Robyn Srigley: What Causes Hirsutism And How To Treat It #52

21 May 2020

Robyn Srigley Hirsutism #53

Robyn Srigley, The Hormone Diva, Holistic Nutritionist and Women’s Health and Nutrition Coach.
Robyn’s (@thehormonediva) own journey with Polycystic Ovarian Syndrome (PCOS) jumpstarted her passion for helping women replace their anxieties with joy to open possibility in their lives and break free of hormonal imbalance. Robyn runs a successful meal plan and group program practice where she uses diet, movement, botanicals and a self-love lifestyle to transform the lives of women with PCOS, Endometriosis, PMS, Painful Periods and much more. Robyn provides research-based evidence, valuable advice and answers questions women frequently ask in relation to PCOS and periods.

Today I welcome Robyn Srigley back to the podcast. Robyn was the first PCOS expert guest I had the honour of interviewing on the podcast back when I launched in 2018. So it was a pleasure to have her back on for a second time to discuss hirsutism which is a very popular topic in the PCOS community. So, if you suffer from PCOS hirsutism and are looking for ways to improve this symptom, this episode is for you.

Here is what you will find out in this episode:

  • What is hirsutism [00:07:37]
  • What causes the hirsutism in PCOS (the hormones involved) [00:09:02]
  • Other potential causes of hirsutism [00:24:00]
  • How to treat PCOS hirsutism [00:28:16]
  • Testosterone lowering foods for PCOS [00:32:50]
  • Foods to avoid for hormonal balance [00:35:49]
  • Supplements for PCOS hirsutism [00:42:52]
  • Topical treatment for hirsutism [00:46:40]
  • Do medications help PCOS hirsutism? [00:50:27]

 

Please enjoy!

You can find the transcript of this episode below.

Listen to the episode on Apple PodcastsSpotifyOvercast, or on your favorite podcast platform.

Want to hear the first time Robyn was on the podcast? — Listen to our conversation here. In that interview, Robyn talks all about regaining and regulating a healthy menstrual cycle. (Stream below or right-click here to download.)

Podcast Episode Sponsors

Huge thank you to our sponsors,

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I talk a lot about getting to the root cause of your PCOS on this podcast and hormonal testing is one of the most important ways of understanding your condition. Without testing your hormones, it is very difficult to know what type of PCOS you have.
Now, many women do not get the PCOS testing they need, whether it is because they're healthcare provider is not very supportive or because they purely do not have the time to visit their doctor. That is why I am excited to announce a new partnership with Let's Get Checked!

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Your health should never take a backseat!

Robyn Srigley: What Causes Hirsutism and How To Treat It

Despina Hello and welcome back to the podcast Robyn.

 

I'm so happy to have you back and to be recording another awesome and highly requested episode.

 

We recorded our first episode, I believe it was like a year and a half ago, I think it was episode seven.

 

You were the first guest I had on the podcast and we spoke about how to regulate, your cycle with PCOS and you gave some awesome tips in that episode. So I highly recommend you listen to that episode after listening to this one, of course.

 

But anyway, so since 2018, things have changed in your life. Good changes, like becoming a mom, which is an amazing thing, growing your Hormone Diva in a community and continuing to provide tons of amazing value and programs for the PCOS and Endometriosis community. Some of these programs that you've just started this January was a new program and you are continuing your PCOS boot camp.

 

So can you just share a little bit more about you and what you've been up to since the last time you were on the podcast? Just so I can find out more about you.

 

Robyn For sure.

 

Yeah. My life personally has changed completely since the last time we talked. I was living in a different place. So I've moved since then. I got pregnant, which was a surprise, but a totally welcome one. I had my son Ronan in June 2019. So he's a little over seven months now, which is crazy.

 

And the healing from that has been a long road. But I'm super excited to be kind of really back into my work now just in the last couple of months since late November, December. This is the end of January. And just really being able to get back in because this is the stuff that I love to do and it really fulfils me more than anything else.

 

And so I started off this year with my community doing the detox were on day two right now, actually it in December with my boot camp group as well. But day 2 headache, brain fog, tired, super irritable. But we're going to do this and it's going to be awesome.

 

And this year, I'm actually going to be transforming my boot camp program into the hormone diva society, which is going to be a membership, which is super exciting because like on these podcasts. Right. There's no end to the topics that we can talk about when it comes to balancing our hormones and sometimes short term programs, at least for me don't allow me to like really dive deep on some of the stuff that I want to. And so membership is coming in March, which is really exciting. I've been working on that for like a month now and I just can't wait. I'm so excited.

 

And the topics like what we're talking about today hirsutism is going to be a big part of that and what you can do with your hormones, with your food, supplements, all that good stuff in order to deal with these often embarrassing issues.

 

Despina Yeah, exactly.

