Natural Treatments For PCOS – A 9-Step Evidence-Based Guide

PCOS symptoms are caused by three things. Chronic low-grade inflammation, insulin resistance, and elevated androgen levels. These mechanisms interact, with each making the others worse [1-4].

Through diet and lifestyle changes, we can address these mechanisms. By doing so, we can then bring our symptoms under control.

Diet is always the best place to start. This is what my free 30-Day PCOS Diet Challenge is all about. But if you want to dive deeper, into PCOS natural treatments, then there’s a lot more to explore.

Here are the nine best evidence-based natural treatments for PCOS.

1. Focus On Your Gut Health

The gut serves as a key interface between our food and our bodies. It’s where the good gets sorted from the bad. When intestinal permeability is compromised, inflammation occurs [5]. More specifically, imbalances in the gut microbiome cause inflammation [6].

The majority of PCOS women I work with suffer from poor gut health of one kind or another. Addressing this problem can have profound impacts on many of their symptoms.

Studies show that women with PCOS have a lower diversity of healthy gut bacteria than our non-PCOS friends. These differences correlate with how the disease is expressed [7, 8].

But it’s not just PCOS that’s affected by poor gut health. “Leaky gut syndrome” is a feature of many metabolic and autoimmune diseases [9]. Many scientists now believe that the gut microbiome is an epigenetic cause of disease [10, 11].

So, gut health is important. This is why diet is the best of the natural remedies for PCOS. If you want to fix your gut, then you need to fix your diet.

Research using primate models of PCOS shows that the gut microbiota can be altered by diet [12]. Other studies suggest that these changes can occur within days [13]. This may partly explain the quick results seen in women who complete my free 30-Day PCOS Diet Challenge. It’s not uncommon for participants to start looking and feeling better within the first few weeks of changing their diet.

But gut health goes beyond changing your diet. This is where a naturopathic doctor or functional medicine practitioner is needed. Addressing chronic infections and microbial overgrowths can make a big difference too (see below).

2. Reduce Inflammation Through Diet

A PCOS diet can reduce inflammation in many ways.

Eat less:

• Fructose
• “Vegetable” oils
• Gluten
• Dairy

Eat more:

• Anti-inflammatory foods
• Fiber and vegetables

Sugar is roughly 50% fructose and 50% glucose. Fructose and its metabolites cause inflammation and increase intestinal permeability [14]. High fructose consumption is one of the biggest risk factors for insulin resistance, obesity, and cardiovascular disorders [15-17].

“Vegetable oil” is a euphemism for industrially produced seed oil. This includes oils produced from soybeans, corn, canola, cottonseed, and safflower seeds. It’s what they use in almost all processed foods. Research has shown that the overconsumption of these oils creates a pro-inflammatory, pro-allergic, and pro-thrombotic state [18].

Gluten is a protein found in wheat, rye, and barley. Studies show that gluten increases intestinal permeability, even in healthy people [19, 20]. This causes inflammation.

The elimination of dairy is a bit more person-specific. The problem with most dairy-related studies is that they’re not designed for women with PCOS [21]. This is where practical experience is key. The most successful women who complete my Beat PCOS 10-Week Program all do better after eliminating dairy.

Many foods contain antioxidant and anti-inflammatory properties. Ingredients found in a DASH diet or Mediterranean diet give us plenty of examples of these types of foods. Olive oil, herbs, and leafy greens should feature prominently in a PCOS diet. Oily fish and tree nuts are also helpful for fighting inflammation.

As described above, the health of our gastrointestinal tract is a function of the microbiota that inhabit it. The best way to support our gut microbiome is to eat a diet rich in fermentable, prebiotic fibers [22, 23].

While many foods contain prebiotic fibers, some of the best sources for women with PCOS include:

• Asparagus
• Dandelion greens
• Flaxseeds
• Garlic
• Jerusalem artichoke
• Leek
• Mushrooms
• Onions
• Seaweed

3. Eat For Better Insulin Sensitivity

When it comes to insulin sensitivity, diet is the most significant factor.

