26 May Food & lifestyle considerations for PCOS & Hirsutism
Besides keeping tweezers in eeeeeevery bag and coat pocket, I literally didn’t know what to do with all these thick, dark hairs that were covering my chest and my chin.
And even after a good plucking, there’d always be those that would grow exponentially in the handful of minutes it would take for me to leave the bright lights of my bathroom and arrive at whatever social gathering was on the cards for that day or night. (If you know, you know.)
But what on actual earth was going on? What was with all the hair?!
Well, first up and as more of a side note, I do want to acknowledge how abnormal hair growth (also known as hirsutism) can be one of the more shame-inducing PCOS symptoms. And I get it – I hand on heart absolutely do. But if you’re experiencing any shame as the result of abnormal hair growth (or any PCOS symptom for that matter), let’s just hold up right there.
You are worthy, regardless of what is going on with your PCOS symptoms, excess hair and all. You are worthy, regardless. You are absolutely 100% hands down more than enough.
Except, I know firsthand how flippen hard it is to get behind that belief when you’re the one dealing with not only the excess hair, but also the long & irregular cycles, the angry acne, the fatigue, and in some instances, the weight that just. won’t. shift.
And this is why, when I work with 1:1 clients, that’s where we start: I meet you in everything that your symptoms are, give space for how they’re making you feel (shame and all) AND, at the same time, I help you to see & believe *for yourself* that absolutely nothing can add to, or take away from, your innate worth.
Because when we do that, instead of having your worth be defined by or dependent on your PCOS symptoms, or the lack thereof?
Not only can you see your symptoms as things you can do something about – things that you have a REALLY BIG say in – but you can also make space to hear, and really listen to, what your body is trying to communicate to you through them.
Back to the what’s going on with PCOS and all the abnormal hair growth
Our entire bodies are covered in hair, with the exception of our palms, soles and lips.
But not all hair is created equal.
There are three types of hair that differ in follicle size:
- Lanugo Hair which is what new born kiddos are often covered in.
- Villus Hair which is the soft, short, un-pigmented hair.
- Terminal Hair which is the thicker, pigmented hair found on our scalps, beard area (men), eyebrows, eye lashes, genitals, under our arms, and on our limbs.
In the case of hirsutism, what ends up happening is that the villus hairs are converted to terminal hairs.
And the thing that’s driving that?
Our dear familiar friends (?), the androgens.
What’s behind increasing those? Chronic inflammation and/or insulin resistance.
But the reason that we don’t turn into Cousin It, is because this only happens in areas that are actually sensitive to these hormones, including on our upper lips, chins, necks, chests, lower bellies, bikini areas and backs.
Given that hirsutism varies in severity, using a Ferriman-Gallwey chart to score and keep track, is recommended and can be done together with your trusted health care provider. This also highlights too that with hirsutism we’re not talking just one or two thicker, darker hairs.
So, in summary: high androgens (driven by chronic inflammation and/or insulin resistance) cause villus hairs to convert to the thicker, darker terminal hairs.
What does insulin resistance have to do with hirsutism though?
Remember, insulin is the hormone that helps the cells in our body bring in something called glucose, which they then use to make energy. Insulin resistance is when this process happens less efficiently (and can be because of a number of reasons). As a result, we end up with a whole heap of excess insulin which then causes the ovaries to produce higher levels of androgens and ultimately, those hairs then become thicker and darker.
One of SHBG’s roles is to transport hormones around the body, like a bus. When there are enough (but not too many) buses, all is well. But, when there aren’t enough buses (i.e. SHBG is low owing to high insulin), our sex hormones are left to run wild, and can cause havoc in the process.
High insulin can also stimulate the production of an enzyme called 5-alpha-reductase; 5-alpha-reductase converts testosterone to its more potent form: dihydrotestosterone (DHT) which then can translate into the excess hair.
As you can see, high insulin/insulin resistance is a major contributor to hirsutism in PCOS. And given that approximately 75% of women with PCOS have insulin resistance (even when of a ‘leaner’ build), it’s so essential to push further upstream to understand what’s causing this to begin with.
