Manage my PCOS drug-free?
August 28, 2011 9:27 AM   Subscribe

I need your tips on dealing with PCOS -- drug free!


I have PCOS (diagnosed when I was eighteen, now in early thirties.). All the traditional symptoms -- excess hair, acne, irregular periods etc. Luckily, I'm not really overweight, but do have an extra few pounds I'd like to lose. For most of my life, I've been able to manage the symptoms okay using birth control. But now I went off the pill because I want to start trying for a kid in the next few months, and want to see how my periods are without the pill. All those old symptoms are back.

Yes, I've been to an endocrinologist and gynecologist, and both suggested metformin. I'd really like to try to manage this thing drug free, or at least at the start I would. (I will totally use drugs if I have difficulty getting pregnant, but want to try drug free at the start).

So I'd love any tips for regularizing hormones (diet? no sugar? intensive exercise?) and the symptoms (laser hair therapy? Clarisonic for acne?) that I can do without drugs. And, that said, if you've used metformin and liked it, then that would be helpful to hear about as well. But no drug options are my preference.

posted by anonymous to Health & Fitness (17 answers total) 20 users marked this as a favorite
I do not have PCOS, but I did a program (about other issues) with Laughing Sage Wellness a few years back. Finding drug-free solutions for PCOS is one of their specialties and they work with women all over the world via phone and skype (or in person in NYC). They offer some free resources, articles, teleclasses, and a free initial consultation as well as paid programs where they work with women one on one. I have recommended them here before. Feel free to memail me if you want more info on my experience.
posted by pupstocks at 9:48 AM on August 28, 2011 [1 favorite]

Here is a link to a testimonial by a woman who treated her PCOS with the Paleo Diet. Might be worth taking a look at the rest of the site, too.
posted by lizifer at 10:31 AM on August 28, 2011

+1 to the Paleo Diet or something similar. I saw a huge improvement in all of my PCOS-like symptoms after completing a Whole30. Seriously, just do it. It's only 30 days and you might see a big change. I tried it for the first time about a year and a half ago and have continued to eat that way probably 90% of the time.
posted by telegraph at 10:33 AM on August 28, 2011

Any diet where you avoid sugar and processed carbs will probably help. Metformin is the standard treatment for PCOS because it reduces insulin resistance. Exercise also reduces insulin resistance, though you only mention dietary changes.
posted by annsunny at 11:02 AM on August 28, 2011 [1 favorite]

Dr. Mirkin suggests not eating simple carbs.
posted by oceano at 11:30 AM on August 28, 2011

I had decentish results a decade ago with the low-carb / vegan diet recommended by a PCOS book I'd read (hard combo to stick to, though!). I didn't lose any weight pounds-wise, but my body fat reproportioned so that I was several sizes smaller, and I got pregnant when I was told that wouldn't be possible. My skin did clear up a bit (that might have been the vegan diet part, though), but I was still quite wolfy.

I realize you're wanting to do this drug-free, but I had to hop on to tell you that there are better drugs for PCOS than the ones you're being offered.

I was on Metformin for a while. It worked -- I lost 60 pounds -- but it's infamous for making people sick. I had a diabetic friend who was on a higher dose than me who never went anywhere without a trash bag and an extra pair of pants... the diarrhea can be that bad. I was sick to my stomach the whole time I was on it, regardless of what formulation I was on.

My new gyno is a PCOS specialist, and he said there was a better alternative now: Victoza. It does the same basic thing as Metformin, but it does it more effectively and without the side effects.

My doctor's "PCOS Program" is Victoza + a low-dose birth control pill + Spironolactone, a diuretic that lowers testosterone levels (to fix the hair etc.)

What I have heard is that if you want to get pregnant with PCOS, the thing to do is stay on the pill until the last minute... let it induce a normal cycle and then stop taking it so you can get pregnant. There's even some term for doing this that I don't recall.

Also -- if you're like me, simply being pregnant will help your PCOS. I was definitely NOT trying to lose weight then, and I weighed less when I went into labor than I did before I was pregnant.
posted by Gianna at 11:46 AM on August 28, 2011 [4 favorites]

Moderate low-carb worked for me, that means, I eat carbs in the form of fruit and vegetables and dairy, but no sugar, grains or potatoes.

The easiest approach is probably not to follow a specific program (Atkins, Paleo, whatever) but to get a glucose meter and try to keep your numbers down, find the right carb level for your body. Some people can eat whole grains, pulses and sweet potatoes without messing up their blood sugar (I can't). Cutting out processed stuff is a good first step, not because processed=poisonous, but because processed=usually full of cheap carbs. Good luck!
posted by The Toad at 12:21 PM on August 28, 2011

My wife has PCOS. She tried a lot of different things to get pregnant but avoided metformin as the side effects sounded unpleasant.

What ended up working to get her pregnanet the first time was an extreme low-carb diet (the induction phase of Atkins if I remember correctly) and a fair amount of exercise (running). Once she got pregnant she immediately dropped the low-carb diet, of course.

The second time she got pregnant via a moderately low carb diet and more running.