 

So that's exciting. I'm so happy with all the good news and the new projects and just stuff that all creating in the background behind the scenes. It's exciting I can't wait to see all come to life.

 

But like you said, can we talk about hirsutism. So I guess we can just jump straight in and address like what is hirsutism? What causes it was the exact thing behind that symptom?

 

And then we'll just delve into what you can do about it further down in the interview.

 

So what is it?

 

Robyn Absolutely.

What is Hirsutim?

Hirsutism is excess hair growth essentially.

 

Typically in women this is going to show up on the face, usually the chin, jaw, line, neck than the mustache. And sometimes on other areas of the body, like the belly, excess hair, hair in the groin and pubic area, more than what would be considered, quote unquote, normal.

 

There is a scale that is used sometimes. Honestly, it's usually just used in the research to kind of assess whether things are working or not.

 

Your doctor typically isn't going to talk about the scale. I think it's the Ferriman-Gallwey, if I'm remembering correctly. And so basically it's just like, you know, where do you fit in there? How severe is it? And with PCOS, this is one of the main, you know, outward physical symptoms that we might be dealing with besides like acne or hair loss or weight gain, of which I've had all of the above. And there are some major hormonal stuff going on that's causing hirsutism in the first place.

 

And one thing I want to mention before I kind of dive in on that is you can have, quote unquote, normal levels of some of the hormones that we're going to talk about and still be getting these symptoms and still have those hormones be behind the symptoms, even though your labs are normal. We'll kind of talk about that a little bit.

Causes of Hirsutism

Insulin Resistance and PCOS

But the first thing that really needs to be looked at is insulin resistance. And this is a recurring theme with almost anything, any symptom of PCOS, insulin resistance being known underlying causative factor and that's in both lean and overweight women with PCOS.

 

There's it's kind of like a myth where if you're lean, you know, I don't have blood sugar problems, I'm not gaining weight. But that's absolutely not true.

There is this PCOS myth that if you're lean, so you don't have blood sugar problems, you are not gaining weight, you can't be insulin resistant. But that's absolutely not true.Click to Tweet
And insulin resistance when you have that, so that's to back up a little bit, insulin resistance is when your body is not recognizing the signals of insulin anymore.

 

Insulin is supposed to have like a key to open your cells so the sugar can get in, so that energy can be produce, your cells can function, so on and so forth.

 

But with insulin resistance and PCOS, it's almost like your cells have changed the locks and so the key that insulin has no longer works. And so you end up with weird levels of insulin, potentially high levels or like huge spikes and dips in your blood sugar. And this leads to miscommunication with your ovaries.

 

And so when this is happening, you're having insulin resistance. Insulin in your ovaries are like speaking different languages. Your ovaries begin to overproduce testosterone, which is an androgen hormone. It's sometimes thought of as like a male hormone. But in fact, in small amounts, we as women, we need this hormone. It's very beneficial.

 

But when we overproduce it as in PCOS, it can lead to things like hirsutism.

 

And it's important to realize, as I mentioned before, it's not all about what the number says on your lab tests because you can have what looks like totally normal levels of testosterone on your blood work. But if you are more sensitive to these hormones than other women, if you have issues with your androgen receptors or metabolism of these hormones, if you have exaggerated activity of an enzyme called five alpha reductase, all of these things might not show up on labs, but they'll still cause you to grow this excess hair.

 

And so here's the mechanism of how it works.

 

Insulin resistance and inflammation and also stress your adrenal glands play a part in this mean overproduction or increased production of these androgen hormones at the tissue site.

 

So in the case of hirsutism, that's our hair follicles right on the body. This creates prolonged growth phases of the hair. It causes the hair to grow in thicker and darker and it causes the hair to grow thicker. And so this is where you kind of get that lady beard happening or whatever, and you end up needing to shave all of the time. And when testosterone is converted into DHT, this is the form of testosterone that really matters for hirsutism. It's dihydrotestosterone or DHT. When this happens and all of that lovely hair growth stuff is going to be happening on your face and on your body.

 

So it's important not just to think about, you know, kind of talk about remedies, but not just to think about like popping a birth control pill or something to deal with this, but really taking a look at reducing that conversion of testosterone into DHT in order to get rid of these types of symptoms.

It's important not to just think about taking the birth control pill or something to deal with this, but really taking a look at reducing that conversion of testosterone into DHT in order to get rid of the PCOS symptoms.Click to Tweet

Despina Mm hmm. And the other thing with when you have insulin resistance or high insulin is that research also shows it can affect SHBG, Sex Hormone Binding Globulin, which attaches itself and takes that testosterone, free testosterone throughout the body.

 

That's another thing that women with PCOS struggle with is the SHBG levels. That's why it's important it be addressing the insulin resistance if that's what's causing your hirsutism.

