Q: My daughter is about to get married and is keen to start a family. Since the age of 17, she has suffered from Polycystic Ovaries, showing symptoms such as facial hair, hair loss and a weight problem. She has also been warned that conception may be more complicated for her. She used to have infrequent periods but now has them regularly every 5 to 6 weeks. The normal help for her condition, such as the contraceptive pill or metformin, she cannot be prescribed as the first gave her occasional blackouts and the second nausea. She keeps her weight under control by sensible eating but even so is probably a little more than she should be for her height. Is there any advice you would give her to increase her chances of conceiving?

A: In each menstrual cycle, follicles (which contain eggs) grow on the ovaries. One of these follicles will reach maturity faster than the others and be released at ovulation. The remaining follicles will degenerate. In the case of polycystic ovary syndrome (PCOS), the ovaries are much larger than normal, and there are a series of undeveloped follicles that appear in clumps, like a bunch of grapes. This can cause a hormonal imbalance, leading to a series of symptoms including being overweight, having no – or very few – periods, being prone to acne and excess body hair. And with this can come problems with fertility and recurrent miscarriages.

Over the last few years, research into the nutritional approach to PCOS has revolutionised the treatment of this problem. It is known that women with PCOS are more likely to have problems balancing blood sugar and can produce high levels of insulin. The more circulating insulin, the more the ovaries produce testosterone.

 

So the aim is to balance the blood sugar by eating little and often and going for foods that do not cause the blood sugar to rise quickly. There is not enough space to go into this in detail here but the best recommendation is to either read the PCOS chapter in my Nutritional Health Handbook for Women or, as your daughter’s main focus is to get pregnant, then read my book ‘Getting Pregnant Faster’. 

 

As her blood sugar stabilises your daughter will lose weight and it has been found that as women with PCOS lose weight, hormone levels start to return to normal. One study found that 11 out of 12 women who had been overweight and not ovulating conceived naturally after reducing their weight.

 

Certain vitamins and minerals can also be useful to make the dietary recommendations more effective. For fertility it is best to add in the Fertility Plus for Women and the Fertility Plus for Men (see the Resources Page).

 

 

The common name of this pretty herb is Chaste Tree, harking back to the Crusaders’ belief that it would crush their wives’ libidos whilst they were off crusading. Whether it actually achieved this effect is doubtful as it is now recognised as boosting female fertility and easing menstrual symptoms.

Agnus castus, the ‘Chaste Tree’ is actually not a tree at all but a shrub with violet flowers and fruit, containing volatile oils that create a peppermint-like scent. In modern times, Agnus castus has increasingly become recognised for its beneficial effect on female hormones, boosting the levels of luteinising hormone and therefore the production of progesterone. It may not seem important to have enough progesterone – oestrogen is the hormone most people are aware of and many women worry that lower oestrogen levels experienced in the menopause will bring them uncomfortable symptoms. It is, however, high oestrogen levels in the menstruating woman that we associate with symptoms such as Premenstrual Syndrome (PMS), breast tenderness, fluid retention, heavy, painful periods and many other miseries that women think are an inevitable part of their lot. Increasing progesterone levels can alleviate many of these symptoms, and there is research to prove this!

 

A trial published in the British Medical Journal in 2001 showed agnus castus to have a beneficial effect on PMS symptoms, ranging from anger and irritability to bloating and breast fullness. The herb was well tolerated and did not cause unwanted side effects. Another trial published in 2000, showed 42% of the 1,634 women involved reporting that they no longer suffered from PMS! Overall, 93% of the women on the trial reported that their PMS symptoms either disappeared or decreased. Interestingly, 23 of the women on the trial fell pregnant whilst taking Agnus castus, and 19 of them had previously had fertility problems. Seemingly, not only does agnus castus increase progesterone but it inhibits prolactin, high levels of which have been connected to infertility as this hormone stops ovulation. (See the Resources Page for a good herbal combination containing agnus castus called Agnus Castus Plus.)

 

Other uses of this interesting shrub are for teenage acne, for both boys and girls, and for the symptoms of PCOS or polycystic ovary syndrome, a common hormone imbalance which can cause irregular periods, acne and facial hair. In fact it may be one of the most powerful herbs for PCOS because it works as an adaptogen, helping to balance hormones – lowering them when they are raised and decreasing them when they are low – which in turn can ease symptoms of PCOS.

 

And last, but by no means least, the hormone balancing properties of Agnus castus may also prove useful for easing symptoms of the menopause, such as hot flushes.

(Do not take agnus castus if you are any medication that has an effect on the female hormones e.g. the Pill or HRT.)

This month’s case study is 30 year old ‘Julie’ – who came to the Clinic because of Polycystic Ovary Syndrome (PCOS).

During my early twenties while I was at university my periods became quite erratic. I would often go 3 months without a period. All the time I was at university I put this down to stress as I had heard this can interfere with our menstrual cycles. It was actually quite nice not having too many periods! When I reached 30 I suddenly started being more aware of my periods and what was happening to my body. I noticed that I was also developing more hair around my chin and inner thighs. I had developed some acne on my back which was very unusual as I had always had such clear skin. I was putting on weight rapidly, particularly around my middle,  which was also distressing. I decided to go to my GP who said that I had a condition called Polycystic Ovary Syndrome (PCOS). I asked what this meant and all he said was it was a condition of hormone imbalance and it is linked high testosterone. He recommended I go on the Pill which he said would regulate my periods. I explained that I was not keen to take the Pill and would rather have more investigations. He was reluctant to recommend anything else apart from the Pill so I decided to do my own research.

