When approaching treatment, it is a much more correct approach to treat the patient rather than the diagnosis of the disease.
All laboratory tests of the patient should be evaluated and all underlying metabolic disorders should be focused on.
Insulin resistance is the cause of many polycystic patients, but not all patients with polycystic ovary syndrome have insulin resistance. Therefore, the tests I have listed above in laboratory tests should be examined in detail and whether the person has insulin resistant polycystic ovary syndrome or insulin resistant polycystic ovary syndrome.
After eliminating insulin resistance, the focus should be on the adrenal system.
***When treating polycystic ovary syndrome, I consider the liver-adrenal system-intestines-lymphatic system a lot. Diseases that occur in these systems cause many metabolic problems and eventually come to us as polycystic ovaries. It is actually quite wrong to focus only on the ovaries and certain parameters in polycystic ovary. As a result, it is said that there is no treatment for polycystic ovary syndrome. For years, you have seen in many of my patients that both the infertility disappeared and the cysts in the ovaries disappeared, and the patients recovered completely both in the laboratory and clinically. It is important to look at the patient as a whole and to resolve any underlying metabolic problems.
***At the same time, focusing on the spiritual and mental system rather than seeing the patient as just a body reveals permanent and real treatment.
Note: Many polycycic ovarian patients are prescribed birth control pills and metformin as treatment. These are not therapeutic but symptomatic drugs. I only prefer metfformin in cases with severe insulin resistance, but I do not recommend the use of birth control pills at all. Bleeding caused by the birth control pill is not your body’s natural bleeding. While all the problems that cause polycystic ovary continue at the bottom, you are only masking the event with these pills.
Chronic toxicity should definitely be considered and it is important to support detox mechanisms if necessary.
Vitamin and mineral deficiencies must be taken into account.
In addition, the fact that the person used birth control pills and stopped them may make us think about the symptoms of pcos due to post-drug hormonal changes. In this case, this table should be examined and eliminated for treatment.
Diet and nutrition are perhaps the most important in the treatment of polycystic ovary
Adrenal stress has always been the underlying undetected cause of many polycystic ovary syndromes.
ADRENAL PCOS
When the body is under stress, the Hypothalamus secretes the hormone ACTH. As a result, cortisol, adrenaline, noradrenaline and also DHEA, DHEA-S, ANDROSTENEDION are secreted from the adrenal glands (which can be converted to testosterone in the surrounding tissues). Therefore, chronic stress can cause both androgen hormone excess in the body and polycystic ovary syndrome. At the same time, it will cause many problems such as intestinal flora problems, insulin resistance and liver problems, and the body will enter a vicious circle.
Acth stimulates adrenal androgens because these androgens protect the brain from the long-term effects of stress (from the effects of cortisol and adrenaline). But it has a bad side. There is a negative feedback between acth and the cortisol secreted by acth, that is, if cortisol increases too much, acth is suppressed, but there is no negative feedback between these androgen hormones and acth. In other words, as androgen hormone secretion increases, acth is not suppressed. In addition, chronic stress-related responses will also cause problems in this communication (HPA AXLE COMMUNICATION) in the long run and disturbances will occur in the body’s normal response to stress.
As a result, androgen hormone excess will occur in cases of cornic stress. This means polycystic ovary and its symptoms.
SYMPTOMS AFTER BIRTH CONTROL Pill-PCOS
Those who use birth control pills may experience bleeding due to drug withdrawal after quitting. These bleedings are not real menstrual bleeding.
During this period, most women are misdiagnosed as polycystic ovary. This should definitely be taken into account when making the diagnosis.
Even short-term infertility may occur after discontinuing birth control medication.
Symptoms experienced after discontinuation of birth control medication may return to normal spontaneously within 1-2 years.
The symptoms experienced during this period should be considered holistically. In general, androgen excess is observed and a treatment should be established for this.
Zinc supplementation can be very useful in this period.
I will write a much more detailed article about post-contraceptive syndrome. There will be a much more detailed post on this.