 

So with regards to high cortisol or how does that how work?

 

Robyn With Sex Hormone Binding Globulin we tend to have lower levels of this, which means more testosterone ends up being free-floating in the body than it should. And it's that free testosterone, not the stuff that's bound and being used for other things that's converted into DHT via 5 alpha reductase. And then you get hirsutism.

PCOS women tend to have low levels of SHBG which means more testosterone ends up being free-floating in the body. It's that free testosterone that's converted into DHT via 5 alpha reductase causing hirsutism.Click to Tweet

Despina So to see all these other enzymes and hormones, often practitioners recommend the Dutch test, which shows you the in detail kind of hormonal stuff that's going on rather than just going to like a general practitioner, which just does the general testosterone and SHBG, if that and yeah, stuff like that really shows you where exactly the changes are going on, which is a good thing to do if somebody is interested in doing that.

 

So yeah. What are there any other particular causes that might be causing hirsutism, apart from insulin resistance? You said inflammation and stress.

 

Robyn Yes. So we can definitely talk about that a little bit.

 

So there's different PCOS types as those listening might be aware. I know that you talk about this quite a bit.

 

And so let's say insulin resistance isn't your main, you know, underlying causative factor of your symptoms, it may be inflammation, it may be a adrenal related.

Stress and PCOS

Adrenal PCOS is a huge one and it's often seen more in women who are moderate to lean versus very overweight or obese. And so what's happening there is instead of or in addition to your ovaries messing up hormone production, you're adrenals will do the same because your adrenal glands also produce sex hormones like testosterone, DHEA, which is another androgen hormone. They produce estrogen and progesterone in tiny amounts and they may take overproduction and after menopause as well when your ovaries are no longer functioning. And so it's really important to address adrenal function so that your body is not constantly stressed out in this state of like fight or flight constantly, because unfortunately, your body doesn't realize that your life is not actually in danger. Right.

 

This whole mechanism of fight or flight of stress response was developed because we used to have life threatening stresses all the time. Running away from predators, crazy weather and so on, like tens of thousands of years ago, like this is a long, long time ago.

 

But this mechanism has not evolved with us to our modern lifestyles, where now we have just stress coming at us all the time. And regardless of what the stress is, whether it's physical trauma, you know, you break a toe, whether it's financial stress, family stress, work stress, whether it's, you know, road rage, whatever. Right. There's all kinds of different stress out there.

 

Your body is still going to have that same reaction where your body's like, oh, my gosh, something's happening. We are in danger. Stress response, let's go. And they're going to secrete all kinds of stress hormones, like cortisol is kind of a big one a lot of people have heard of. And when this happens and you end up with more insulin resistance because your body needs more sugar to deal with the perceived threat, you're gonna end up with higher levels of inflammation and you're going to end up with those hormones like testosterone and other androgens being produced in the wrong amounts at wrong times.

 

And so managing stress is incredibly critical for dealing with not just hirsutism, but honestly almost any symptom of PCOS.

 

Like when I was first on my journey, one of the big things that I dealt with was irregular cycles. And I worked on my insulin, you know, I kind of had the diet where I was like, yeah, this seems to be helping a little bit, my cycles went from every three to four months to every two to three months and I was like, this is great.

 

But it seemed to plateau and I could never get it below that point. And it wasn't until I started focusing heavily on my stress and supporting my adrenals that I was able to regulate my cycles and it will also have major effects on androgen production and the symptoms like hirsutism, acne and hair loss, for example.

 

So really important to pay attention to stress. And I think more than anything, this is an area that most women are not addressing with any regularity at least they might be like, oh yeah, once a month they go for a massage or whatever. Once a month I scream into a pillow, you know, or whatever it is.

 

But it needs to be a regular, consistent thing, just like your diet. Right. And so that's a huge component of that.

Inflammation and PCOS

And then there's the inflammation part of the spectrum, which in PCOS there's often low grade chronic inflammation in all of us. And unfortunately, that's another thing that doctors typically are not testing for. They're going to test your sex hormones, testosterone, estrogen, progesterone. That's fantastic. They might even test your blood sugar, but they're not typically testing for inflammation using something like C-reactive protein, CRP.

Women with PCOS often suffer from low grade chronic inflammation.Click to Tweet

And if you have this inflammation, this one makes insulin resistance worse to puts your body or keeps your body in that state of stress, that kind of fight or flight that we've been talking about and so, again, you end up with weird stuff happening with your androgens, higher conversion of testosterone to DHT and then you get the hair follicles, which are growing and thicker, faster there in the growth phase longer. And so on and so forth. And so you can see kind of like everything is connected.

 

Insulin resistance is a stress on the body, makes the adrenals worse as is inflammation.

