Integrative Treatment Options for Ovarian Cyst and PCOS: Specialty Testing, Nutrition, Supplements

The ovaries are one of the most important organs for female health. They bear the burden of carrying all the eggs a woman will have from birth, and they are responsible for the primary production of female hormones. This article will discuss the ovaries' role in the body, the top health conditions associated with the ovaries, and functional medicine testing to evaluate those conditions. We’ll then discuss complementary and integrative medicine treatments for ovarian conditions, including diet, supplements, and herbs.

[signup]

What Are The Ovaries Role In The Body?

The female body has two ovaries that are arguably the most important organs for reproductive health. The ovaries sit in the lower abdominal cavity and are separated by the uterus. The ovaries attach to the uterus via tendons and ligaments and two long tubes called fallopian tubes. Each ovary holds thousands of ovarian follicles: fluid-filled sacs that contain immature eggs. Every month, until menopause, the female body goes through a menstrual cycle where one of the ovaries will release an egg with the intent of pregnancy. Normal menstrual cycles can last anywhere from 21-35 days.

The Menstrual Cycle

The ovaries are active through all three phases of the menstrual cycle: the follicular, ovulatory, and luteal phases. The follicular phase starts at menstruation, which is the shedding of the uterine lining. A hormone called Follicle Stimulating Hormone (FSH) begins to be released from the pituitary gland. FSH stimulates follicles in the ovary to begin to grow. A dominant follicle is chosen by days 5-7 of the menstrual cycle. This dominant follicle will begin to produce estradiol which causes the uterine lining to grow. The purpose of thickening the uterine lining is to accommodate the implantation of a fertilized egg or to prepare for pregnancy. As the cycle continues, the dominant egg will continue to release estradiol until levels reach a threshold that causes the pituitary to release another hormone, luteinizing hormone (LH). LH causes the dominant follicle to grow until it essentially bursts, releasing an egg. This release of the egg is referred to as ovulation, and this phase can last from 16 to 32 hours. The ruptured follicle turns into a structure called the corpus luteum. The corpus luteum makes the second ovarian hormone, progesterone. Progesterone enhances the function of the uterine lining, making sure it receives proper blood flow and nutrients. Progesterone production marks the luteal phase, which typically lasts for 14 days. If the egg is not fertilized, the production of estradiol and progesterone begins to decline. The decline causes menstruation to begin, and the cycle repeats itself.  

As you can see, the ovaries take directions from hormones released from the pituitary gland, FSH and LH. The pituitary gland also takes direction from a center in the brain called the hypothalamus. This entire communication network is called the hypothalamic-pituitary-ovarian (HPO) axis.

What are the Top Ovarian Health Issues Treated With Integrative Medicine?

There are many ovarian health issues that integrative medicine can help with. Here are the most common:

Polycystic Ovarian Syndrome

Polycystic ovarian syndrome is a condition affecting the ovaries and how they function. To be diagnosed with PCOS, a woman must have two of the three criteria, including high levels of androgens (testosterone, dihydrotestosterone, DHEA) or signs of high testosterone such as dark hairs on the face and body; irregular periods; ovarian growths as seen on ultrasound These are commonly referred to as “cysts,” as the name PCOS implies. However, they are not true cysts but rather immature follicles that have stopped growing. Signs and symptoms of PCOS are menstrual irregularities, including lack of periods (amenorrhea) or skipping periods (oligomenorrhea), oily skin, acne (especially on the jawline, chest, and back), heavy periods, infertility, weight gain, especially in the abdomen, patches of dark, velvety skin (acanthosis nigra), and dark hairs on the chin, chest, face, abdomen, and upper thighs (hirsutism). Women with PCOS are at greater risk of developing type 2 diabetes, heart disease, endometrial hyperplasia (thickening of the uterine lining), and more. The exact cause of PCOS is unknown. However, insulin resistance, improper communication of the HPO axis, inflammation, and genetics seem to play a role.

Ovarian Cysts

Ovarian cysts are fluid-filled sacs that attach to the ovaries. A woman of any age can develop them, and while mostly benign, ovarian cysts do have the potential to cause twisting of the ovary (ovarian torsion), malignancy, and rupture. Often times cysts are small, do not have any associated symptoms, and dissolve naturally. However, larger cysts have the potential to develop symptoms including achy, dull pain in the lower back, abdomen, or pelvis, feeling bloated, painful sex, changes in bowel movements, changes in urination, and painful menses. Ruptured cysts or ovarian torsion lead to more severe symptoms, including acute pain, fever, nausea, vomiting, dizziness, and vaginal bleeding. Hormone fluctuations, endometriosis, and infections of the genitourinary system, including chlamydia and gonorrhea, can cause ovarian cysts. Rarely certain cancers can cause ovarian cysts. Risk factors for ovarian cysts include hypothyroidism, previous ovarian cysts, cigarette smoking, and tubal ligation.  

