Finding the Right PCOS Naturopath: Your Ontario Guide to Natural PCOS Management
PCOS (Polycystic Ovarian Syndrome) is one of the most misunderstood hormonal conditions affecting women today. Many women are told their symptoms are normal or that their blood work is fine, only to continue struggling with persistent issues (e.g., irregular periods, acne, weight gain, hirsutism, hair loss).
Understanding how a PCOS naturopath can help and what to look for when choosing one can make all the difference in your PCOS journey.
How Naturopaths Diagnose and Monitor PCOS
Through Comprehensive Hormone Testing
Our healthcare system generally does not look into PCOS comprehensively unless you have a classic presentation (e.g., you have irregular periods, acne, hirsutism, hair loss, weight gain).
However, PCOS needs to be treated on a spectrum because of how different each patient case can be (e.g., not all PCOS patients are overweight or have irregular cycles). In addition, there are different presentations of PCOS and different root causes to consider.
I typically assess about 5 or 6 androgens (or male hormones). Usually, our healthcare system will only do one or two of them. If one or two are normal, they assume that everything is normal, but this isn’t always the case.
This is why I have people who come tell me, "I was told that my blood work is normal and that I don't have PCOS," despite all of their symptoms. When we reassess, it’s generally the missing tests that come back suggesting they actually do have PCOS.
Read more about comprehensive hormone testing in women’s health.
A Comprehensive Androgen Panel
Comprehensive hormone testing for PCOS can include the following androgens:
Testosterone
Dihydrotestosterone (DHT)
Dehydroepiandrosterone (DHEA)
Androstenedione
17OH progesterone
Sex Hormone Binding Globulin (SHBG)
Whether we order all of them or not depends on the case.
The Importance of Proper Testing Protocols
It's really important to ensure that we've done proper screening and testing. We can’t just assume the patient's symptoms are normal or that the blood work they’ve had in the past is enough, because oftentimes it isn't. We need to look for the missing pieces of information that could help us understand the patient’s concerns.
What's the Difference Between Conventional PCOS Treatment and Naturopathic Approaches?
Conventional Treatment Limitations
Our healthcare system typically recommends hormonal oral contraceptive pills (OCP) or birth control pills to manage PCOS.
The problem is that some birth control pills contain progestins (synthetic progesterone) that have what we call a high androgen index (or high male hormone index). This means that the progestin can mimic or increase male hormones in the body leading to side effects such as acne, hair loss, or hirsutism.
These symptoms are the issues that some women with PCOS are already suffering from. When they come off of birth control pills, if they didn't have PCOS to begin with, they could get what we call pill-induced PCOS. Or they can get worsening of their PCOS symptoms prior.
There's not enough education around birth control use for women, so many will go on it thinking that it'll regulate their period, but it doesn’t always.
The Withdrawal Bleeding Misconception
The other thing is, women assume that they have regular menstrual cycles when they are on birth control pills. If they had irregular cycles before, they’re under the assumption that their hormones are now regulated. However, this is not the case because the period that they get on birth control pills is just a withdrawal bleed. It’s not a natural cycle.
Naturopathic Treatment Options
Many patients are rushed into managing PCOS with birth control pills or in vitro fertilization (IVF) for fertility. Some patients are even told that it’s normal not to have a period each month or that they will never be able to conceive naturally, but these are not true.
There is nothing wrong if patients want to use birth control pills or opt for IVF if this is what they want. I too was on birth control pills. However, there is so much research now for natural treatment options (for example the use of herbs) to treat PCOS and these options should be made available to patients so that they can make an informed choice about their care.
These natural treatment options can help with issues like:
Managing insulin resistance behind PCOS
Lowering androgen hormones (male hormones)
Supporting inadequate progesterone levels
The use of natural therapies like herbs can help women get their menstrual cycles back regularly, to help manage symptoms, and for them to get pregnant naturally.
What Should I Look for When Choosing a PCOS Naturopath?
It’s important to find a Healthcare Provider who seeks to find out what’s missing in your care—reviews your history in detail and finds what hasn't been explored.
A session with a PCOS Naturopath will include a comprehensive assessment of your current symptoms, health history, and labs regarding your symptoms.
I get so many cases where people are told everything’s normal, that their blood work is normal, or that their symptoms are fine. But then, when we dive deeper, it always seems like something's missing.
Lab Testing to Guide Treatment
The health food store and online offers many generic supplement formulas that are marketed for PCOS. However, depending on the type of PCOS that you may have, these generic supplements may not benefit you at all. Lab testing helps us identify which supplements are best for you and what is the appropriate therapeutic dosage you may need.