The best way to improve insulin sensitivity is to reduce the glycemic load (GL) of your food. The glycemic load is a function of the glycemic index (GI) and how much you eat. It’s a proxy for how food impacts your blood sugar levels. A smaller, slower change is better. What we want to avoid are short sharp spikes that can lead to the development of insulin resistance.

For PCOS women that already have insulin resistance, the right diet can reverse this problem.

The best way to reduce your GL is to stop eating sugar and other readily available sources of glucose. This includes desserts, bread, potatoes, pasta, and rice. The best way to enjoy carb-rich foods is to choose whole foods like root vegetables, legumes, and wild or black rice. You also want to keep serving sizes small. Eat slow-carb, and low carb, from whole food sources and you can’t go wrong. This is especially useful if weight loss is one of your goals.

For help putting these PCOS diet principles into practice, join my free 30-Day PCOS Diet Challenge. This free 3-Day Meal Plan download is another great way to get started.

4. Consider Nutritional Supplements

Nutritional supplements can address all three targets of a PCOS treatment strategy.

Evidence-based supplements that reduce inflammation include:

• Fish oil [24]
• Curcumin [25]

Well-supported supplements that can improve glucose metabolism and/or insulin sensitivity include:

• Inositol PCOS products
• Berberine [26-29]
• Vitamin D [30, 31]

Many herbs help ease PCOS symptoms.

The following medicinal herbs have potential impacts on PCOS-related biomarkers [32]:

• Lipid profiles: Aloe vera, chamomile, and cinnamon
• Insulin resistance: cinnamon, chamomile, Aloe vera, and Camellia sinensis
• Hormones: Aloe vera, silymarin (milk thistle), chamomile, fenugreek, Camellia sinensis (tea shrub), Heracleum persicum (Persian hogweed), Potentilla, Mentha spicata (spearmint), Foeniculum vulgar (fennel), licorice, and Marrubium
• Ovarian tissue: Aloe vera, chamomile, Camellia sinensis, Mentha spicata, and silymarin

Other popular herbs used within the PCOS community include:

• Maca root
• Holy basil
• Peony (Paeonia lactiflora)
• Black cohosh (Cimicifuga racemose)
• Vitex agnus-castus

Many women with PCOS have an insufficient dietary intake of several micronutrients. One study found that women with PCOS were most at risk for mineral deficiencies in calcium, potassium, and magnesium. When it came to minerals, folate, vitamin C, and vitamin B12 deficiencies were most common [33].

Besides many of the products listed above, a 2021 review identified the following compounds as potential PCOS therapies [34]:

• Flavonoids and isoflavones
• Vitamins E, folate, and omega-3 fatty acids
• Selenium
• Carnitine
• Chromium
• Melatonin
• Probiotics

When used as directed, many products pose little risk of adverse outcomes. That said, some nutritional supplements have the potential to cause harm. Furthermore, most of these products are not regulated by the FDA. This includes compounds that may interact with other medications or health conditions. With so many factors to consider, it’s always best to get personalized advice from a trusted healthcare professional.

5. Make Sure To Exercise

Exercise is another great way to treat PCOS. Both strength training and aerobic activity improve insulin sensitivity in women with PCOS [35-37]. Strength training may also improve androgen levels [38].

Exercise targets the underlying mechanisms that cause PCOS. This is why a sustained exercise habit can help keep this disorder in check. Since hormone levels are improved, exercise can increase pregnancy rates, reduce body fat, and help with skin and hair issues. Cardiovascular risks are decreased, and we just feel better. Exercise, after all, is a safe and effective antidepressant [39].

A 2017 systematic review looked at seven studies that investigated the effect of exercise on overweight women with PCOS. They found that with or without diet, exercise can lead to the resumption of ovulation. They also made some useful observations for people that exercise a lot or are underweight. For these people, they found that excessive exercise may be bad for healthy hormone regulation [40]. The key finding here is that exercise is good. But we don’t want to overdo it.