 

Inflammation makes insulin resistance worse. Stress requires more sugar, so you end up with more insulin resistance, and that's inflammatory. So you get more inflammation. It's just kind of back and forth in this huge, vicious cycle that needs to be addressed in order to really get a true handle on something like hirsutism versus just, you know, waxing every two weeks for the rest of your life or shaving every day.

 

Despina Mm hmm. Exactly.

 

It's really important to be addressing all of these root causes because like you said, it could be a mix of all three or just two or just whatever it is. You know, waxing or whatever you personally do doesn't really address that problem. And you're just going to be doing it for the rest of your life.

 

But yeah, like you said, the whole thing with adrenal PCOS and high cortisol, it's something I feel like everyone's just like experiencing.

 

I feel we really need, this is like one of the fundamental things you have to be addressing because I feel like when you've just been diagnosed with PCOS the doctors like lose weight and then you end up like Google search and how do you like, how do I lose weight? Or you just go on a low calorie diet and then that is a stressor and then you over exercise, that's another stressor. Which also causes, inflammation. And then you go over consuming caffeine because you need that energy to help with your fatigue and makes just more stress and all the stresses that builds up.

 

So it's just that's really important to understand that all these stresses are not just like a stress, that you just got an exam or you're sitting in traffic or your bosses being a annoying person and that's causing you stress.

 

So when we go through all this stress, these male hormones are basically increasing to essentially that predict protect us from this high damaging levels of cortisol so that people think the androgens are the bad thing. But in a way that kind of like protecting you from high cortisol, which is really bad.

 

But like you said, we just we need to be addressing the root causes. So working with a professional to address that and just delving into that.

 

Yeah. Is there anything else you want to address about the possible causes or anything before we move on.

 

Robyn I think there's one last thing to add to our stress conversation is that women with PCOS in general already have issues with cortisol and adrenal stuff without any other stress that might be happening in our lives or to our bodies. We just have that. It's kind of a baseline, just like we have as a baseline, kind of low grade chronic inflammation. And so it's extra extra important for us to deal with this stress. And it's honestly not even about stress reduction because there's always going to be stress, you know.

 

There's sometimes we can get away from stressful situations. Like I have some clients who are like, yeah, my job is the main source. We switch jobs or whatever. But regardless, right. There's always gonna be something come up in your life that's stressful. It's much more in how you manage it and how consistent you are in managing that and where you're going to end up seeing changes in your hormone levels if you're getting any kind of lab tests. And then, of course, in your symptoms.

There's always gonna be something come up in your life that's stressful. It's much more in how you manage it and how consistent you are in managing that.Click to Tweet
Despina Exactly. That's very true.

 

It's easier said than done. Just do this thing with stress, stressful go down because stress really is everywhere. And some people take it a lot easier than others. But it's just about being consistent, like you said, and just everyday, just trying to stuff to just manage it a little bit better so it doesn't effect you as much and then eventually it just becomes, I guess, easier to manage.

 

Robyn Yeah, it's a habit, right?

 

It's like anything just developing a habit. Just the stress management, the self care, the whatever you want to call it is just part of your life, like brushing your teeth, like eating dinner, like going to the bathroom or whatever. It just becomes habit eventually. But it's a matter of finding things that actually help you and you enjoy and doing them, actually doing them.

Despina Exactly.

 

Before we move on to possible ways to treat. Is there any other possible causes apart from what we mentioned and PCOS that can be causing hirsutism? So like some people might not have PCOS, but they have hirsutism are there any other possible explanations?

 

Robyn Yeah, for sure.

Other Potential Causes of Hirsutism

So I mean, it's all hormones, right, whether you have that PCOS diagnosis or not. Sometimes this can be seen in women with adrenal problems that affect their periods and their hormones without PCOS at all. And that can often result in like amenorrhea. So not getting your period at all. It can result in the increased production of these androgen hormones like testosterone, DHEA through the adrenals. And so again, right. More adrenal stuff.

 

There's also brain issues, right? Because all of the hormones that are being produced in your body are doing so because they've been signalled to do that by your brain. And so sometimes there's like pituitary issues, which is kind of like the master gland that that tells everything else what to do in terms of hormone production. And some women will have pituitary issues or hypothalamus issues. The hypothalamus in the brain to maybe a little bit of tumors or other things not functioning properly.

 

But those are things that definitely require like more testing, more scans and potentially a specialist like an endocrinologist, something like that in order to be diagnosed.

 

How To Treat PCOS Hirsutism

Robyn When it comes to the physical symptoms, hirsutism, acne, hair loss, I'm all about a dual approach, internal and topical.

 

It doesn't matter how often you wax your face or you shave your face or whatever. If you're not doing anything internally to deal with the symptoms and the hair is just going to keep growing back in, it is what it is. And if you want to just shave your face forever, then that's fine.

