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).

 

 

This month’s case study is 33 year old ‘Katy’ who came to the clinic with painful breasts

Every month during the week before my period, my breasts would become swollen and very lumpy. This had started during my late twenties. They were extremely tender to touch and even rolling over in bed would be uncomfortable. I had become quite concerned about the lumps and went to see a doctor for an ultrasound scan who reassured me they were benign (non cancerous) but suggested that I could have them drained if they continued to be troublesome. I felt scared by this because I didn’t like the thought of having to go to hospital. The other option my doctor offered was to take the Pill to ‘balance’ my hormones but I was reluctant because of potential side effects.

 

One of my friends who was training to become a nutritional therapist told me that changing my diet and taking supplements could help with breast tenderness. She recommended that I check out The Dr Marilyn Glenville Website. I did this straight away and downloaded an e-book on ‘Understanding Breast Problems’. This was so useful and by the time I read it I had a better understanding of why some women suffer with lumpy, painful breasts. It felt very reassuring that other women suffered and I was not alone. After I had read the ‘e-book’ I decided to phone the Dr Marilyn Glenville Clinic because I felt that I would benefit more from having a one to one consultation with a nutritionist. I knew this would motivate me more to change my diet and it would be more supportive for me.

 

I spoke to a helpful receptionist who, before booking my first appointment suggested I speak to one of the nutritionists to see if there was anything I needed to do before coming to the clinic. When I had a chat with the nutritionist she suggested that I perform a ‘Female Hormone Profile’, which was an assessment using saliva, of my hormones throughout my menstrual cycle. The great thing about this was that I could do it from home! She explained that this would tell me if I had any hormone imbalance as this can cause lumpy breasts. The test took me a month to complete, because it covered the whole cycle, which I didn’t mind because at least it would give the nutritionist more information about me at the first consultation. A nutritional questionnaire was also posted to me, which I had to complete before my consultation and the kit for the ‘Female Hormone Profile’ arrived a couple of days later.

 

I met with the nutritionist about 6 weeks later (to ensure that my results were back in time) and she went through my questionnaire and my test results. Interestingly the results indicated that I had excess levels of progesterone, which is the hormone that is high during pregnancy, and this is a time when women can also experience tender, lumpy breasts. It was great to see that there was something out of balance and to see it right in front of me. The nutritionist explained that we could use a combination of dietary modification, nutritional supplements and herbs to address the imbalance. With hormone excess and trying to control this, she explained that it was essential to also support the digestive system and liver to ensure good detoxification and excretion of the hormones out of the body.

 

My diet on the whole was OK, as I try to cook from scratch and was conscious of eating my fresh fruit and vegetables. However, I knew I drank too much tea – 6-8 cups a day!! On one hand it was to get me through the day to keep my energy up, but also I really enjoyed it! The nutritionist explained that tea not only contains caffeine and tannin, which can inhibit mineral absorption, but it contains compounds called methylxanthines. Methylxanthines are substances that are found in black tea, green tea, chocolate and even decaffeinated tea which can increase breast discomfort. She said that not all women are sensitive to these compounds but if they are they really need to be avoided altogether and not just in the week leading up to the period! She recommended an herbal tea substitute called Redbush or Rooibos which is naturally caffeine free and contains very little tannin and no methylxanthines.

 

She also said that I needed to increase my intake of fibre from wholegrains and flaxseed because this would help my body to get rid of the excess of hormones. My bowels were sluggish and she explained that this was not healthy because if you are not opening the bowels on a daily basis, hormones can get reabsorbed back into the body and that can create more imbalance.

 

The nutritionist also talked about foods that can cause inflammation because lumpy breasts can be a sign of inflammation. The saturated fats from meat, chocolate and dairy products are pro-inflammatory (cause inflammation) and the fats from oily fish, nuts, seeds and avocados are anti-inflammatory.  I rarely ate oily fish because of the smell cooking it – and I supposed I did eat too much cheese!! She suggested that I use tin sardines and salmon if I wasn’t keen on cooking them as they were just as nutritious and a lot more convenient! She gave me a menu planner for additional meal suggestions which was really helpful.

 

After we went through my diet in depth the nutritionist talked about nutritional supplements and herbs that can be a useful addition. She recommended I take a good general multi-vitamin and mineral, a vitamin B complex to help my liver detoxify the excess hormones, and fish oil. The fish oil was a potent omega 3 supplement to really help calm the inflammation. Finally she recommended some herbs to help rebalance my progesterone.

 

By the end of my first consultation I was raring to go and put the recommendations into place! The nutritionist ordered my supplements for me and they were posted out to me (and arrived the next day) which saved me the hassle of trying to find them!!  I went food shopping and stocked up on Rooibos tea, nuts and seeds and tinned fish!

 

It was recommended that I book my follow up consultation for 8 weeks so I could have 2 periods to see if there was an improvement as she explained it can take this length of time or sometimes longer to balance our hormones. The nutritionist gave me a detailed diet diary to fill in over the next 8 weeks. This was to help me keep on track of what I was eating but also to help monitor my symptoms.

 

It was quite extraordinary – my period came without me realising!! In just a month of cutting the tea out and generally improving my diet, my breasts were not lumpy or tender! It was amazing and in such a short space of time. I was prepared for it taking longer as the nutritionist had explained, so it was brilliant to see improvement this early on.

 

I had my follow up consultation and again I had been symptom free in my last period! The nutritionist was so pleased with me and really encouraging and suggested that I continue with everything for at least another 8 weeks and then review again. She explained that although some of the supplements and herbs were only for the short to medium term, the diet is more of a life change. 

 

I am so pleased that I finally contacted the Dr Marilyn Glenville clinic although in hindsight I should have done this 5 years ago! I’m telling all my friends and colleagues now about nutrition and just how powerful it has been for me. I will never go back to drinking tea and I’m much more aware of what I’m putting in my body.

 

Marilyn’s Comment

 

This is a wonderful case where Katy benefited in a short space of time from changing her diet. Sometimes it can take longer to address underlying hormone imbalances but there is often no black and white answer in regards to how long it will take. The main thing is to keep focused and be supported by a nutritionist and understand that sometimes it can take longer, but it is better to address the underlying cause rather than taking something like the Pill which only masks what is actually going on.

 

If you would like to find out more about our clinics and the test mentioned, then please 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.)