Guidelines for PCOS recommend at least 150 minutes of physical activity per week [41]. Others recommend a minimum of 120 minutes of vigorous-intensity exercise. This has the greatest impact on fitness, body weight, and insulin resistance [42]. It should be noted here, that the intensity, rather than the amount of exercise, appears to be the most important to health outcomes.

6. Manage Your Stress

The science is clear that stress management is a natural cure for PCOS.

Stress influences body weight. Studies show that women with PCOS are more affected by stress than non-PCOS women [43]. Since many pathways connect stress to obesity, the psychological effects of stress make weight loss more difficult [44].

Stress also influences fertility. A US study found that women with the highest levels of stress were twice as likely to suffer from infertility [45].

There are hundreds of things you can do to help manage stress. Learning to say “no” more often is a good place to start. Some of the best evidence-based stress management techniques include:

• Mindfulness-based stress reduction
• Mindfulness meditation
• 4-7-8 Breathing technique
• Heart math
• Exercise
• Improve your sleep quality

7. Get Better Sleep

Of all the home remedies for PCOS, sleep has to be the most underrated.

Insufficient sleep is an independent risk factor for insulin resistance [46-48]. Sleep disturbance and duration are also associated with systemic inflammation [49].

So, sleep impacts both of the most important factors in our PCOS natural treatment framework. This may, in part, explain why sleep disturbances are approximately twice as common in women with PCOS [50].

From a more day-to-day perspective, sleep restriction makes us less active [51]. Insufficient sleep quality has negative effects on eating habits too [52]. Studies have shown that getting more sleep makes us less prone to crave sugar [53]. Preliminary research suggests that an extra 45 minutes of sleep at night can reduce sugar intake [54]. If you’ve ever tried to quit sugar before, this finding is huge.

Some basic steps to improve sleep quality include:

• Going to bed earlier
• Ensuring your bedroom is cool
• Reducing blue light exposure in the evening which disrupts your circadian rhythm
• Practicing guided relaxation exercises before bed
• Use of essential oils like lavender or rose to help promote sleep
• Use of nutritional supplements like melatonin and 5-HTP

8. Reduce Exposure To Endocrine Disruptors

Endocrine disruptors are chemical substances that inhibit the endocrine system. That’s the messenger system that controls our hormones. There’s substantial evidence showing that fetal exposure to endocrine disruptors contributes to the development of PCOS [55-58]. This is referred to as fetal programming of PCOS. Many studies have shown that ongoing exposure can also make symptoms worse [59-61].

Some of the most common endocrine disruptors people are exposed to in daily life include:

• Bisphenols (BPA, BPS, BPF, BPAF)
• Phthalates (DEHP, MEHP)
• Flame-retardant compounds (PBDEs, PFAS)
• Glyphosate (RoundUp)
• Heavy metals (mercury, cadmium, lead, arsenic, aluminum)

These chemicals are found throughout most households. Common sources include:

• Indoor and outdoor air
• Food and water
• Cookware
• Cleaning chemicals
• Textiles (clothing and furniture)
• Skin and beauty products
• Gardening products

The Environmental Working Group (EWG) is a non-profit organization that provides the best guidance on how to do this. Their consumer guides can be found here. This includes their now famous, Dirty Dozen^TM and Clean Fifteen^TM. I also recommend their water filter guide.

9. Diagnose & Treat Other Factors

The eight steps described above are helpful for anyone with PCOS. But many other factors can cause and exacerbate symptoms. For these issues, personalized help from a range of healthcare professionals is needed.

Some of the most important lines of inquiry include:

• Thyroid dysfunction
• Indoor air quality
• Chronic infections

Thyroid dysfunction affects three times as many women with PCOS compared to non-PCOS populations. Many of these cases are undiagnosed [62]. As explained here, a proper diagnosis requires a full thyroid panel. Treatment for thyroid dysfunction is especially valuable if you can’t manage your body weight with diet changes alone.

