While diet often plays a central role in managing PCOS, there’s more to it than diet alone. If you have been diagnosed with PCOS and you already eat relatively healthy, you might be wondering why you still have symptoms and what you can do to feel better. 

If this sounds like you, take a careful look at your lifestyle - especially where stress comes into play. For example, consider if you've: ⁠

• Experienced stress for a long period of time⁠

• Experienced a stressful event that you cannot seem to mentally overcome⁠

• Have dieted and engaged in high intensity interval training or excessive exercise for a while now

• Foregone on sleep and an overall healthy and balanced lifestyle due to a busy or overwhelming schedule⁠

⁠You may be experiencing adrenal-type PCOS. ⁠

Over time, stress may have caused your adrenal glands to secrete the androgenic hormones DHEA/DHEA-S and androstenedione in excessive amounts. These hormones ultimately get converted to testosterone. Testosterone is the culprit in many PCOS symptoms. So this is why the symptom picture with adrenal-type PCOS appears similarly to insulin resistant-type PCOS. Symptoms of this type of PCOS commonly includes:  

• hirsutism (hair grown in unwanted areas) ⁠

• acne on the jawline

• hair loss, especially around the hairline⁠

Interestingly, if you have adrenal-type PCOS you may also have insulin resistance, though it's unclear which comes first.⁠

If this is you, I urge you to take a look at your lifestyle and ask yourself, "What is causing me to move through life at such a rapid pace?" Societal, parental, and internal expectations may be at the root of this and I truly believe that this energetic component is important to resolve for healing to take place. ⁠

There are many lifestyle and herbal recommendations I can make for adrenal-type PCOS, but this depends on where your cortisol is at. Cortisol is the body’s primary stress hormone⁠ and is made by the adrenal glands. 

Cortisol plays a role in: 

• Macronutrient metabolism and glucose control 

• Reducing inflammation 

• Regulating blood pressure  

• The circadian rhythm 

• Energy levels 

• Restoring the body after experiencing stress 

You don’t want your cortisol to be either too high or too low. 

⁠If your cortisol is too high, we need to bring it down because chronically elevated cortisol can lead to your body staying in a prolonged state of parasympathetic nervous system arousal (aka the fight or flight response). This causes elevated heart rate, blood pressure and other systems being on high alert. The body is not meant to be in this state all the time. 

If your cortisol has gotten to the point where it is low, this typically results in burn out. This is because when the adrenals are overworked, they don’t produce sufficient amounts of cortisol to properly meet the body’s needs. In this case, we need to help the body to begin producing cortisol in adequate amounts to restore balance. ⁠

Blood work from your doctor can identify if DHEA/DHEA-S and testosterone are elevated. Salivary cortisol or DUTCH (Dried Urine Test for Comprehensive Hormones) are best for assessing cortisol, if within budget. Salivary and DUTCH tests can be run if you choose to work with me.

In the meantime, my number one tip for you is to slow down. I promise it will get you further and your body will thank you for it.⁠

Here are some additional ways you can manage adrenal-type PCOS. The goal is to keep cortisol in check so that testosterone levels don’t get too high. 

Sleep: There’s no substitute for a good night’s sleep to help reduce stress. Sleep is when the body restores all of its systems - including the endocrine system, which governs hormonal balance. Aim for 8-10 hours per night. If you struggle with getting enough sleep, try to make it a priority by establishing a regular routine that allows you to wind down in the evening so that you’re primed for restful sleep. 

Reduce Caffeine: Caffeine can raise cortisol and contribute to adrenal fatigue, which means you might not produce enough cortisol. Too much caffeine, especially later in the day, can interfere with your sleep cycle.  If you are an avid caffeinated-beverage drinker (I feel ya!), then be sure to drink your caffeinated beverage with or after your meal that contains protein and fat to prevent a cortisol spike.

Move Your Body Everyday: Gentle to moderate intensity movement can help lower androgen and testosterone and promote better hormone balance. The key with adrenal-type PCOS is to not overdo it. Exercising too intensely can be stressful on the body and can elevate cortisol. So be sure to move in ways that feel good without over-exerting your body. This type of movement can help regulate your heart rate and blood pressure, which helps bring the nervous system into a parasympathetic state (rest and digest).  Stay clear of intense exercises, classes and programs which can worsen this type of PCOS.

Herbs to Reduce Androgenic Hormones: Some herbs — for example, liquorice, nettle leaf and spearmint — can be taken as a tea. This is a nice alternative to caffeinated beverages and is also ideal for enjoying a restful pause during a busy day. Other beneficial herbs include alfalfa leaf, berberine, cinnamon, peony and saw palmetto. These can be taken in capsule or tincture form. Reishi mushroom is another option (although technically not a herb) that can be taken as a tea, capsule or tincture.  Always speak to a holistic practitioner prior to taking herbs.

Eat at regular intervals throughout the day: and don’t skip meals! Intermittent fasting places a stressor on the body. When we fast, this triggers the release of cortisol. Cortisol signals to the liver to release stored glucose molecules so we can use something for fuel. Instead of inducing that cortisol spike, feed and fuel your body every 3-4 hours. Ensure you are consuming protein, fat, and fibre at every meal.

If your PCOS symptoms came on after chronic stress, then perhaps you have Adrenal Type PCOS. If this is you then conventional treatment to “eat less and exercise more intensely” will not work for you. Consider these recommendations from today’s blog post or reach out to me so we can work together to manage your PCOS symptoms together, holistically.