WEIGHT AND POLYCYSTIC OVER
Weight loss is very important in the improvement of symptoms and laboratory findings in most polycystic ovary syndromes.
In many studies, it has been observed that as the weight loss of the patients, the testosterone levels return to normal, the SHBG levels increase, and the serum insulin levels return to normal.
It is seen that after weight loss, ovulations are disrupted and the polycystic appearance of the ovaries improves.
This may not be the case for all polycystic ovarian syndrome patients. There are many patients who are especially underweight but still have polycystic ovary syndrome. However, in most cases with insulin resistance, weight is one of the most important factors.
Now I would like to tell you one more important detail. Very low body fat mass, exercising too much and eating less calories can also cause insulin resistance and polycystic ovary. Yes, you heard right. Having a very high fat mass such as obesity, on the contrary, having a very low fat mass can also cause polycystic ovary. Exercises that will stress the body excessively and excessively long-term calorie restrictions are also among the causes of polycystic ovary syndrome.
1- NUTRITION
***all refined processed foods should be removed from the diet!
***Foods made with the frying method should never be consumed.
***Consumption of gluten-containing products can cause inflammation. It is now slowly emerging that it causes many problems. I would like to state that a gluten-free diet is very beneficial in polycystic ovarian syndrome.
*** There are always suggestions for you to eat a diet with a low glycemic index. In polycystic ovary, I both agree and disagree here. Cereal groups with a high glycemic index, processed foods, snacks, pastries are the things I never recommend in polycystic ovary. But fruits are perhaps one of the most important components in polycystic ovary. The number of patients that I have looked at as polycystic ovary for years is quite high, and we get excellent results in all of them with a plant-based diet containing plenty of vegetables and fruits. The aim here is not to focus directly on the glycemic index; Rather than generalizing, it is necessary to focus directly on foods.
Although ketogenic diets seem to be effective at first in polycytic ovarian syndrome, many functional medicine physicians and authorities never recommend this diet for reproductive system health in the long term. In the long run (more than 2-3 months), these diets may cause different problems. Even when I met with a functional medicine physician in the USA, who advocates the ketogenic diet, he stated that he did not prefer the ketogenic diet especially for patients with polycytic ovaries. A low-carb diet can have negative effects on the reproductive system in the long run. BUT I want to reiterate here. By carbohydrates, we never mean refined processed foods, too many grains, pastries, artificial sugars, etc. I’m talking about purely organic vegetables and fruits! I want you to focus on this point! Our carbohydrate source will be vegetables first, then fruits, then legumes and then gluten-free grains. I also leave the links to the studies related to this subject in the bibliography section below; unprocessed holistic carbohydrates may improve insulin resistance. But processed refined foods and grains have the opposite effect.
***trans fats and harmful fats should all be removed from the diet. (For a detailed article about fats, read my article on “FATS”.) But healthy fats (olive oil-avocado-coconut oil-butter) –clarified butter-raw nuts) should be a part of our diet.
***Foods to which the person is intolerant can often stimulate many inflammatory parameters. Observe the foods that you are intolerant to with an elimination diet.
***Removing milk and its products from your diet is very beneficial in polycystic ovary syndrome. All dairy products contain IGF-1. This hormone, which has a similar structure to insulin, plays the usual suspects in insulin resistance. In addition, the positive effect of cutting dairy products in reducing the production of androgen hormones has been shown by studies. As we mentioned above, androgen hormones are among the main problems in polycystic ovary.
***Reduce alcohol consumption or cut it out if possible. Alcohol harms most of the liver detoxification parameters. The liver is especially important for the detoxification of hormones. Continuous consumption of alcohol can prevent the metabolism of hormones. Alcohol consumption is also important in the formation of insulin resistance Cutting the arm is very important to reduce the burden on the liver.
***Reduce caffeine or cut it out if possible. We mentioned that the adrenal system is among the points to focus on under polycystic syndrome. Caffeine is highly stimulating for the adrenal glands. Caffeine is also very important for estrogen levels and metabolism. Excess caffeine consumption can disrupt estrogen metabolism in the body. Coffee also reduces the level of B vitamins in the body (with excretion and processing) and B vitamins are very important in polycystic ovary syndrome. The number of studies showing that coffee is associated with infertility is also quite high.