When it comes to indoor air quality, mold presents a significant risk for women with PCOS. An estimate conducted by the EPA found that approximately 47% of U.S homes have dampness or mold problems [63]. This creates an inflammatory burden that causes a range of illnesses. Poor quality air also contains many endocrine-disrupting chemicals [77].

Viruses in the herpes family are a classic example of opportunistic chronic infections. These include things like Epstein-Barr virus, which is the agent of mononucleosis or “glandular fever”. Cytomegalovirus and human herpesvirus 6 are also members of the herpes family. These cause pneumonia and roseola respectively. It’s also possible to carry a bacterial infection that’s secretly undermining your health. Examples include Bartonella, mycoplasma, and chlamydia. Diagnosing and addressing these infections can resolve many PCOS-like symptoms.

The Bottom Line

PCOS is a complex disorder but the treatment framework is simple. We need to reduce inflammation, improve insulin sensitivity, and treat the symptoms.

Since gut health is key, diet and nutrition are by far the most essential variable. But other lifestyle habits matter too. Exercise, stress management, and sleep are evidence-based interventions that anyone can do themselves. Reducing exposure to endocrine disruptors also makes a lot of sense. After doing all that you can on your own, it’s worth seeking personalized help. There are often other underlying factors that need diagnosis and treatment.

If you’re ready to take back control of your health, then these natural treatments are just what you need.

FAQ

How do I know if I have PCOS? Polycystic ovary syndrome affects around 1 in 10 women of childbearing age. The most common PCOS symptoms are absent or irregular periods, and difficulty losing weight. But you can still have PCOS without these issues. Facial hair, excess hair growth, or thinning hair are other common signs. Women with PCOS also frequently suffer from acne and other skin issues. Mood swings and poor mental health also impact women with PCOS more than in non-PCOS populations.

How is PCOS diagnosed? A diagnosis of PCOS is made when two of three conditions are met [64]:

1. Absent or irregular periods
2. Elevated androgen levels (testosterone)
3. Polycystic ovaries as seen on ultrasound

Other health issues that can explain these symptoms must also be excluded. These include congenital adrenal hyperplasia, androgen-secreting tumors, Cushing syndrome, thyroid dysfunction, and hyperprolactinemia.

What causes PCOS? The underlying cause of PCOS is a combination of genetic, epigenetic, and environmental factors [65-68]. Estimates put the genetic component of PCOS at around 70%. But there’s also a significant role played by environmental and lifestyle factors. This starts in the womb and continues throughout childhood [69]. Researchers refer to this as a “two-punch” hypothesis [70]. It’s not just the prenatal insults that lead to the development of PCOS. How we eat and our environmental exposures matter too.

What are your thoughts on acupuncture for PCOS? There are a limited number of randomized controlled trials investigating acupuncture for PCOS [71, 72]. The work done to date is inconclusive. In my view, this suggests the strength of the effect is not large for reproductive outcomes. That said, a recent study found that acupuncture may be helpful for PCOS patients with diabetes [73].

Do PCOS superfoods help? PCOS superfoods include things like apple cider vinegar, maca powder, goji berries, cinnamon, raw cacao, and green tea. These ingredients are all helpful, but the strength of the effect is small. Consideration of your overall diet is more important than any single food item.

Do I need to be worried about AGEs? Advanced glycation end products (AGEs) are highly reactive molecules that cause inflammation. Animal-derived foods that are high in fat and protein are generally AGE-rich and prone to new AGE formation during cooking. In contrast, carbohydrate-rich foods contain relatively few AGEs, even after cooking [74]. Dietary AGEs have been associated with hormone imbalances in PCOS [75, 76]. Some useful tips for reducing AGE levels can be found here.

What about soy and coffee? See the FAQ section of my PCOS diet article for my thoughts on soy, coffee, intermittent fasting, and much more.

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