Functional Medicine Labs That Can Help Individualize Treatment for Patients with Ovarian Disorders

There are many functional lab tests that can help to individualize treatment plans for ovarian disorders. Here are the most commonly ordered functional medicine tests:

Hormone Testing

The DUTCH Complete by Precision Analytical is a dried urine test that assesses hormone urine metabolites. Assessing metabolite levels allows the patient and practitioner to see how hormones are being metabolized or broken down. This information can be incredibly useful, as hormone metabolism has the potential to go array in many different ways. For PCOS, the androgen metabolism portion of this test is of utmost importance since high androgens are implicated in some cases of PCOS. This test can also be useful for ovarian cysts since hormonal fluctuations can lead to ovarian cysts.

Blood Sugar Testing

Insulin is the taxi for blood sugar and is required for the entry of blood sugar into cells, where it can then be converted into energy. Cells may stop accepting insulin, and thus, blood sugar levels can become elevated and predispose a person to type 2 diabetes; we refer to this as insulin resistance. Since insulin resistance is thought to play a role in the development of PCOS, and diabetes is a risk factor for those with PCOS, measuring markers related to blood sugar is essential. The HOMA-IR test by Boston Heart Diagnostics measures fasting glucose and insulin, as well as HOMA-IR, a marker of insulin resistance. Additionally, an Hba1C test by BioReference Laboratories may also be needed, as Hba1C is a level that indicates the average glucose level of the past three months.

Vitamin D testing

Vitamin D, a fat-soluble vitamin, is important for bone health, immune and inflammatory processes. Vitamin D has been implicated in both PCOS and ovarian cysts; thus, testing vitamin D levels may be warranted. Many companies, including the Vitamin D test by US Bio Tek, offer a vitamin D test.

Inflammatory Panel

Since inflammation plays a role in both PCOS and ovarian cysts, checking inflammatory markers is warranted in both conditions. Markers of systemic inflammation, including CRP and ESR, can give insight into the inflammatory process of the body that may contribute to the ovarian conditions discussed.  

[signup]

Complementary and Integrative Medicine Treatment for Ovarian Disorders

Complementary and integrative medicine for ovarian disorders can include nutrition, supplements, and herbs. Let’s look at some of the most evidence-based practices for ovarian health.

Best Nutrition for Ovarian Health

A review study done on women with PCOS concluded by recommending a diet low in saturated fat and a type of sugar called fructose and high in fiber. The Mediterranean diet fits these criteria, and additionally, the Mediterranean diet can lower inflammation, which is implicated in PCOS. The Mediterranean diet consists of fresh fruits and veggies, fatty fish, nuts, seeds, olive oil, and minimally processed whole grains. The diet is void of processed foods and sugars and added sugars.

While not a diet, seed cycling may be a great option for those with ovarian cysts. Seed cycling incorporates the consumption of seeds that support different hormones during different times of the cycle. For the follicular phase, when estrogen should be high, pumpkin seeds and or flax seeds are consumed, which can help obtain healthy estrogen levels. During the luteal phase, when progesterone is high, sunflower or sesame seeds are eaten to support progesterone levels.

Top Supplements and Herbs for Patients with Ovarian Disorders

Top supplements and herbs for ovarian disorders include inositol, berberine, and curcumin.

Inositol for PCOS

Inositols are naturally occurring compounds that our bodies make and are also found in certain foods, including nuts, fruits, and grains. Two types of inositols can be beneficial for women with PCOS. Supplementation with Myo-inositol and d-chiro-inositol can improve metabolic and ovarian functioning, including inducing ovulation. Additionally, inositol was shown to lower androgen levels and improve markers of blood sugar and regulate menstrual cycles.

Dose: 100 mg inositol twice daily

Duration: 14 weeks

Berberine for PCOS

For thousands of years, Chinese medicine has used berberine. Berberine has been shown to positively impact blood sugar by improving insulin sensitivity and ovulation rates. Its effects on blood sugar are significant; studies have shown its effects are similar to the diabetes drug Metformin, which is sometimes prescribed to women with PCOS.

Dose: 500 mg 3x/day

Duration: 3 months

Curcumin for Ovarian Conditions

Curcumin is an extract found in the Indian spice turmeric and is well known for its anti-inflammatory properties. Studies done on curcumin for PCOS specifically have shown reductions in inflammatory markers as well as blood sugar, cholesterol, and other metabolic markers.

Dose: 80-1500 mg/day

Duration: 6 weeks- 6 months

Vitamin D for Ovarian Conditions

Research has shown that vitamin D greatly impacts women’s health and ovarian functioning by influencing progesterone production and hormone sensitivity and signaling. Because of these actions, vitamin D can impact follicular development. For women with PCOS, low levels of vitamin D have been linked to insulin resistance. Additionally, vitamin D levels were found to be deficient in many women with a specific type of ovarian cyst called an endometrioma.

Dose: The dose of vitamin D should be dependent on lab values

Duration: Duration of supplementation with vitamin D should be dependent upon lab values.  

[signup]

Summary

The ovaries' role in women's health is essential to overall well-being. Controlling both the release of eggs and hormone production- the ovaries are responsible for some of the most important jobs in a woman's body. Conditions that involve or affect the ovaries can have a variety of symptoms that can significantly impact a woman's quality of life. Functional medicine testing can help assess the root cause of ovarian conditions and thus can help develop a treatment plan to aid in symptom resolution.