Health/Natural: Polycystic Ovaries & PMS

Q. I have had polycystic ovaries now for over 10 years, and as I get older (I am 30) the symptoms seem to be getting worse. I have been on Metformin for 5 months, without success. I am now turning to the more natural approaches to see if they can help me. I have bought some DIM and vitex, as I have read they are good for balancing hormone levels. Can you take both of these tablets together, and how many mg's per day should I start on? I also take a multi B tablet, and until a few weeks ago evening primrose oil, but read that EPO can exacerbate acne. Many thanks, J Wheeler.

**********

I was wondering if it is possible to use progesterone cream and vitex agnus castus at the same time for PMS, tender breasts, etc? I am 35, have no kids and have been struggling with this problem for some years. My gynecologist did blood tests and found nothing significantly wrong. I do drink a lot of coffee, which I know is a contributing factor.

I tried to search for answers on the internet, but found no conclusive answers. I also saw the two (vitex & progesterone) combined in capsule form on a website, although I would use the vitex drops and progesterone in cream form.

I would appreciate your advice.

A. For women, these are both very common issues... polycystic ovaries and PMS. Natural medicine looks at these conditions somewhat differently from allopathic medicine, and we view them as potentially treatable. Of course, there are many other details which I don't have regarding each individual's question from above. We seek to treat the individual person, not the disease, and details of the person's case become extremely important in defining protocol of supplements, nutrition and remedies. PMS symptoms, for example, can differ tremendously from one person to the next, and each person's overall program can differ somewhat. Let's look at some options, but try to find a practitioner in your area who can sit down with you, take your case and recommend a program chosen just for you.

PMS and polycystic ovaries can both be linked with hormonal imbalances in natural medicine. We commonly refer to the imbalance as "estrogen dominant", but more recently the term "progesterone deficient" defines it more appropriately. What this means is that there is an optimum balance between healthy estrogens and healthy progesterone on a monthly basis, but it is very common for estrogen to be in a higher than desirable range in relation to progesterone. In natural medicine, the key to monthly hormonal balance is to support healthy estrogen levels for the first part of the month (from the end of the menses until mid month) and to support healthy progesterone levels for the second part of the month (from mid month until the beginning of the period.) There is a delicate balance between the two together throughout the entire month. PMS and polycystic ovarian problems can both stem from this "estrogen dominant" or "progesterone deficient" situation.

What can contribute to these problems?

Poor nutrition... A daily diet high in "bad" fats (especially saturated), dairy products, meats, salt, caffeine, sugars and alcohol can significantly contribute to these problems. In my opinion, vegetarians have the right idea by eliminating foods coming from animal sources, which are believed to contain extra toxins, along with high levels of "estrogen-inducing" hormonal residues. Through the years I have seen women suffering from terrible PMS, breast tenderness, etc., do very well with only a change to a vegetarian diet.

There are "good" fats and "bad" fats... Hydrogenated fats, fried foods and other processed foods which contain high saturated fats, and fats from animal sources (meats, dairy) are not considered beneficial for PMS, ovarian cysts, fibrocystic breasts and many other reproductive-related problems. In other words, there is a world of difference between olive oil and margarine. Olive oil is healthy all the way around, and margarine (a hydrogenated fat) should be avoided by everyone, especially women dealing with these issues.

Caffeine is another possibility... I would say to any woman dealing with ongoing breast tenderness/fibrocystic breasts, "Stop the caffeine!" You will be amazed at how this alone will help your monthly breast tenderness and pain. Coffee is the worst of all, and drinking many cups of it per day, plus perhaps tea and soda also, will flood your system with unhealthy caffeine levels which can also contribute to other problems from insomnia, anxiety, uterine fibroids and dizziness. Search out caffeine substitutes in your local health food store. There are many good herbal teas to choose from, many of them made especially to help replace caffeinated tea and coffee. Check into green tea, one of the healthiest options, especially for protecting breast tissue. Regular green tea has about 1/4 the amount of caffeine as regular caffeinated tea or coffee, and has a whole list of other wonderful antioxidant benefits. Decaf green tea is also available. Also, drink plenty of water, at least 6-8 glasses per day. This is important for anyone and most people don't drink nearly enough of it.