***A holistic plant-based anti-inflammatory diet is the type of nutrition I get the best results from in my patients with polycystic ovary syndrome.
In the beginning period, while eating raw foods as much as possible, I gradually increase the rate of cooked food over time.
I never recommend counting calories because I focus on micronutrients as well as macros with my patients.
but if you look roughly, it may be beneficial in polycystic ovary syndrome that most of the calories you take in your diet are in the morning meals.
***Dark leafy vegetables such as kale, spinach, kale, and all greens should be the most important part of your diet for healthy iron and calcium sources.
***Reducing foods containing AGEs (advanced glycation and products) in nutrition can be very beneficial in polycystic ovary syndrome with insulin resistance. Foods containing AGEs = processed foods! Animal processed foods!
***animal foods should not be consumed at high rates in polycystic ovarian syndrome. In a study on infertility at Harvard ( I leave the link below ) ; reported that when women get their protein from plant sources instead of animal sources, the chance of infertility recovery is higher. Among animal protein sources, the best quality protein source is eggs (for health reasons), but it should also be consumed within certain limits.
***Sea fish can be preferred in the season, red meat can be eaten, but I recommend you to stay away from chicken meat completely. (If you can find organic village chicken that you know how to grow, it can be consumed rarely)
*** Spices, especially cinnamon and turmeric, black cumin , red pepper is very useful in polycystic ovary syndrome.
***Stay away from conventionally grown meats, (The use of hormones to raise animals is common.) Prefer natural animal meats grazed on the pasture, this issue is very important.
Note : Iron deficiency and iron excess can both cause and result in polycystic ovary syndrome in both conditions. In this case, sometimes when iron medications are started directly in patients with iron deficiency, the absorption and use of this iron will not be much due to the inflammation in the body, and iron stores will not increase and an iron toxicity will occur. Therefore, first of all, chronic inflammation should be treated with an anti-inflammatory diet and some supplements if necessary, and then iron medications can be used if necessary. In most of my patients, iron levels increase and iron deficiency symptoms disappear with foods high in iron, without the need for iron medication. The first choice should always be diet and iron sources, and patients with polycystic ovary syndrome should not be started on iron medication immediately.
***omega 3 and phytoestrogen sources such as flaxseed-chia-sesame are very beneficial in polycystic ovary.
***especially phytoestrogen consumption can reduce many symptoms you experience during your menstrual period. Because the problem in this period is the situation where estrogen, which we call estrogen dominance, cannot be met with progesterone. In this way, phytoestrogen consumption can reduce estrogen fluctuations and can cure many symptoms.
***Many supplements and phytotherapeutic agents can be used in the treatment of polycystic ovary depending on the condition of the patient and the underlying problem. )
• VITAMIN D = vitamin d levels are very important in insulin resistance. Many studies have shown that vitamin d is even in milk for metformin in some cases. I want vitamin D levels to be around 60-80. Daily doses of vitamin D are appropriate instead of loading doses. I am seeing.
• MAGNESIUM = Low magnesium levels are associated with insulin resistance and many metabolic symptoms. 200-300 mg of elemental magnesium daily can be very useful in insulin resistance in polycystic ovary. For higher doses, consult your doctor.
• Chromium = Chromium is among the essential minerals in regulating insulin and blood sugar. In a study, it has been shown that the daily use of 200 mcg of chromium mineral in women with polycystic ovary syndrome is very important in the regulation of blood sugar. It has also been shown that the level of free testosterone in patients with polycystic ovary is reduced after chromium supplements. 200-600 mcg can be used after meals.
• OMEGA 3 = omega 3 has a great place in the treatment of chronic inflammation and in many diseases. In a study, a significant decrease was found in the testosterone levels of women who took 3 g of omega 3 daily in 8 weeks; and their menstrual patterns became much more regular compared to placebo.