Things that can cause/contribute to insulin resistance include everything from inadequate sleep, psychological stress, digestive issues, eating frequency & timings and/or consuming certain foods that may cause your individual blood sugar levels to spike (to name just a few).
As you see from this, it’s about taking a multi-factorial approach in addressing insulin resistance (and therefore PCOS, and associated symptoms such as hirsutism). When we know this, we can be way more gentle with ourselves on our PCOS journey, invest in the support we need and be patient with the process.
What about the role of inflammation in Hirsutism?
Although not fully understood, research suggests that PCOS in and of itself is associated with longterm low-grade inflammation (that might not show up in blood test results).
Remember, in the short term, we’re all about inflammation: it’s our body’s natural way of protecting herself through activating the immune system. You’ve experienced inflammation as the redness, heat and tenderness after stubbing your toe or getting a paper cut. But chronically (or longterm), it’s not our favourite because it interferes with hormonal communication throughout the body.
Other signs of inflammation include fatigue; skin conditions such as eczema, acne or psoriasis; sore joints; allergies or histamine intolerance.
And inflammation is thought to stimulate androgen production, independently of insulin resistance.
So just as we did with with insulin resistance, we want to push further upstream to understand what’s actually causing the inflammation in the first place. This can range from imbalances within your gut bacteria; high emotional or psychological stress; inappropriate exercise; food sensitivities and/or exposure to environmental toxins (naming but a few). Again, underscoring and highlighting the importance of taking a multifactorial approach in addressing the upstream causes contributing to hirsutism.
What can we do for Hirsutism?
Beyond laser treatments and stocking up on tweezers ’til actual kingdom come, what are our options for doing something meaningful about aaaaallll the hair?
Below, I’m going to offer some food & lifestyle considerations for hirsutism, but as always, consult your trusted healthcare provider before making any changes 🙂
First and foremost, put on your patient pants.
Hirsutism is one of the slowest PCOS symptoms to shift. Even once you have all the ‘necessary’ things in place to address what’s causing the abnormal growth to begin with, it can often take up to twelve months to see an improvement.
I know! Twelve months sounds like a very long time! And it is, but at least through knowing this from the get go, we don’t then get all up in our body’s grill, frustrated and despondent.
Something else that’s really helpful when you’re making food & lifestyle changes to reverse your hirsutism but you can’t yet see the benefit? (So it’s all a bit uncomfy & stretching & really easy to call it quits because WHY ISN’T THIS WORKING ALREADY?!)
Having a ‘wins book’ where you write down everything that IS working.
This way, you’ll:
- Be in awe of all the meaningful changes you are making & how incredibly well your body is responding (regardless of how small).
- Be able to take consistent action from the place you want to be rather than the place you are presently in (this is KEY).
Secondly (and as always) make sure that you have a solid foundation in place to address both Insulin Resistance & Inflammation
As we already know from above, there are a large number of factors that can cause & contribute to inflammation and/or insulin resistance, and therefore trigger an increase in androgens and subsequent hirsutism.
But while you journey to figure out the reasons behind either your inflammation and/or insulin resistance?
We cannot overlook the seemingly simple – the things that I call “foundational”.
Imagine you were building a house, you wouldn’t choose the furniture before you had rooms to put it in.
And even before the rooms, you’d not only start with the foundation, but you’d also want to make sure that it was as solid as possible.
It’s not that the furniture or the rooms themselves are “bad”, it’s simply that the setting up the foundation is the very first step of the process.
And the same applies with your PCOS and hirsutism.
More comprehensive testing to understand your individual picture, and the use of individualised supplements, can be compared to the furniture in the analogy above: they have their role and they play their part.
But instead of starting here and grasping at test results, or chasing silver bullet solutions (often in the form of supplements and ‘superfoods’)?
Begin with your foundation.
Your foundation consists of food AND lifestyle factors & behaviours that are going to be beneficial regardless of what comes back in test results.
Not only that, but having these in place will also ensure that you’re waaaaay better set up for addressing whatever does come back in more comprehensive testing. A solid foundation also ensures that your body is much more able to make use of individualised, indicated nutrients & supplements too.
When I support my 1:1 PCOS clients, these foundational factors get personalised to where they at are on their individual PCOS journey.