The Ashwagandha Example
With PCOS, many people may experience a lot of stress and ongoing anxiety from their hormonal imbalance. They could go to the health food store and buy an adrenal support formula for stress management.
Because it's a generic formula, it often contains the herb ashwagandha, which has been seen to increase testosterone. So they think it's helping with one aspect of their health, but then it could be worsening the PCOS.
It's really important to make sure we've done the proper screening and testing so they're not taking something they think is helping them, but is actually making things worse.
How Long Does It Take to See Results with Naturopathic PCOS Treatment?
Most people will see a change in their symptoms or menstrual cycle in about 3 months. This is also when we may see shifts in their hormones on blood work.
This means that women with PCOS may start to experience regular periods at this point or if they were experiencing delayed cycles before, they may see their cycle length start to shorten. For example, if their periods were every 45 to 60 days, it may shorten to 32-45 days.
The Science Behind the Timeline
It takes a follicle in the ovaries about 90 days or 3 months to develop before ovulation. This is why we don’t expect to see changes until at least 3 months.
Ongoing Monitoring
Initial lab testing helps us build a treatment plan based on the results. It'll help us decide which supplements we need. For example, if testosterone is elevated on blood tests, then we can use herbs (e.g. spearmint tea) that have been shown in research to help lower it.
Ongoing lab testing also helps us monitor treatment progress and determine next steps. For example, if someone’s cycle is not regular, but blood tests show that testosterone levels are decreasing, then we may decide to continue the current plan as is.
If someone’s cycle is still not regular, ongoing blood tests can help us identify if we’re heading in the right direction. For example, if we see male hormones decreasing, it could mean that they are responding to the supplements. This can help us decide if we want to continue the treatment plan as is or modify it accordingly.
Will My Naturopath Work with My Family Doctor or Gynecologist?
Absolutely! In my personal experience, I’ve been very fortunate to have doctors who were very collaborative regarding my care.
There is more and more research emerging in the field of natural medicine and many people (including various healthcare professionals) are becoming more open to alternative therapies.
What Does a Typical PCOS Naturopathic Consultation Involve?
A typical PCOS naturopathic consultation involves a thorough assessment. Usually, I'll walk patients through their concerns and goals, then ask a set of questions to better understand their hormones.
Key Questions Explored
Did these symptoms come on since puberty?
Did it come on later in life?
Was it before or after birth control?
Postpartum?
Where are they in their life—is it a perimenopause transition?
What do you mean by irregular when you say “irregular periods”?
I'll look at any blood work, any previous investigations they've had with their doctors, gynecologists, and endocrinologists, and whatever led up to that.
My Approach
I try to find what's missing in their care and what hasn't been explored.
From there, we determine next steps, whether it's, "Okay, we have enough information to start a protocol," or if there are missing tests and things that we need to do. Just doing the thorough assessment to make sure we have all the information is critical.
Are Naturopathic PCOS Treatments Covered by Ontario Health Insurance?
No. Unfortunately, naturopathic treatments are not covered by our Ontario Health Insurance Plan (OHIP). Some extended healthcare benefits include health spending accounts, where they may be able to expense supplements.
However, understanding the supplement market (for example, knowing what forms of vitamins, minerals, and herbs we need, being familiar with different supplement brands, and understanding dosages) can help us plan and budget accordingly.
Complimentary Naturopath Consultations
Many naturopaths, including myself, offer complimentary consultations to answer any questions you may have and help you determine whether naturopathic medicine is right for you.
During these consultations, we can also review your blood work together and see if there’s anything missing.
Patients will also often ask, "What should I take?" or "These are the things that I'm taking, what are your thoughts?" We can review the list of supplements that they are already taking together. As I mentioned, some of the supplements actually increase male hormones, so it could make things worse for them.
Taking the Next Step in Your PCOS Journey
There’s a lot of lack of education around women's health in general. But finding the right healthcare provider who will dig deeper, test comprehensively, and provide individualized treatment can make all the difference.
Remember: you can't assume. You just have to test and see. These missing pieces of information are what patients need to find answers about what's going on with their health.
Ready to get answers about your hormone health? Book a consultation with Dr. Kathy Nguyen to discuss your symptoms and create a personalized treatment plan.
About the Author
Dr. Kathy Nguyen, N.D. is a licensed Naturopathic Doctor who graduated from the Canadian College of Naturopathic Medicine (CCNM). Prior to studying naturopathy, she received her Honours Bachelor of Science from McMaster University, Hamilton. Dr. Kathy Nguyen ND is in good standing with the College of Naturopaths of Ontario (CONO), and is a professional member of the Canadian Association of Naturopathic Doctors (CAND) and the Ontario Association of Naturopathic Doctors (OAND).