 

But I think most people are on listening to this because they want a different way to get rid of it on a more permanent basis. Or even like imagine give your someone who has to shave on a daily basis. Imagine what it would be like for your life to only have to do that half the time, even every other day or once a week or maybe waxing, you know, I've had some clients are like I wax and seven days later already it's coming out. What if that lasted you a month. Right. And so even slowing the process of the hair growth can be incredibly helpful.

 

But the majority of that change comes from working on your body internally versus what you're doing externally. But I definitely want to talk about both because I think both are important.

So if we start with internal right, the focus has to be on the things that we discussed, the insulin resistance, the inflammation and the stress and the ways that you can do that will vary from person to person. But typically, right. The diet that you have, the food that you're eating. And of course, the amount that you're eating, we talked a lot, you mentioned calorie restriction already as kind of being a stress and not so great, but your food, there are supplements that can help as well. And then all of that stress management piece.

 

So maybe we'll start with the foods a little bit in order to deal with that.

 

So for inflammation and insulin resistance and the stress, it's really important to eat enough fats. This is critical. So many women for years and years have done low fat diets. I've done it as well because I thought that's what you do, right? Fats are bad. Fats give you heart disease, that's give you diabetes. Fats make you fat, whatever. It's absolutely untrue. If you're thinking about healthy fats and one of the things that I notice for the women that I work with privately or those I worked with in my boot camp in the past, when I look at their food diaries, they're like, oh, my gosh, I eat so clean. Why am I not seeing results that I want to see? And so I look at their food diaries and the one thing that stands out to me, ninety nine percent of the time is that there's not enough fats.

 

They will be like, oh, I'm having chicken and salad or whatever. Well, where's your fats? I'm having, you know, a smoothie with banana and spinach and protein powder. Well, where's your fats? Right.

 

Fats are the only macro nutrient out of fats, protein and carbs that have no effect on increasing insulin or blood sugar. Protein does to a small extent and then of carbs and do every time, the more processed, the more of that spike of sugar that you're going to see in your blood levels. But facts don't have that effect. And the more fats you eat, the less insulin that your body needs and the more you're able to become re sensitized to that insulin. So you can get rid of that resistance piece happening.

 

And so I'm always telling them, you know, how fats with every single meal and snack every time you eat. There needs to be a healthy source of fat and probably more than you think. Right. It's not just, you know, a teaspoon of olive oil you use to saute your vegetables, and it needs to be more than that. And so that's really critical.

 

Some healthy sources of fats. Some of my favorites for PCOS, avocados, nuts and seeds, especially chia seeds, hemp seeds, flax seeds, walnuts are fantastic. Brazil, nuts, fatty fish like salmon, mackerel, sardines, anchovies, meats that have fat with them.

 

So like a chicken thigh has more fat than a boneless skinless chicken breast or eating the skin or having beef, not extra lean ground beef, but maybe medium or lean or something like that so that you get more fat in there as well as olives and olive oil, coconut products like full fat coconut milk from the canned coconut oil, coconut shreds, whatever. Right.

 

There's no end to the sources of good fats that you can include in your diet, and it needs to be there every single time you eat. So that's number one in terms of food.

 

Testosterone Lowering Foods for PCOS

The second thing when it comes to food is eating foods that have specific nutrients in them that have been shown to help with androgen levels. So there's a few that I'll touch on here.

 

First one is omega 3s. These are sometimes used in fish oil supplements, so that's where a lot of people have heard of of omega 3s before. And typically we tend to have more of the omega 6 and omega 9, then omega 3. And those 6 and 9 are much more inflammatory than 3. So we need to make sure we're including a lot of omega 3 sources. And most of those fats I was mentioning are the omega 3s, chia and hemp seeds and walnuts and fatty fish in particular. And official supplements certainly never hurt anyone, but you definitely can't supplement about diet. So eat these foods, Google it Omega 3 foods. Put them in your diet. Really, really important. This is helpful for inflammation. It's helpful for stress response in the body. It's helpful for insulin resistance and it lowers androgen levels. So those foods are really important.

 

Second food type, nutrient type is zinc. Zinc is a mineral that often women are deficient in, especially if there's hormonal imbalances. And so getting sources of zinc can help to balance out androgen levels. Beef, lamb, sesame and pumpkin seeds, lentils, cashews. Again, Google it. Get on the Internet. Find some zinc foods. Get those into your diet. Really, really critical.

 

And then magnesium, another mineral. Magnesium is used in over 300 different ways in the body. I mean, it's so powerful and we are so deficient in this mineral. So leafy greens, pumpkin and sesame seeds again. Black beans and any kind of legumes really will have a good amount of magnesium in them. Oats as well. Fantastic for magnesium and also adrenals and stress response and calming that in the body. So getting those magnesium foods in.

