PCOS and Chronic Inflammation - What You Need to Know
Inflammation is a complex process where the immune system becomes activated in response to harmful stimuli. Acute inflammation is a necessary and protective response (think of the inflammation that occurs during a viral infection to help fight the virus), but chronic inflammation can wreak havoc on the body. When chronic inflammation develops, it can lead to tissue damage and systemic dysfunction. Chronic low-grade inflammation plays a central role in many cases of PCOS and can be one of the driving factors in issues like insulin resistance, ovarian dysfunction and metabolic disturbances - many of the hallmark features of PCOS. In this article, we'll delve into the intricate relationship between inflammation and PCOS, exploring how naturopathic approaches offer insights and solutions for managing this complex condition.
There are several factors that contribute to inflammation in PCOS:
Insulin Resistance
Insulin resistance, a core feature of around 70%+ cases of PCOS, occurs when cells become less responsive to insulin, leading to high blood sugar levels and feelings of fatigue. Chronic high insulin and blood glucose levels trigger inflammation in the body, leading to oxidative stress and further tissue damage.
2. Hormonal Imbalances
Dysregulation of sex hormones such as in PCOS (e.g. high androgens and disrupted oestrogen-progesterone balance) can fuel inflammation in PCOS. Androgens stimulate the production of pro-inflammatory cytokines and activate inflammation in various tissues of the body, contributing to insulin resistance and ovarian dysfunction.
3. Oxidative Stress
Oxidative stress occurs when there an imbalance between the production of reactive oxygen species (ROS) and the body’s antioxidant defences. People with PCOS frequently have markers of high oxidative stress due to chronic inflammation, mitochrondrial dysfunction and impaired antioxidant capacity.
4. Gut Dysbiosis
Emerging evidence suggests that there might actually be a link between gut dysbiosis (imbalance in the gut microbiota) and inflammation in PCOS. Alterations to the gut microbiome can disrupt intestinal barrier function, increase intestinal permeability (leaky gut), and promote systemic inflammation, through the release of bacterial endotoxins through the “leaky” gut walls.
As you can see from the above, each aspect affects multiple other factors in PCOS, worsening symptoms - this is why PCOS is such a complex condition!
Reducing PCOS Inflammation with Naturopathy
So, what can we do to reduce inflammation in PCOS? And how can a PCOS naturopath help? Thankfully we have some amazing tools at our disposal when it comes to holistic management of chronic inflammation. Here are some of my favourite ways to address chronic inflammation in PCOS:
Anti-Inflammatory Diet
A whole foods, anti-inflammatory diet really forms the foundation of naturopathic treatment for PCOS. Here we want to emphasize nutrient-dense foods that are rich in antioxidants, fibre, omega-3 fatty acids, and phytonutrients. We also want to minimise highly processed foods, refind sugars, trans fats, and foods that promote inflammation.
Some of my favourite foods to incorporate for PCOS include:
Non-starchy vegetables and leafy greens, like bok choy, broccoli, Brussels sprouts, cauliflower, green beans, spinach, zucchini
Fresh fruits, like apples, oranges, tangerines, berries, kiwi fruit, mango
Nuts and seeds, like almonds, Brazil nuts, cashews, pumpkin seeds, flax seeds, hemp seeds
Quality sources of omega-3 fatty acids, including wild-caught salmon, sardines, cod, herring, and vegan omega-3 sources such as kombu, wakame, flax seeds, hemp seeds, walnuts
Lean proteins, such as lean grass-fed red meats, organic chicken, organic tofu, free range eggs
Anti-inflammatory herbs and spices, such as turmeric, ginger, garlic, and fresh herbs like parsley, oregano, rosemary, coriander - remember fresh is best when it comes to herbs and spices!
Blood Sugar Balance
Keeping blood glucose levels in check can be an absolute game-changer and is truly essential when it comes to reducing inflammation and managing PCOS symptoms. Here are some of my go-to strategies for managing blood glucose:
Keep all meals (and snacks!) balanced with a source of complex carbohydrates, protein and fat with each meal/snack
Never skip meals
Eat breakfast first before you have your morning coffee
Eat mindfully and be present while you eat - avoid eating while distracted by work, TV, phone, etc.
Herbal Medicines
There are some absolutely fantastic anti-inflammatory herbs that can be useful for PCOS inflammation, including:
Liquorice
Turmeric
Peony
Cinnamon
Ashwagandha
We can also use anti-androgen herbs like saw palmetto and spearmint, which will help to reduce inflammation that is occurring due to androgenic pathways. Gut-healing herbs, like meadowsweet, calendula, chamomile, will help to reduce inflammation originating from the gut. Blood-glucose regulating herbs like goat’s rue can also be great here!
Supplements
Supplements for reducing inflammation in PCOS include:
Omega-3 fatty acids - especially important to supplement with if you are vegan/ vegetarian or don’t eat fish regularly. Vegan supplements made from algae are available
Vitamin D
Magnesium
N-acetyl cysteine (NAC)
Lifestyle
We of course also need to address any lifestyle factors that are driving inflammation. Some of the big ones to consider include:
Daily physical movement - be it a gentle walk, yoga, pilates, or something like a run or gym session, making sure you are moving your body every single day is vital for reducing inflammation. Unless illness or physical limitations prevent it, you should be aiming for at least 150 minutes of moderate intensity physical activity every week.
Sleep - did you know women actually often need more than 8 hours of sleep per night? Many women actually need 9-10 hours of sleep per night for optimal function. Making changes to your lifestyle, such as going to bed earlier to prioritise sleep, can help.
Reduce overstimulation of the nervous system - high cortisol drives stress, and cortisol is up when we are overstimulated and stressed. Switch off the screens, practice mindfulness activities like meditation (or a hobby like knitting!), deep breathing exercises, or other relaxing activites that get you out of the stress loop.
Avoid exposure to endocrine-disrupting chemicals and other inflammatory chemicals - use low-tox self care products, filtered water, and ditch the plastics and non-stick cookware.
We absolutely can improve PCOS symptoms and reduce PCOS inflammation. It takes time and finding the right strategies to suit you unique health picture. Working with a naturopath can make all the difference!
Want to get in control of your PCOS symptoms and regain your life? Let’s work together. Click here to book your appointment.
About the Author
Lizzie Stow is a clinical naturopath from Newcastle, Australia.
To find out more about Lizzie, click here.
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