• VITAMINS B = vitamin b deficiencies are important in most of the symptoms in polycystic ovary syndrome. Especially b2-b3-b5-b6-b8-b9-b12 are important in weight control, thyroid functions, hormonal balance and mitochondrial functions, detoxification of hormones.
• B6 BITAMIN = It is important in serotonin and dopamine secretion and mood changes.
• ZINC = Zinc is an essential mineral that is very important in many metabolic steps. Zinc deficiency can cause appetite. Cement deficiency can cause loss of taste and smell. If you need more intensely flavored foods and salt, consider zinc deficiency. It is very important in the activation of the hormone insulin. It is very important for the development of follicles in polycystic ovary and for proper menstrual cycle. It is very important in acne treatment. It is important in losing weight. It is important in insulin resistance. Daily doses of 15-30 mg can be used in polycystic ovary syndrome. It can be quite effective in depression in polycystic ovary syndrome. Zinc deficiency can cause depression. is happening.
• PROBIOTICS = They are very important in suppressing inflammation and balancing testosterone and estrogen. There is also a very strong connection between polycystic ovary syndrome and intestinal flora. Especially probiotics containing lactobacillus and bifidobacterium are very effective.
• COENZYME Q10 = is very important for energy production and carbohydrate metabolism. In a study, it was revealed that the use of coenzyme q10 doubled weight loss in people on a low-fat diet.
• ALPHA LIPOIC ACID = It is very important in balancing blood sugar. Daily dose of oo mg can be used.
• N ACETYL CYSTEIN ( NAC ) = very important in insulin resistance and liver detoxification.
• GLUTAMINE = It can be useful in sugar addiction. It is very important in muscle building.
• AGNUS CASTUS (VITEX-CHASTETREE BERRY ) = very important for the proper functioning and function of the pituitary. BY ENSURING PROPER RELEASE OF LH SECRETION FROM THE Pituitary Gland; It reduces estrogen and androgen levels, increases natural progesterone secretion and thus provides balance in the ovaries. It may take several months to take effect, so it should be used for at least 3-6 months to see the effect. It can be used in acne irregularities. It can be used between 40-60 mg daily.
• BLACK COHOS (CIMICIFUGA RACEMOSA ) = May be important in reducing lh levels. It may be quite effective in premenstral symptoms.
• SAW PALMETTO ( SERENOA REPENS ) = studies show that saw palmetto has an antiandrogen effect. If you suffer from androgen excess symptoms, you should consider using it. Studies have shown that it reduces testosterone levels. (It also blocks the conversion of testosterone to dihydrotestosterone-5 by blocking alpha reductase enzyme)
• MELATONIN = Some patients with polycystic ovary syndrome may also experience sleep problems. Melatonin supplementation can be used for a while until sleep is restored or in severe insomnia cases. I preferably use 3-6 mg sublingual melatonin forms.
• MILK THISTLE ( SİLYBUM MARIANUM ) = It is a very important supplement for the liver. It is important in liver regeneration and detoxification. As I mentioned above, the liver plays the central role in the polycystic ovary area. It has been found useful in clearing excess estrogen in the body and in insulin resistance.
• Nettle (URTİCA DİOCİA) = Root increases the rate of SHBG. In this way, the rate of free testosterone decreases. Its leaves are also very effective, in insulin resistance,
• DONG QUAI = It is important in returning Hromon levels to normal. It strengthens the immune system. It strengthens the uterus and can be effective in menstrual pain.
• Raspberry Leaf ( RUBUS İDAEUS ) = Strengthens the female reproductive system on many levels. It can be effective in heavy menstrual bleeding. It is rich in iron, strengthens the uterus. It can increase fertility.
• EVENING PRIMROSE ( OENTHERA BIENNIS ) = is very important in balancing hormones. It can be useful in estrogen and progesterone imbalance. It can be effective in high cholesterol seen in Pcosta.
• LINEN SEED (LİNUM USITATISSIMUM ) = Increases SHBG levels, decreases androgen levels and is important in metabolizing estrogen. It is rich in Omega 3. They also act as phytoestrogens thanks to the lignans in their content. It is also a very useful source of fiber. I always tell my patients with polycystic ovary syndrome to include flaxseed in their diet.