 

And then any foods that are high in antioxidants, anything that's going to help to reduce inflammation in the body is going to help with all of these kind of hormonal patterns that we discussed before. So the more colorful the food likely the higher and antioxidants, it's going to be. Berries, leafy greens, carrots and sweet potato, the kind of orange family as well as alliums. So onions and garlic really, really high in antioxidants and green tea. Green tea has also been researched and shown to be fantastic for reducing androgens as well. And just being good for hormones in general.

 

So those are kind of the main foods that you can be adding in omega 3s, zinc, magnesium and antioxidant foods really critical to kind of get those in.

 

Foods to Avoid for Hormonal Balance

And then. Right. We've talked about what to include, what about what to avoid in terms of diet, inflammatory foods, processed oils, any oil that you buy to cook with that's clear or almost clear on a shelf is typically going to be a processed oil, depending on where you live, that might be whatever they call, quote unquote, vegetable oil, cotton seed oil, canola oil, sunflower oil, safflower oil, peanut oil, corn oil, you name it. If it's like, or yellowish clear, it's processed, it's inflammatory and it's going to wreak havoc on your hormones and your hirsutism.

Any oil that's yellowish clear or almost clear is typically processed, inflammatory and is going to wreak havoc on your hormones. These include vegetable oil, cotton seed, canola, sunflower oil, safflower, peanut, corn oil.Click to Tweet

Another food is dairy. Unfortunately, sorry for my cheese addicts out there. But dairy is a big, big one. It has a huge impact on your insulin resistance. And it's not the lactose, which I think is like a miscommunication. A lot of people like, well, I have lactose free milk. Like, what's the big deal? It's not actually the lactose. It's one of the proteins called A1 casein. And it actually is kind of like an opiate, acts like an opiate. So that's why dairy is super addictive. And people were like, I can't give up cheese. I can't give up cheese. You can give up cheese. It's not tough I promise, you can do it.

 

But dairy, the A1 casein messes with insulin sensitivity in the body and is highly inflammatory. And most women with PCOS do well eliminating dairy for a period of time and then testing it.  If you do okay with small amounts of organic dairy or cow or goat or sheep dairy instead of cow dairy because they don't have that A1 casein as much might be better option for you. But you only know by doing a complete elimination and then trying it in small amounts.

 

Despina Mm hmm. Yeah. Great tips there. And I just. Let's backtrack to the fats bit.

 

I just want to point out that obviously we know keto diet, is a high fat diet. Everyone in the PCOS community at one point tried the keto diet. And I just want to say, it's the fat that people eat on the keto diet that basically help with is why they kind of feel better with their symptoms.

 

But on the other kind of like a spectrum with Keto diet is obviously you are eliminating carbs that helps with insulin resistance. What would happen if you actually reintroduce the carbs? It hasn't exactly helped. So rather than following a keto diet or cutting your carbs just kind I feel like people just have to go back to basics and just not be thinking about oh I have to follow the keto diet, oh I have to go on a vegan diet, or follow this diet and that diet.

 

Literally go and start from basics. Just follow whole food diet. Get all these natural whole foods and colorful foods put them on your plate and just experiment with different meals and recipes and yeah, just it's just stuff like that sometimes you just think, you really don't have to delve into these different diets and just stock up on all these nutrients and food because there is no best diet for like PCOS.

 

You just have to find what works for you. And yeah, that's just one of the big things I want to touch on.

 

And another good tea that was well, I guess it's not like certain. There's like been research into it, but Spearmint teas and other good one that they say is and anti androgenic. So people can add that to their little grocery list.

 

But more so. Yeah dairy is another one I think. Just choose a maybe goat or sheeps milk, like you mentioned that have A2 casein in a not the A1 which has been shown to cause people to not be consuming cows milk, just maybe choose those ones and see how you feel if your body kind of respond better.

 

But yeah, those are some great tips. And you know, I just think people just have to stop overwhelming themselves with what they read online about avoiding this and avoiding just so much food and just obviously avoid the foods that are highly inflammatory like processed foods, everyone knows all that stuff.

 

We just have to implement it at the end day. Everyone knows all this stuff. It's just that thing that. I don't want to stop eating bread. Well, I have some other kind of stuff that are inflammatory and just end up just doing it if you want to see the improvements in the same time in the day.

 

Robyn Absolutely.

 

It's so important because it's not even so much how many different things you avoid, but the intention behind the foods that you include. That's really key. And that's where a lot of the labeled diets like Keto fail you because they're much more about what you avoid. Avoid carbs. Don't go over whatever it is, twenty five grams of carbs a day and then it's almost eating disorder territory. And women with PCOS already struggle with this in huge numbers. So absolutely focus on the things that you're including.

