The role of naturopathic medicine in the management of women with polycystic ovary syndrome (PCOS)

Abstract

Polycystic ovary syndrome or PCOS was first described in 1935 by Irving F. Stein and Michael L. Leventhal as Stein Leventhal Syndrome; 'women with ovarian hyperthecosis presenting with persistent anovulation, obesity and hirsutism.' Today, PCOS is the most common reproductive endocrinopathy of women, the most common cause of ovarian infertility and the cause of significant distress. PCOS is associated with serious health risks in the short and long term including significantly increased risks for diabetes, cancer and cardiovascular disease, independent to body weight. For the health care system, the annual cost of PCOS in Australia was conservatively estimated as AU$400 million. The negative personal impact of PCOS on women's quality of life and self-esteem is well defined and recognised. Current evidence-based medical management emphasises a multidisciplinary approach with lifestyle intervention recommended as first-line treatment. However, the strength of evidence for lifestyle intervention is limited by high attrition in RCTs and the clinical uptake remains impeded by the lack of evidence for optimal dietary and exercise practices. Additional forms of management are often needed. Pharmaceuticals and surgery may be used to regulate menstruation, reduce androgens and treat infertility and hyperinsulinaemia however these have limited capacity to address the range of PCOS symptoms, are often contra-indicated due to increased risk of co-morbidities or have high adverse effect profiles. In addition, women with PCOS have expressed preferences for alternatives to birth control pills and fertility drugs. Naturopathy is a type of complementary medicine with traditional origins in ancient western civilisations. Naturopaths could be described as complementary 'general practitioners' as they provide health care for a wide range of conditions using a variety of treatment modalities to enhance well-being and support the natural healing capabilities of the body. The case for naturopathy for PCOS is presented here based on three rationales; first on the basis of a clinical gap in medical management; second based on the clinical potential for naturopathic herbal medicine and nutritional supplements in women's reproductive pathology, and third based on the increasingly high use and acceptability of complementary medicines by women throughout the world.

Date of Award	2015
Original language	English