• WHITE PEONIA (PEAONIA LACTIFLORA ) = It has been shown to increase progesterone levels and decrease testosterone levels. Calms the liver. Important in menstrual irregularity.
• MINT ( MENTHA CORDİFOLIA ) = Studies have shown that it reduces ANDrogen levels and free testosterone levels. It can be consumed especially as a tea. It can be used especially in cases of acne and hair growth.
• GURMAR PLANT (GYMNEMA SLYVESTERE) = this plant, also known as herbal metformin, has been used in ayuverdic medicine for centuries. It can be important in insulin level control and carbohydrate laying.
• RED CLOVER = It shows phytoestrogenic effect. It is very important in acne treatment. It is very important in cleaning the blood (detoxification).
• Cinnamon = It is very useful in polycystic ovary syndrome due to its positive effect on insulin resistance. It is also effective in regular menstrual cycles. It can reduce bleeding in women with heavy menstrual bleeding. It can reduce menstrual pain.
• LICORICE ROOT = It is very important in the management of stress. It is partially effective in lowering excess testosterone. It can be very useful in acne and hair growth. You can consume supplements or tea. Licorice root is very effective when it comes to the adrenal system. It can also be beneficial in cases of hypotension.
• INOSITOL = Inositol may appear as myo-inositol or d-chro insoritol. The supplements you buy may contain one of these. The most suitable ones are those with a myo-inositol / d-chiro-inositol ratio of 40/1. It has been shown to reduce the volume more effectively than birth control pills. It has been shown to increase egg quality. Some studies show that it is even more effective than metformin. It may even be effective in depression and panic attacks. It can be used in doses between 500-2000 mg. Dose adjustment must be made under the supervision of a doctor.
• BERBERINE = can be very useful in patients with polycystic ovary syndrome due to its effect on insulin resistance. It should be used especially in polycystic ovarian patients whose insulin resistance diagnosis has been confirmed. 500 mg berberine can be taken 2-3 times a day.
• ASHWAGANDA = It is very important in polycystic ovarian syndromes originating from the adrenal system (chronic stress). It is an important adaptogen in Hpa repair. It may be effective in correcting cortisol levels. Its positive effect on cholesterol levels has been reported in studies. It may be very important in weight loss. Its effect on anxiety and stress is the most are important effects.
• L-THEANINE = It is an amino acid naturally found in green tea and some mushrooms. It crosses the brain barrier and can compete with some neurotransmitters. It provides calming and is important in focusing.
• DANDELIBA = Detoxifies the liver, it is very important in cleansing the hormones. There are two studies related to the fact that dandelion stimulates the production of SHBG due to this hormone cleansing. Increasing SHBG means that free testosterone in the environment is bound and removed. Testosterone excess is one of the most important symptoms in polycystic ovary.
• MACA ROOT = It is very important in balancing hormones and balancing cortisol. It is a plant that has been used for years to increase fertility. It can also be useful in depression.
• HOLY BASİL(tulsi) = may be useful in insulin resistance, It is effective in cortisol levels, It may be effective in weight loss. It also has an antiandrogenic effect.
• TRIBULUS TERRESTRIS = can stimulate ovulation, it is important for the smooth functioning of menstrual cycles. There are studies showing that it reduces ovarian cysts.
3-EXERCISE
If you are looking for a miracle method, this is EXERCISE for polycystic ovary syndrome! I got the treatment when I combined the fastest and best response with exercise in my polycystic ovarian syndrome patients and myself. Exercise is not an option but a necessity! Having a weekly routine is very important.
I usually recommend my patients to be interested in the type of sport they love. Although this is very important for the continuity of exercise, doing the sport you love is also very important for your hormonal balance.
In some cases, the exercises we call HIIT (HIGH INTENSE INTERVAL TRAINIG) may be more effective. There will be a long article about this type of training. But if your polycystic ovary syndrome is caused by the adrenal system, HIIT training may not be suitable for you. Exercises such as yoga-walking-pilates, which include more breathing exercises, may be more appropriate.