Stress can contribute... We all know stress in our lives, but try to take a close look at how stress effects your monthly cycle, PMS problems (physically and emotionally) and other problems like ovarian cyst flare-ups. And there are those of us who are quite out of touch with the effects of stress and just keep plowing through our lives without any sense of how the stress may be effecting our system. This is especially important for women to realize. Be aware of stresses and try some of the suggestions below to help protect you from the negative effects of stress on your delicate hormonal balance.

Here are some positive natural options for supporting hormonal health:

• DIM (dindolylmethane with Indolplex) - special extract derived from broccoli which has been known to aid in "estrogen dominant" situations. Look for a 120 mg. blend, 1-2 per day with food.
• Natural Vitamin E (d-alpha mixed tocopherols, 200-400 iu.) - vitamin E may help with breast tenderness.
• Vitex agnus castus (Chaste Tree Berry) - this is a wonderful traditional herb, used by women for centuries to help support healthy progesterone levels. I usually recommend a "Full Spectrum" Vitex extract, either in liquid or tablet form, 1 tablet providing 375 mg. of the whole herb and 125 mg. of vitex extract, which will give 625 mcg. of the active ingredient, Agnusides. Most women will take from 1-2 tablets per day of this potency.
• Natural Progesterone Cream - works very well along with Vitex and DIM, but check with a natural healthcare practitioner for dosages of each along with the progesterone cream for your specific case.
• Colon & Liver Cleansing - cleansing is being rediscovered as a benefit for many people. It was a traditional part of seasonal changes for our ancestors, especially in the Fall and Spring. I usually recommend a cleanse twice per year for anyone, especially women dealing with PMS, etc. Refreshing the system is very important, and can help liver function, which then can aid in hormonal-related issues. There are many different cleansing formulas available currently, some more gentle and some stronger, so check with a practitioner to pick the right one for you. More info about cleansing in future columns...
• High quality Multi Vitamin/Mineral - extra good nutrition to fill in for things missing in your daily diet. For example, women need lots of dark green leafy vegetables, usually 3-4 servings per day, to provide extra minerals, organic iron, and chlorophyll. If you don't get this in food, (and most of us don't!) then choose a multivitamin from the health food store which gives you the full spectrum of nutrients, plus vege and green food extracts, too.
• High quality CoEnzymated B-Complex for Stress - choose a CoEnzymated formula, which means that the B-vitamins in the formula are already converted over to a useable form, a job usually done by the liver (one less thing the liver has to do each day.) This will assure a faster and greater absorption potential. Available usually in oral tablets or sublingual lozenges.

Reading List: Diet & Nutrition by Rudolf Ballentine, M.D. Women's Bodies, Women's Wisdom by Christiane Northrup, M.D. The Detox Diet by Elson Haas, M.D. Women's Herbs, Women's Health by Hobbs & Keville Herbal Healing for Women by Rosemary Gladstar (this is one of my favorites) The Complete Women's Herbal by Anne McIntyre Women's Encyclopedia of Natural Medicine by Tori Hudson, N.D. Family Herbal by Rosemary Gladstar (another great book by one of my favorite herbalists)

©Copyright 2003 by AlternativeApproaches.com

Susie Cooper, ND earned her Doctor of Naturopathy degree at the Southern College of Naturopathic Medicine, and is Board Licensed and Certified. She has continued most of her study in Classical Homeopathy with the New England School of Homeopathy. Dr. Susie has taught workshops in homeopathy, herbal medicine and nutrition in North Carolina for many years. She now teaches all her workshops in her shop, Blue Mountain Herbs & Supplements, in beautiful Pilot Mountain, NC, where she also takes private appointments for herbal, nutritional and homeopathic assessments. (336) 368-5955.

Important note: The information contained in this column is not meant to diagnose or prescribe for specific ailments, but is intended for educational support only. Please seek the advise of a licensed health practitioner for specific illnesses and emergency situations.