 

I searched on the Internet for PCOS and came across The Dr Marilyn Glenville Clinic. I downloaded an e-book, which was very informative because it explained what PCOS was, something that my GP had never done and it gave me advice about the conventional (medical) approach and nutritional approach. This information gave me so much hope and encouragement and I was very excited. I decided to book an appointment with one of the nutritionists at the clinic because I knew I would need the motivation and support of a qualified practitioner.

 

I phoned to book my first appointment and the reception booked me and sent me a comprehensive questionnaire to complete before my first consultation. She recommended that I check my mineral levels and this could be done via a simple hair sample. I decided to go ahead with this because I thought that the more information the nutritionist would have the better able to advise. I filled in the questionnaire which was very interesting because it really made me think about my health and my diet! I must admit I was quite shocked when I saw my diet in black and white because it was very low in fresh food and far too much coffee and sugar! I found that I was constantly craving these foods so I would just give in.

 

My first appointment with the nutritionist was great – really motivating and I felt that I was being listened to finally! She explained that no definite cause has been established with PCOS but it has been suggested that the problem stems from the ovaries, which are unable to produce the hormones in the correct proportions. This in turn gives the message to the pituitary gland that the ovaries are not working properly and this gland then releases high levels of a hormone called Luteinising Hormone (LH) which results in an irregular cycle and low progesterone. Another reason is that some women just simply can’t deal effectively with the level of hormones which then gives rise to higher oestrogen and testosterone. Blood sugar imbalance has also been linked with PCOS which gives rise to the weight gain and high testosterone. The more insulin that is circulating will encourage the ovaries to produce even more testosterone and so the cycle continues. The nutritionist explained that the conventional approach is to recommend the contraceptive pill and/ or a drug called metformin which is given to Type II diabetics to control their blood sugar. She explained that treatments like the Pill are only going to mask the underlying hormone imbalance and yes it would bring a regular but artificial cycle back for me, but usually reverts back once it is stopped. Metformin comes with digestive disturbance like nausea and diarrhoea, plus there is no scientific evidence to suggest that it does actually help with PCOS! I knew now more than ever that I wanted to support myself naturally.

 

The nutritionist pointed out that my diet was too high in starchy carbohydrates, i.e. white bread and white rice and lots of sugar and caffeine. I explained that I felt I needed these because I was craving them but she said this in fact is very common when blood sugar levels are unstable. The more insulin being produced in response to an high starch/sugar and caffeine diet the more likely the body will develop ‘insulin resistance’ whereby our cells cannot utilise the sugar and it then gets converted and stored as fat. This is when the weight creeps up around the middle area. The higher insulin then leads to higher circulating testosterone. She suggested that I ate less starchy carbohydrates, avoiding altogether after 6pm and eating plenty of fresh vegetables and protein (fish, eggs, beans, quinoa and nuts and seeds). She gave me a menu planner to give me some suggestions, which was very helpful. The nutritionist asked me to reduce my coffee intake to 1 cup per day and to always have it alongside a meal so not on an empty stomach. She told me to slowly reduce it so I would not get a headache! She also said that I had to eat every three hours to keep my blood sugar stable as any longer would result in fluctuations which are not conducive to hormonal balance.

 

The nutritionist went through my hair mineral analysis results and it showed I was low in zinc and chromium. She explained that chromium is an important mineral for regulating our blood sugar and therefore reducing cravings for sugar and caffeine. She recommended I take a supplement of chromium (which would work in a similar way to metformin) to help address this deficiency. Zinc is key to the health of the reproductive system and plays a role in the regulation of blood sugar level. It is also needed to produce adequate levels of sex hormones.

 

She talked about herbs and how they can be very supportive for addressing the underlying hormone imbalance, having a ‘nurturing’ effect on the pituitary gland and ovaries. She prescribed me a formula containing black cohosh, agnus castus and milk thistle which would help to lower LH levels, support the liver and hopefully regulate my cycle. Alongside this, she recommended a good multi vitamin and mineral, a fish oil supplement and the chromium and zinc I was deficient in from the Hair Mineral Analysis.

 

I followed the diet for 8 weeks and in that time started to feel the day-to-day benefits. I had more energy, my skin seemed to be clearing and I had had a period! I couldn’t believe it as I hadn’t had a period for 3 months! I was so excited and at that point I went back for my follow up consultation. The nutritionist was extremely pleased with my progress and recommended that I continue the programme for another 8 weeks and then re-assess. She explained that the herbs would be a medium term support and after we had managed to reinstate a cycle, we could slowly take them away until the herbs could be stopped altogether.

 

After 16 weeks, my cycle had started to regulate and I had lost a significant amount of weight. I was delighted! I had lots of lovely comments from friends and family and this really encouraged me to continue with all my hard work. I am now a year on since visiting the Dr Marilyn Glenville Clinic and blood tests have shown that my hormones are getting back into balance and I have a 32-day cycle. I still have some excess hair but much lighter in colour so this is a positive sign.

 

All I can say is ‘thank you’ to The Dr Marilyn Glenville Clinic for supporting me and helping me get my hormones and life back on track. It is so frustrating when doctors only every recommend drugs when I know for myself that nutrition can really help.

 

My Comments

 

Julie’s story just shows how effective changing your diet and using highest quality supplements and herbs can help to balance female hormones. As we know from her story, doctors are quick to recommend the Pill but it simply suppresses the root cause of the condition and once the Pill is taken away, more often than not the hormone imbalance returns, often more severe.

 

Julie has made some excellent progress with her diet and she went from living on caffeine and sugar to now limiting these and eating an abundance of fresh fruit and vegetables and protein. This has really helped her to get where she is today. Although the supplements and the herbs have been very beneficial, it is the combination of everything that really works rather than just one aspect.  

 

If you are interested in having the test mentioned here please see the resources page.