Up until this point, you’ve had an irregular menstrual cycle, you continue to experience acne and excessive hair growth, and struggle with losing weight despite maintaining a healthy diet and movement routine. 

You were put on the birth control pill as a young adult to help “regulate” your hormones and things got a lot better. 

Now you’re well into adulthood and thinking of your family planning future. Coming off of birth control, your symptoms came back with avengence. 

Your acne, hair growth, blood sugar dysregulation and irregular cycles are back stronger than ever. 

This is a story we see far too often, and these patients with PCOS are often underserved and not given the care they deserve. PCOS is way beyond a hormonal diagnosis, it is more well defined as a metabolic syndrome due to the development of insulin resistance and how that impacts hormonal health.

Fortunately, the amount that we can serve and help these patients is endless. Despite running through the conventional medical realm, we have the potential to provide these patients with a roadmap to PCOS resiliency. 

Establishing clear and realistic goals is imperative to patient success, emphasizing that PCOS is not a disease we cure, but a disease that we manage.

It is estimated that as many as 1.4 million Canadian women may be afflicted with polycystic ovary syndrome (PCOS). Although PCOS is one of the most common endocrine disorders occurring in women, its diagnosis, management, and associated long-term health risks remain undervalued.

There has been much controversy surrounding the diagnosis of PCOS, as its trademark symptoms are anovulation and androgen excess symptoms which can be very subjective and poorly defined. Currently, the following criteria is necessary for a diagnosis according to the Rotterdam criteria: 

Patient demonstrates two of three criteria:

1. Oligo-menorrhea or anovulation (irregular cycles being 8 or less per year, or longer cycles over 35 days with no signs of ovulation)
2. Clinical and/or biochemical signs of hyperandrogenism (signs of androgen excess, such as acne and hair growth)
3. Polycystic ovaries on ultrasound

It is extremely important that we properly screen, assess, and treat PCOS. People with PCOS are more at risk for long term health outcomes, including but not limited to: 

• Obesity 
• Sleep apnea 
• Cardiovascular disease 
• Hypertension 
• Type 2 diabetes 
• Dyslipiedemia 
• Non-alcoholic fatty liver disease
• Infertiltiy and miscarriage

Despite the diagnostic criteria, a huge success limiting step is addressing the underlying cause of the hormonal disruption in people with PCOS – insulin resistance. This is the key that puts people at risk for long term health outcomes, and is often overlooked.

The way I explain insulin resistance, is how loud does your body have to yell to give your cells energy? I explain to patients that insulin “talks” to the cell to let glucose in for energy production. The more the cell doesn’t listen, the louder the insulin has to shout at the cell. So your blood sugar may be “fine”, but you still had to yell. Insulin in your blood makes you tired and have low energy. This causes downstream cardiometabolic and hormonal disruptions. It is so important to highlight that weight gain and obesity is not the patient’s fault…their metabolic state predisposes them to more weight, low energy, and hormonal dysfunction.

With our PCOS patients, here are the goals we collectively strive for: 

1. Regulating menstruation and restoring ovulation 
2. Reducing hyperandrogenic symptoms (weight gain, acne, hair growth and alopecia)
3. Preventing long term diseases and disorders

These goals tie perfectly into the 3 simple steps to resiliency with PCOS, including: 

1. Blood sugar regulation 
2. Hormone optimization (for fertility and beyond) 
3. Stress management & long term disease prevention

The obstacle to cure for most patients is the spread of conflicting and misinformation about how to manage their diet, movement and lifestyle. There are so many ways naturopathic medicine can help a PCOS patient. Here’s a little insight into what the journey looks like: 

1. Intake: A sufficient and comprehensive intake to understand the patient’s individual picture. This involves deep questions about the patient’s history and menstrual cycle. 85% of people with PCOS have menstrual cycle irregularities. Patients are also unaware of how to track ovulation or what to look for. We also dive into symptoms such as acne, hair growth, hair loss, fertility/pregnancy history, family history, and medication use.
2. Lab work: sufficient serum levels can help us to identify and target deeper markers of disease progression. This can involve female hormone testing, androgen testing (although clinical signs are enough to meet the criteria), vitamin D, metabolic markers, markers of inflammation, and fasting blood sugar and insulin. 
3. Foundational work: this would involve optimizing on diet and movement principles for PCOS (a lot of myth busting happens here) as well as correcting any inadequate nutrient levels. Additionally, stress and sleep management is huge as PCOS patients are more susceptible to adrenal dysfunction and inadequate sleep.
4. Comprehensive treatment plan: this potentially involves more deeper work into the foundations, as well as evidence based nutraceuticals depending on the patient goals.  

You don’t need to feel confined by your PCOS diagnosis, or believe that there is nothing you can do. These 3 steps to success can set you up for sustainability and longevity. 

My goal is to make you feel educated and empowered about your diagnosis. 

Find out how we can work together by booking a call with me here.

I look forward to working with you!

You can follow Annaleeza on Instagram @annaleeza.wellness for all things women’s health & hormones!

I have always believed that everyone deserves to feel extraordinary. Since completing my undergraduate degree at the University of Toronto, I have always known I was meant to help people feel their best. Now being a naturopathic medical graduate from the Canadian College of Naturopathic Medicine, I am so honoured to be joining the Integrative Health Institute team. I have deep roots in this community, and my mission is to continue serving its people.

My passions are anything women’s health, from hormones, to fertility, to menstrual issues, to digestive concerns. I am so excited to be apart of this community of practitioners who strive to make people feel their best everyday. My promise to you will always be to make you feel safe, comfortable, and empowered. I look forward to working with you.