4-YOGA
Many studies have shown that mainly yoga and other sports have reduced AMH, LH, TESTESTERONE levels. Regular yoga practice has improved insulin resistance and reduced cardiovascular diseases. Its positive effect on stress levels is also very important.
I recommend that you include yoga in your daily routine for many diseases, but its effect is quite evident especially in hormonal disorders. Yoga exercise 2-3 times a week is very useful in the treatment of polycystic ovary syndrome.
5- WEIGHT LOSS
Losing weight in women with polycystic ovary with a high body-mass index (BMI) and insulin resistance may improve many symptoms. Normal body mass index is between 18.5-24.9.
In these patients, it is very important to support the detoxification parameters while losing weight and to ensure that they lose weight with an anti-inflammatory diet. The nutrition part I mentioned above is an anti-inflammatory diet. In patients who will lose or lose 10 kilos or more, medical detox support may be required (with necessary supplements and phytotherapeutic agents, the aim is to support the detoxification parameters and excretion pathways of the liver in the form of phase1-phase2-phase3)
6- SLEEP
We talk about sleep all the time in every disease because it is one of the most important details, but most of the patients I have observed for years are not aware of the seriousness of it.
Sleep is not just about resting the body, it is necessary and important for the proper functioning of your hormones, the proper functioning of your detoxification parameters, the functioning of your mitochondria, and thousands of other things. The hormone MELATONIN is essential for liver detoxification and your mitochondria, and this hormone secretion gradually decreases every hour after 12 at night. .You should sleep for 7-8 hours a day and your sleep time should not exceed 12 at night. The ideal is to fall asleep around 10 pm.
7-FIX YOUR STRESS LEVEL
Regular chronic stress disrupts the HPA (HYPOTHHALAMUS-PITUER-ADRENAL) axis, and as a result, many hormonal imbalances and inflammation occur as a result. Chronic stress management is also known to people but not enough. An area he doesn’t dwell on is just like sleep. I tell most of my patients that if we can’t solve our stress problem, we won’t get very far. Meditations, breathing exercises, certain books, trainings, yoga are the points I recommend most to my patients. Stress will always be in our lives, what matters is how we deal with it.
Some studies have shown that meditation lowers cortisol levels and is even beneficial for insulin resistance.
8-FREE CHEMICALS
Endocrine disruptors are chemical agents that disrupt your body’s natural hormone functioning. I will write a much more detailed article on this subject. But generally, you use at home
*cleaning materials
* Do you know that many things such as plastics
*personal care items
*laundry, dishwashing detergents
*perfumes and fragrances
*packaged foods
*canned foods
can be and contain hormone disruptors?
If we give an example of some endocrine disruptors = DIOXINS, PESTICIDES, BPA, GLYSOLE ESTERS, PHthalates.. There will be a very detailed article about this.
9-HORMONE REPLACEMENT THERAPIES
In particular, progesterone hormone replacement (bio-identical) can be tried, but hormone replacement therapy is never my first choice for polycystic ovary. Çok ciddi komplike vakalarda öne alınmalıdır.
10-HOMEOPATİ
Homeopati temel felsefesi “benzer benzeri tedavi eder” seklinde olan bir tamamlayıcı tıp yöntemidir.Homeopatide amaç kişinin yaşam enerjisini aktif etmek ve semptomları değil bütüncül tıptaki gibi kişiyi tedavi etmektir. Homeopati tek basına ya da diğer bütüncül bakış acısıyla beraber tedavide değerlendirilebilir.
Polikistik over sendromu yönetilmesi ve tadavi olunması zor bir hastalık değildir , ama zaman gerektirir.kişinin iyileşme ve düzelme belirtilerini görmesi 6 ayı bulabilir.Alttaki nedenin ne olduğunu bilmek burada oldukça önemlidir.
Ama polikistik over sendromu bir kader değildir , konrtol altına alınabilir ve tamamen düzelebilir.
Mutlu , huzurlu günler dilerim…
