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Ask the Doctor
About Polycystic Ovarian Syndrome (PCOS)
By Tom Cowan, MD
Question: I am a 30 year old female with a history
of facial hair, acne, slight male pattern baldness (bitemporal), moderate
weight problem, menstrual cramps and low libido. I have recently discovered
how hormones influence these problems, and I am wondering what to do
to get my hormones back in balance? I was a vegetarian for 10 years,
but I've recently switched to a traditional diet over the last few months.
I've lost weight and feel great, but I've still got the facial hair
and slight acne. How long does it take to get everything back to normal?
Thank you very much for any help you can provide!
Answer: Congratulations on the changes in your diet
and lifestyle! Hopefully, you are well on your way to regaining your
health. It sounds as though your problem is Polycystic Ovarian Syndrome
(PCOS), and that you have many of the common symptoms of this condition.
This usual syndrome of PCOS consists of a young female who is often
overweight (though not always), and has signs of excessive androgens
(testosterone). These signs include male pattern baldness, facial hair,
acne, abnormal menses (either irregular and painful or irregular bleeding
patterns), changes in libido, and sometimes abdominal distress or bloating.
Laporo-scopic examination of the ovaries usually reveals ovaries that
are too large and full of cysts, hence the name of this condition. The
source of the excessive testosterone is not clear. It is thought that
the damage to the ovaries from the cysts results in their abnormal secretion
of hormones, and therefore the myriad symptoms of hormonal imbalance
that are seen.
The conventional treatment for PCOS is either to do a wedge biopsy
of the ovaries, which simply means cutting a wedge out of one or both
ovaries. For some mysterious reason this procedure often results in
an at least partial resolution of the symptoms and a return to normal
hormonal balance. Again, it is not understood at all why this surgical
procedure would affect future function. If this is unsuccessful, then
usually the woman is placed on some variation of birth control pills
and her hormonal balance is controlled in this manner.
As I have often related in this column, "normalizing" hormones by simply
giving the person synthetic hormone pills violates the basic principle
of healing. Instead, whenever possible, the doctor or healer should
strive to teach the patient a way to normalize the hormones on their
own. In your case, by changing your diet you have started on this road
to healing. The reason why changing to a diet based on the principles
of Nourishing Traditions is the first step in the therapy of PCOS is
that your ovaries need the animal fats, and yes, even the cholesterol
found in food in order to make estrogen and progesterone, the correct
female hormones. Swollen ovaries is a condition analogous to goiter,
when the thyroid swells in response to iodine deficiency. Goiters often
also result in a hormonal imbalance leading to hypothyroidism. In the
case of PCOS, the starvation of the ovaries causes them to become cystic,
swollen and eventually unable to regulate the synthesis of their hormones.
The other main dietary trigger for this imbalance is that when the
proper dietary fats are missing, they are inevitably replaced by excessive
carbohydrate consumption. This results in excessive insulin production,
weight gain, abdominal bloating, and eventually will itself cause hormonal
shifts. The biochemistry of this process is well described in the book
The Schwarzbein Principle which also suggests a diet based on the principles
in Nourishing Traditions, along with a restriction to about 75 grams
of carbohydrates per day. More good fats and fewer carbohydrate foods
should help in restoring your hormones to their proper balance.
In addition to the dietary program I have outlined, there are many
natural medicines which I have seen, and which have been shown in the
medical literature to help PCOS. The first is the protomorphogen extract
from Standard Process called Symplex F. This medicine is a mixture of
specially processed glandular extracts from the four organs that make
up the so-called pituitary axis--the pituitary, thyroid, adrenal
glands and the ovaries. It was the insight of Dr. Royal Lee to suggest
that it is far more productive to work on the entire system rather than
trying to normalize one gland. For we now know that these glands compensate
for each other, and that they all get ill as a group. I usually give
a dose of 1-2 tablets per day for one whole year to help normalize the
function of these important organs.
The final therapy that I use for PCOS is a 50/50 mixture of the herbal
extracts of Peony lactiflora and Glycyrrhiza uralensis (commonly known
as licorice). There have been three studies in the literature showing
that this combination of herbs can result in a complete remission in
PCOS, and that it does so by normalizing adrenal function and reducing
testosterone levels. It is important to use the correct dosages, which
were also indicated in these studies.* I use the Mediherb extracts and
give them at a dose of 1/2 to 1 teaspoon of the mixture, 2-3 times per
day. I usually use this mixture for six months with breaks of a week
or two every 4-6 weeks.
It is instructive to see our plant medicines not only as plant "drugs,"
but also as metaphors for the condition we are trying to treat. If what
has been said about the dietary causes of PCOS are correct, then one
could say that PCOS and many other hormonal diseases, as well as disease
of the adrenal gland, could rightly be called the "sweet" diseases.
That is, they are all ultimately linked to excessive consumption of
carbohydrates, especially the refined carbohydrates that have become
the staple foods of the Western diet. This, as I have shown, results
in excess insulin production, weight gain, stress on the ovary and eventual
hormonal imbalances.
What we need as therapy for this constellation is sweetness--but
without the sugar--sweetness that is more like true love or compassion
than the superficial sweetness of eating a sugary dessert. If we combine
this with a tonic for the adrenal gland we would have our true medicine
for PCOS. Licorice is just such a medicine. It is virtually the sweetest
substance known to humankind, but it has the sweet effect without providing
any sugar--it is a carbohydrate-free sweetener. In addition, it
contains chemicals called saponins which the adrenal gland can easily
turn into the cortisone-like chemicals that do so much to regulate our
physiology.
Licorice is the exact picture or metaphor in nature for what we need
to do to heal this illness: substitute sugar for a kind of sweetness
that is healing, not destructive. I would suggest that this is why in
many traditional systems of medicine, such as Chinese medicine, licorice
was called the "universal healer," or the "medicine that brings about
harmony." It is the medicine of deep sweetness and compassion, not the
superficial sweetness of a high-sugar diet.
*Yaginuma T, Izumi R, Yaui H et al. Nippon Sanka Fujinka Gakkai
Zasshi 1982;34 (7): 939-944. Takahashi K, Kitao M. Int J Fertil
Menopausal Stud 1994; 39 (2): 69-76. Basso A, Dalla Paola L, Erle
G et al. Diabetes Care 1994; 17 (11): 1356
About the Author
 Thomas
Cowan, MD, is a physician in private practice in San Francisco, California,
a board member of the Weston A. Price Foundation, and a regular contributor
to our "Ask the Doctor" column. His book The Fourfold Path to
Healing is now available from NewTrends Publishing, http://www.newtrendspublishing.com/.
Visit Dr. Cowan's website at http://www.fourfoldhealing.com.
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