from the bowels back into circulation. They can also increase the risk of cardiovascular disease & metabolic syndrome.



Can a Naturopath help with PCOS?


Yes, absolutely. I would suggest seeing a Naturopath that specialises in Periods & Hormones like myself; to help support you. Perhaps you suspect you have PCOS or have been told that this is the case for you.


Treatment wise, we would be using Natural medicine: including herbal medicine & nutritional medicine based on pathology findings, symptoms & signs, diet & lifestyle. I also use NER (Naturopathic Emotional Release) to look at underlying emotional contributors.


The treatment aims depends on your presentation but generally it would be things like:


  • Reducing inflammation

  • Hormone balance & support (oestrogen / progesterone ratio, testosterone)

  1. Good liver function: making sure liver is working properly to break down & clear hormones

  2. Good bowel function: making sure you are doing a poo every day and not constipated to remove oestrogen that has done its job in the body

  • Gut health – Addressing any gut bacterial imbalance (whether that is normally good bacteria commensal suddenly turning bad or whether it is bad bacteria causing havoc) because some bacteria can produce endotoxins known as LPS (Lipopolysaccharides) which have been shown to go on a journey from the gut through the blood stream & into the pelvic area causing inflammation & adding to the nasty symptoms of PCOS

  • Blood sugar / insulin regulation – diet, lifestyle, herbal medicine, nutritional medicine




  • Nutritional Deficiencies

  • Hormonal imbalance: Girly Hormones (oestrogen, progesterone, testosterone etc.), Thyroid, Pancreas, Adrenals

  • Assessing gut health: might include microbiome testing for large bowel (dysbiosis common in pcos), SIBO testing for small bowel if appropriate.

  • Other general pathology


If you would like support with your PCOS or if you think you may have PCOS, I would love to help you, go ahead and book a FREE 15 min discovery call to find out more about how we would work together and if we are a good fit.

If you have any questions or comments, pop them in the comments box below 🙂