And one more note on the keto diet, honestly, it's a stress on the body. And typically if you see results in the beginning, the longer that you use it, the worse you're gonna end up feeling. And this is the pattern that I see all the time that we like. Oh yeah, in the first few weeks I felt fantastic. I lost 10 pounds, whatever. I got a period etc and so on and so forth. And then it's like three months in and they're like, why is all my weight come back? Where did my period go? Why am I so angry all the time? I can't sleep at night and it's because you're avoiding, but not including the right things.

 

And diets like Keto will also prevent you from being really varied in the types of foods that you're eating to get enough nutrition. So if you don't have enough carbs in your day to have like black beans, which are full of magnesium or a friggin sweet potato, which is like one of the most amazing things in the world, then you're really missing out on all of the benefits that those kind of foods have for you simply because they're quote-unquote too high and carbs.

 

But I'm glad you mentioned the spearmint tea actually had that on my list to talk about in terms of like supplements. Maybe we want to dove into some supplements a little bit?

 

Despina Yeah, and that's why I'll point out that you mention that obviously on the keto diet, you know, you are not eating carbs. So you are not getting that much fiber and research shows that when with PCOS have less diverse gut bacteria.

 

So, I mean, you feed your good gut bacteria with fiber. So, you have to give it the stuff it needs to thrive because an unhealthy gut can affect your immune system, your mood and your digestion all this stuff. It really needs to be addressed and just be focusing on supporting your body and nourishing your body.

 

Let's just move on to some of the other supplements and other ways to help.

 

Robyn Definitely.

Supplements for PCOS Hirsutism

So the spearmint tea that you mentioned in the research is two cups a day and it works on that 5 alpha reductase enzyme that we talked about. So it's really reducing the conversion of testosterone to DHT, which is fantastic for a lot of women it works really well and that can be a really easy thing to add to your daily routine or to add in as a habit, just two cups of that a day is fantastic.

Research shows 2 cups a day of spearmint tea helps to reduce the conversion of testosterone to DHT, by working on the 5 alpha reductase enzyme.Click to Tweet

But there's a couple of other supplements. There's two other ones I thought we could touch on a little bit that are helpful and have lots of research to back them up in terms of their ability to help with PCOS in general, to help with the insulin resistance, inflammation aspect of what we've been talking about and reducing those androgens.

 

The first one is inositol, which is kinda sorta technically a B vitamin. In the research there's two forms that have been shown helpful and PCOS, Myo and D Chiro inositol.

 

But your body needs these in a very specific ratio. And there's one company and I know you love it too, called Theralogix'ss that makes a product called Ovasitol which basically combines both forms of inositol in the ratio 40:1 that your body requires in a super easy to use powder that you just mix in to water, whatever. I have mine mixed into my my big jar of water right here and you don't taste it or anything like that. It's really easy to use and it has fantastic research for dealing with androgens, insulin, regulating menstrual cycles, helping with fertility as well. So this is a really good supplement to have to take in addition to any kind of diet stuff that you're doing.

 

And then the second one that I thought we should mention is N-Acetyl Cysteine or NAC. This is one that, typically women with PCOS who've done their own Googling and research are taking if they are, it's probably because it's been recommended to them by a practitioner, someone like us or naturopath or whatever. But this is a fantastic one for PCOS. It's highly anti-inflammatory. It helps to support the liver as well so that you can metabolize hormones better. It's really great for insulin resistance, which we know is a huge component behind hirsutism and also really great at reducing androgen levels like Ovasitol helping with ovulation, menstrual cycle regularity and all of that. And when it comes to NAC, you want about 600 milligrams three times a day, that's what's been used in the research. Although I have had some clients have some success doing 900 milligrams twice a day. But the idea is like eight hundred milligrams a day in divided doses when you're using the NAC.

 

Despina Yeah and I wanted to mention that the most recent blog post to have his own noted noted how in the benefit show, if anyone wants to find out more about these benefits and how they can actually help with insulin resistance and infertility and other symptoms of PCOS, I will have it linked in the show notes.

 

Yeah, because there is a lot of research done into Inositol. Both the most popular ones, Myo and D-Chiro for insulin resistance. Women are not converting enough Myo to D-Chrio or they are excreting too much D-Chrio. So yeah, supplementing with with either Myo or just both can really help insulin resistance and increase your sensitivity. Yeah, those are those are really the most popular supplements as well.

 

Is there anything else that we shouldd touch on or? Any piece of advice of anything else that has come to your mind?

 

Robyn For sure.

 

So we've talked a lot about the internal stuff, but maybe we can just really briefly touch on the topical because I'm certainly not like an expert on like laser and electrolysis and stuff, but I think it's worth mentioning a little bit that there are some topical solutions that can help either short term or in a longer term, like laser hair removal. And there's even at home devices that you can purchase to do this at home.

