Is There Really No Cure For PCOS?
By Clare Goodwin
Last updated: September 3, 2020
Is there a cure for PCOS? I’m sure that this is a question that you’ve asked before! If you’re anything like me, when you were diagnosed with PCOS you likely did a google search on ‘PCOS’ and one of the first things that caught your eye was: “There is no cure for PCOS”
I think this sends completely the wrong message! While there is no cure, it is possible to entirely revers your symptoms, if you treat the reason why your hormones are out of balance (which is actually what PCOS is).
I (and many other women) have completely reversed our symptoms to the point where we no longer fit the diagnostic criteria for PCOS. Does this mean that I have found the cure for PCOS? No.
If I go back to living the way I was previously then I’ll likely develop PCOS again. A cure means that the disorder can never come back. PCOS is a complex and multi-factorial syndrome. As such, I doubt there ever will be a single cure. However, this does not mean that you cannot reverse it entirely and not have PCOS anymore.
Think of it like putting PCOS into remission, which is as good as a cure to me. We need to focus on reversing PCOS. To do this, we need to understand all of the factors that contribute to the hormonal metabolic storm which is going on inside our bodies. The current widely held belief that there is no cure for PCOS leaves women believing that they are the victim of a condition that they have no control over.
The ‘Cure For PCOS’: Is It Really Possible To Reverse It?
What does reversing PCOS mean? Well, put simply it means that you used to fit the diagnostic criteria but you don’t any more. You could think about this as putting PCOS into remission.
According to the Androgen-Excess Society, PCOS should be diagnosed using the following criteria:
- Hyperandrogenism: high amounts of androgens, such as testosterone.
- Ovarian dysfunction: such as cysts on the ovaries or the failure to ovulate.
- The exclusion of related disorders: e.g., a thyroid condition.
When I was diagnosed, my testosterone was well above the normal range. As you can see from my test results, at 3.9nmol/L, my testosterone levels were considered “High High”. Note the very timely recommendation to my doctor to: “Consider PCOS”:
My DHEA-S was also at the very highest point of the normal range: 10.3 umol/L (standard range: 1.2 – 10.3 ). I hadn’t had a period for 2 years. Additionally, I had severe insulin resistance.
My fasting blood glucose was 6.6mmol/L (Type 2 Diabetes diagnosis is 7 mmol/L). Bear in mind that this was only a few months after retiring as an international triathlete. I certainly hadn’t been sitting on the couch eating donuts and watching reality TV – I was training for one of the the hardest multisport races in the country.
Putting My PCOS Into Remission
I struggled for many years to find a solution to my ever increasing waistline and androgen levels, and my non-existent ovulation. The greatest reason for this was because I was focusing solely on weight, calories and carbohydrates.
A common medical recommendation for women is to “lose 5% of your body weight and PCOS will resolve itself”. The result of this advice, although well intended, is to focus solely on weight and calories and it also leaves the so-called ‘lean PCOSers’ without a resolution.
Weight-gain is only a symptom of a much more complex web of underlying causes. These causes include but are not limited to:
- Chronic inflammation (caused by disrupted gut flora and food intolerances).
- Insulin resistance.
- High stress hormones or HPA-Axis dysfunction.
- Too much or too little exercise.
- Thyroid conditions.
- Heavy metal toxicity.
Diet alone didn’t reverse my PCOS. My PCOS only went into remission when I treated all the causes of my high androgens. This included:
- Improving my gut health.
- Addressing my food intolerances.
- Ending my sugar addiction.
- Reducing my stress hormones.
- Reducing the amount of high intensity exercise that I was doing.
- Eating more, not less.
For the last 2 years, my testosterone level has sat around 1.6 nmol/L. My periods have been on time, every time, and my insulin resistance is also reversed. Gone too is the weight gain, acne and extreme fatigue.
I no longer fit the PCOS diagnosis criteria, and I no longer have symptoms. I’ve put my PCOS into remission.
‘But Clare, you’re just one case. Is this really possible for me?’
While my experience is no randomised controlled trial, it’s also not an anomaly.
Naturopathic doctor Fiona McCullough, author of the excellent book ‘8 Steps to Reverse your PCOS’, had a similar experience. She successfully reversed her PCOS and has been able to conceive naturally.
Alisa Vitti from Flo Living has also reversed her PCOS. Alisa had a similar experience to me. “At age 20, I was told I would never be able to have children naturally… even with the aid of IVF”. Fast forward a few years and she’s no longer 200 lbs or suffering from acne. She also conceived naturally at age 37.
