As a functional nutritionist, I help women to identify and address the root causes of their hormone and digestive symptoms. Say goodbye to fad diets, my mission is to empower you in your health and create change that sustains.
Is adrenal fatigue driving your PCOS? Keep reading to learn how to manage your PCOS and cortisol balance
If you’ve landed here, you’ve probably heard the term “adrenal PCOS” floated around before, right? In the case of adrenal PCOS, classically we would think about our adrenals being in overdrive, pumping out excess cortisol and androgens and potentially creating more of our PCOS symptoms compared to the ovaries. This term comes from an approach to PCOS management where it is believed that the cause stems from one of 3 specific roots : Blood Glucose Dysregulation (this may or may not include insulin resistance), Inflammation, or Stress (may be from coming off of the birth control or related to a more dysregulated adrenal picture).
The problem with this viewpoint is that it tries to create neat and tidy containers for each person with PCOS to fit into cleanly, when this simply isn’t the case. While all of these factors can absolutely play a role in the development and worsening of PCOS symptoms, the fact of the matter is that it’s much more complicated than simply dividing all women with PCOS up into three camps. Most women deal with all of these factors in varying degrees, and stress is almost always a factor. In fact, stress is so intertwined with PCOS that some women that I see in my practice have been mis-diagnosed with PCOS and truly had more of an adrenal stress, imbalanced sex hormone, or hypothalamic amenorrhea picture at play – and at the end of the day, these things are really all related to the same common roots.
All this to say, understanding how stress and PCOS interact is key to not only managing your symptoms, but truly addressing one of the common drivers of PCOS. But before we dive into how adrenal fatigue and PCOS can go hand-in-hand, we need to ground ourselves in what it really means to have stressed adrenals and what dysregulated cortisol levels look and feel like. If these concepts are new to you, you can read this post on hormonal health and adrenal stress to learn more about adrenal fatigue and cortisol.
One of the hallmark drivers of PCOS is blood glucose dysregulation. Many (but not all!) women with PCOS struggle with insulin-resistance, which can lead to issues with blood sugar management. This is part of why we sometimes see Metformin prescribed for women with PCOS. Insulin, estrogen, leptin and other hormones are all deeply intertwined, and an imbalance in one can impact the others, which can lead to a vicious cycle in the PCOS picture. Even without insulin resistance – chronically dysregulated blood glucose can lead to a state of chronic inflammation, so learning to support our blood sugar is critical in a PCOS support plan.
In a long-term state of low-grade inflammation, ovaries can produce greater amounts of androgens or precursors to androgens, our male sex hormones such as testosterone. We all need androgens, women included, but in the case of PCOS by diagnosis there is an excess of androgens. This excess of androgens is associated with some of the symptoms we see in PCOS such as acne and hair growth. Inflammation is also perceived as a stressor by our bodies, which can continue to worsen our PCOS symptoms. In about 20-30% of PCOS pictures we actually see adrenal involvement in elevated androgen levels as a result of a higher level of androgen precursors (like DHEA-S).
And now that brings us back to stress. If we’re experiencing elevated blood sugar levels, chronic inflammation and the typical daily stressors, it’s no wonder that our body is going to be stuck in a state of stress. Managing our stress levels and supporting our adrenals is key for treating PCOS. So if we really want to manage our PCOS holistically, we need to think about how to get our stress levels under control. But what constitutes stress?
Think of physical stressors as being any external source of stress. These types of stressors are all around us, keeping us in fight-or-flight mode. This can be from our environment such as noise pollution or chronic exposure to toxins, or can be in the form of an injury or illness. Our relationships, financial situation and expectations at work can also fall under this category.
When you think about stress, what comes to mind? Probably daily responsibilities at home and work – right? That’s a big part of it for sure, but our bodies can actually experience stress from many of our habits that we might perceive as healthy. This can include:
So what does all of this stress mean for PCOS? When the stress response is activated, our body must prioritize where its resources are going and will turn off certain channels in order to allow our body to function amidst all the perceived threats. One of these pathways that our body sees as non-essential and will stop prioritizing are our hormone production pathways involved in ovulation and fertility (1). Additionally, when levels of the stress hormone cortisol increase, this blocks maturation of ovarian follicles. This means that chronic stressors can exacerbate what’s going on with PCOS, including the buildup of immature follicles in the ovary, infertility and cycle irregularity.
So what do we do about it? Let’s actually back up and talk about what we SHOULDN’T do about it:
And that finally brings us to how we can holistically address your PCOS picture through the lens of stress management and adrenal fatigue. These are the non-negotiables if you’re looking to get to the root:
Need more support? Take the first step in identifying your unique triggers for your PCOS and stress by scheduling a Discovery Call.
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