Below are various foundational factors that you can begin to implement right now – and in varying degrees, they all play a role in improving insulin resistance, and lessening inflammation, so as to reverse PCOS hirsutism.
Balance your blood sugar
This can be done by focusing on what and when you eat. To begin with, you’d want to ensure that you have an adequate intake of protein in each meal; that healthy fats (such as olive oil, avocados, oily fish) are included in each meal; and then adjust carbohydrate quality & quantity based on your individual symptoms after eating them – further blood-work may be necessary here. Also aim for about 4 hours between each meal, unless this causes you to get irritable & shaky – in which case, begin by including snacks (such as nuts & berries) more frequently and gradually increase the time between meals from there.
Optimise your food intake
Be sure to include a variety of colourful vegetables; bring in plenty of foods with anti-inflammatory & anti-oxidant properties such as turmeric, oily fish, berries, green tea. Opt for seasonal produce where possible and be adventurous with your choices if you can tolerate different foods taking a step back from more processed foods; being very aware of sugar intake even in its ‘natural’ forms as they often still contain a lot of fructose which can exacerbate insulin resistance when consumed in excess.
Prioritise optimal sleep
I wrote a whole other article about this – The role of sleep in reversing PCOS symptoms.
Create awareness around your individual stress triggers, how your individual body responds when triggered (shortness of breathing, tightening your shoulders, clenching your jaw etc) and then from a place of curiosity, finding ways that resonate with you to address these; (this could be anything from yoga to journaling, painting to gardening, hypnotherapy to aromatherapy – there is not one ‘right’ way).
Do appropriate movement for where you currently are in your life and what your own body is indicating that she can actually cope with – often that is very gentle yoga rather than a super intense exercise class.
Chew your food
Ultimately we’re aiming for 30+ chews/mouthful but before you get completely cutoff by that? Remember that this isn’t a journey of quantum leaps so see where your chewing is currently at and gradually increase the number of chew from there. There are so many benefits to chewing well from increasing nutrient absorption to reducing inflammation – all of which are beneficial in addressing upstream contributors to hirsutism.
As you can see, these foundational factors are not only about food – they’re multi-pronged – and they serve as a brilliant starting point to reversing PCOS symptoms such as hirsutism.
Specific Nutrient Considerations for hirsutism in PCOS
Alongside the above foundational factors, specific nutrients and interventions can be considered for hirsutism. These include:
Zinc is one of the best nutrients for hirsutism because it supports ovarian function and therefore optimises ovulation. Ovulation is how progesterone is produced – the sac that the egg was in becomes the corpus luteum which then secretes the progesterone – and progesterone is naturally androgen-lowering. Zinc also stops testosterone from converting into its more potent form, dihydrotestosterone (DHT); it does this by inhibiting the 5 alpha-reductase enzymes that allows for this conversion. Supplementation might be necessary in certain instances and should be done under the guidance of your trusted healthcare practitioner. Some food sources of zinc include good quality red meat, oysters, poultry, pumpkin seeds and chickpeas.
Preliminary studies indicate that 2 cups of spearmint tea/day had a beneficial impact in reducing testosterone levels. As highlighted in the article, the reason that this didn’t translate into physical improvements is because the study was too short given “relationship between androgen hormones and follicular hair growth and cell turnover time.” In additional to starting with the foundational factors above, including 2 cups of spearmint tea/day is an easy way to reduce androgen levels.
Another small study showed that 2 cups of marjoram tea/day had a beneficial impact in reducing adrenal androgen levels as well as improving insulin sensitivity. Easy to enjoy hot or cold!
The Marula Wellness Signature Programme for PCOS & Hirsutism
But what if you’re done with DIY-ing your way through hirsutism (and PCOS in general), and you want some truly epic support in using food & lifestyle factors to reverse your symptoms while taking a real root cause approach?
Do get in touch with yours truly to find out more about working together through the Marula Wellness Signature Programme.
Otherwise, you can also go right ahead and book yourself in for a 30 minute complimentary discovery call by clicking the button below. I’ll hear where you’re at and share how I can help through the Marula Wellness Signature Programme. You know I can’t wait!