Even the The PCOS Awareness Association states: “There are many ways you can decrease or eliminate PCOS symptoms.”
How Is This Possible? Isn’t PCOS Genetic?
Genes play a large part in making women more susceptible to developing PCOS. However, it is only when the right environmental factors are present that they go on to cause PCOS. This has been proven in identical twin studies (1, 2). Identical twins have the same genetic makeup. Therefore, if PCOS is solely a genetic condition then it would be impossible for just one twin to develop PCOS. Research shows that this does occur, proving that the syndrome is not solely genetic.
My functional medicine teacher, Chris Kresser, explains it like this: Genetics are like the loaded gun, but it’s environment that pulls the trigger.
In theory, the key to reversing PCOS is remarkably simple. Figure out what factors have caused you to develop a hormone imbalance (which is really what PCOS is) and address them. The reason I say ‘in theory’ is because in practice this can be quite a complex process. This is because it’s very rarely one thing which has caused the syndrome to develop. More often than not it is multiple factors coming together to create the perfect metabolic storm, giving rise to PCOS.
The Most Common Environmental Factors That Cause PCOS
1. PCOS and Insulin Resistance and Inflammation
Inflammation and insulin resistance are the biggest contributors to PCOS. We know from studies that 70% of women with PCOS have insulin resistance.
High insulin levels up-regulate an enzyme called 17,20-lyase which increases the production of testosterone and reduces the amount of Sex Hormone Binding Globulin (SHBG). SHBG is like a sponge for excess hormones. If it is low then the amount of hormones running free will be much higher.
Not all women with high insulin develop excess androgens and PCOS. This is why scientists propose that genes play a role.
You may have heard about insulin resistance, but you probably haven’t been told about its connection to inflammation. Inflammation occurs when your immune system is chronically activated. Studies have shown that inflammation can cause insulin resistance and that it may be that inflammation has to be present for insulin resistance to occur. This becomes really important when we start to talk about treatment. It’s also the reason why simply removing carbs isn’t effective for many women: you also need to treat the inflammation.
Fasting blood glucose and HbA1c are the most common tests for insulin resistance. However, they’re not sensitive enough to pick up early stage insulin resistance. For information about the tests you should be having, read my article all about insulin resistance.
2. High stress Hormones and HPA-Axis Dysfunction
When we are under a lot of stress, our brain detects this and stimulates our adrenal glands to produce our stress hormones. These hormones include adrenaline (the fight-or-flight hormone) and cortisol. However, at the same time the brain also produces androgens, such as DHEA-S and androstenedione.
Most people (even physicians) are not aware that 50% of women with PCOS have excess adrenal androgens. I’ve written an article all about ‘adrenal PCOS’, which I would recommend that you read.
3. Inflammation (Non-Insulin Resistant)
Inflammation is when your immune system is chronically activated. As I mentioned above, it goes hand in hand with insulin resistance, but it can also act alone.
Inflammation can be caused by many things:
- Eating foods that you’re intolerant to.
- Poor gut health.
- High stress hormones (yes, it goes hand in hand with stress PCOS too).
- Environmental toxins.
Inflammation has been shown to increase androgens and stop ovulation, even without insulin resistance also present. I’ve written an extensive article about inflammation which goes into this in more detail.
4. Disrupted Gut Microbiome
Your gut is home to 100 trillion microorganisms, called the microbiome. These are responsible for a multitude of processes within your body, including maintaining your immune system. When there is not enough good bacteria (or variety in the strains of bacteria), or there is an overgrowth of bad bacteria, this is called a disrupted gut microbiome. Studies have shown that poor gut bacteria causes inflammation and insulin resistance, and inflammation contributes to PCOS. This supports the idea that poor gut bacteria is a contributor to PCOS. You can read more about how gut bacteria contributes here.
Although there is no ‘cure for PCOS’, it is possible to reverse it; myself and other women are testaments to this. Focusing on the idea that there is ‘no cure’ for PCOS only serves to demotivate women suffering from the syndrome. There are many underlying root causes of PCOS, the most common of which are:
- Chronic inflammation.
- Insulin resistance.
- High stress hormones.
- Disrupted gut microbiome.
However, all of these issues are highly treatable. By finding out what underlying causes are affecting your body, then treating them, your PCOS can be reversed.
One of the first things you can do is to get some proper blood testing, especially to see if insulin resistance is contributing to your PCOS. The main tests for insulin resistance, HbA1c and Fasting Blood Glucose are not sensitive enough to pick up early stage insulin resistance.