Now that we're done trying to get pregnant, she keeps an eye on her carb intake. She also takes vitamin D which helps regulate her moods.

Your mileage may vary, but hope this helps! Please feel free to mail me if I can answer any questions.
posted by DrumsIntheDeep at 1:02 PM on August 28, 2011

I do not have PCOS, but I do have insulin resistance issues. Whether an induction style low carb eating plan is best totally depends on you. I tried induction several times, and couldn't stick with it. What has worked for me is more like what The Toad suggests.

Also, some data points: I take metformin and after two days of taking it literally in the middle of my meal, all of the gastrointestinal side effects were gone. It has helped my blood sugar levels tremendously. I know someone who takes spironolactone, mentioned above, and has to monitor their potassium intake closely as a result. Quite possible with a low carb diet, but there can be some crossover inconveniences like nuts, spinach, tuna, etc.
posted by gnomeloaf at 2:42 PM on August 28, 2011

I drastically cut nightshades, corn, and anything with BPA out of my diet in the year prior to becoming pregnant.

Not sure if that's what did it, but I'd been off BC for a few years (due to side effects rather than a specific desire to test the infertility claim) and had only tried Metformin for 6mos about 3yrs before conceiving.
posted by batmonkey at 2:45 PM on August 28, 2011

If you have serious excess hair issues, you're going to want electrolysis instead of laser. Every laser practitioner you go to will tell you it's permanent, and it really isn't. Hair that is especially hormonal-related -- facial and pubic hair, but also all-over body hair if you've got a TON of it -- is going to take a long time to get rid of even with electrolysis. Laser will only make coarse hair of this type thinner and less noticeable overall, but if you have a lot of hair it will still be pretty noticeable.

If you can do electrolysis, do it. It's not as fast an appointment and it's more expensive on the whole, but it lasts. In SoCal you can find it for $100/hr, maybe lower, for example; I think other parts of the US are probably higher. You may have to keep up regular appointments for years (an hour or more every two weeks or so depending on what you're getting done) though, depending on the severity of your problem.
posted by Nattie at 4:22 PM on August 28, 2011

I highly recommend vitex agnus castus, or chaste tree berry extract. I don't have PCOS, but it has been invaluable in regulating my cycle and relieving my PMS.
posted by Specklet at 5:16 PM on August 28, 2011

Losing weight, will help.
Anything that increases your insulin resistance, will help. (Exercise, cutting out sugar/carbs, only eating sweet things after dinner - no really, your insulin levels spike less).
There's often crossover with Hypothyroid, get it checked - for that get enough iodine, not too much, cut out cabbages/brassicas (got something in them that is bad for thyroid), and all the insulin things.
Seems to be a higher crossover with Gluten Intolerance as well, although part of that could be the whole carb thing.

I've also heard that even losing 5 pounds can be enough for your body to flip out of PCOS mode (more fat = more... estrogen I think it was?).

Meanwhile, as you are getting older, you're more likely to 'grow out' of PCOS anyway. In fact, you might even have a higher fertility rate in your 30s & 40s than if you didn't have PCOS!

posted by Elysum at 12:18 AM on August 29, 2011

Went through treatments for infertility due to PCOS to have my twins. 6 years later, when my periods had gone stretched from 90-120 day to over a year, and I decided to check with my doc. She put me on the lowest dose of metformin and I literally had a period 15 days later, and have averaged 32 days since then. Haven't noticed any side effects.

I hadn't heard Elysum's possibility of growing out of PCOS . . . interesting!
posted by MeiraV at 5:55 AM on August 29, 2011

Hey Anonymous, I'm another gal that's fixed PCOS with a natural diet, that is, a diet consisting of mostly meat, fish, eggs, lots of leafy greens and low carb veggies and fruit. If you must have grains, make it white rice or rish oats, and don't do it often.
It's not difficult to do this. I do have heavy cream with my coffee, but not sugar. The days before my period, I crave carby things, so instead of candy or cakes, I have sweet potatoes with butter, bananas, or something of the sort. Amazingly, I have no pain anymore, lost weight, and my cycle is loads better. I ovulate on full-moon, and my period starts at new-moon. It took me a few cycles o realize that, hehe!
Since you and I are very insulin ressistant, it's important to be careful with carbs, wether they come from grains, fruits, or vegetables. Protein also raises blood sugar, but we need the protein and fat from meat, so we need to prioritize it over carbs. Anywaaay, google Paleo 101, and Mark's Daily Apple. I'm on my android phone so I can't copy paste the links.

My health is good now, and I'll be tryng for a child this October as I want an August child.
If you look at my previous posts, you'll see I asked about exercises to lose weight. But I ended up not needing it!
Best of luck to you, and if you need help, come over to Mark's, we have a forum and everyone is very supportive.
posted by midnightmoonlight at 2:32 PM on September 3, 2011

Umm, that's Irish oats, not rish oats. Sorry, touchscreen phone!
posted by midnightmoonlight at 2:35 PM on September 3, 2011

Oh I should mention! It only started eating like this around early May this year. Sorry if I sound so excited about this; I am!
posted by midnightmoonlight at 2:40 PM on September 3, 2011

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