 

So the one that I have for the laser is called Tria (T.R I.A.) and they have an at home laser that's super easy to use. However, when it comes to laser hair removal and also electrolysis. Your skin type and hair type matters. And these treatments tend to work best on those with lighter skin and darker, coarser, thicker hair.

 

So if you are someone let's say I've had some clients who are like they have blond hair and light skin and they have the hirsutism but when it grows in, it's very light colored hair. This doesn't work so well for the laser. Or if you have dark skin and dark hair, it doesn't tend to work as well.

 

So if you're gonna get an at home device like Tria, definitely best to kind of read on their website, all the answers to that, whether you're a good candidate or talk to one of their customer service people, or if you go to a practitioner who does laser hair removal or electrolysis, they'll be able to look at your hirsutism, and say whether you're a good candidate for that, because those are pricier and more invasive strategies to dealing with this than simply doing the internal stuff.

 

And then there is waxing, shaving, plucking, all of which can cause damage to your skin over time. A lot of women will end up with like razor bumps from shaving all of it all the time. And so even though you've gotten rid of the hair, you know, you're still embarrassed and lack confidence because you've got bumps all over or from shaving all the time and different things like that.

 

So it's definitely worth seeing someone who specializes in the topical to be able to tell you what the best treatments are for you. And there's even things like essential oils that can be helpful.

 

Again, I'm not an expert in this, but there are some like spearmint essential oil or peppermint, lavender and tea tree have all been shown to be helpful in dealing with this, but it doesn't matter how many oils you slather on your face. If your diet sucks and you don't have, you know, a couple of really targeted supplements in your regime, then you're not going to see the difference in the hirsutism that you really want to see.

 

Despina Yeah, I agree it's important to trying all this stuff, but obviously reading the recommendations, if it's for your skin tone or whatever the recommendations are.

 

Just wanted to point out what if when you go to a doctor and you're saying that you're experiencing hirsutism and they recommend a medication that obviously that, you know, the birth control pill was a common recommendation or Spironolactone. What would you say to all listeners who are who have been recommended this? Or have seen it online. I'm thinking of asking for medication. Does this kind of stuff help PCOS and hormones and the symptoms? Or?

 

Robyn Great question.

Do Medications Help PCOS Hirsutism?

These things can seem to be helping. And your doctor will tell you it will quote unquote, flip or cure or balance your hormones under 100 percent untrue.

 

What those things are doing is give, especially in terms of birth control, is giving your body synthetic hormones, which mask the real stuff that's going on. And when you take these medications, if you see some women see no difference, some see an improvement, some see a worsening of their symptoms.

 

But let's say you did see a small improvement. It can be difficult to come off those medications without a massive flare up of the symptoms that you had that led you to decide to take these medications in the first place.

 

I have a lot of clients come to me more like I'm on birth control. I've been using Spironolactone or maybe even metformin is sometimes given to help with these issues because of the blood sugar piece and they are like I don't want to be on it, I have side effects from it. I know it's not good for me, but I am scared to death of coming off of it because I don't want my beard coming back. I don't want my acne coming back. I don't want to go back to irregular cycles or prolonged bleeding or whatever it is. Right.

 

And so it's very difficult. And when they come off of it, they often have that flare up. It's almost like a second puberty at times the way that things come up. And so if you are not on those medications now, but you've been considering them in most cases, I highly recommend not doing it if you have a targeted plan in place to use your diet supplements, stress management to deal with this issue.

 

Yes. It may not fix it as quickly as these medications might seem to, but in the long run, these medications truly fix nothing. And unfortunately, these are not things that you want to be or can be on for the rest of your life. And when you come off them, it can be an absolute nightmare.

 

So whether you deal with this now, naturally, through some of the things that we were discussing or you take the meds and you end up having to deal with it later, it still has to be dealt with at some point. Right. Or you just have to keep living with the symptoms that you have. And so definitely I'm not a fan of these medications. I've seen a lot of women really struggle. And often become very anxious and moody when they stop using these medications, even in addition to the flare up of hirsutism or acne or anything else that might come.

 

So while it seems like a really easy fix in the long term, it is not a fix at all. And you will just end up having to deal with this at some point. Just face it now and deal with it. And it will save you a lot of time and heartache in the future.

 

Despina Yeah, unfortunately, it's no quick fix or a magic cure because I feel like we've all been there when the doctors suggest the pill. For me, the birth control pill is going to fix your PCOS. I was like, you know, just give it to me like easy, I'll take it, give me all the pills.

 

But it doesn't work. It just makes stuff worse. It's just a Band-Aid on the problem. At the end of the day like you said you have to address the problem.

 

If you take the pill and you see the symptoms improve, like it hasn't fully addressed it and at the end of the day, you're going to have to address it. So you might as well just address it now and just get it over and done with rather than having to deal with it later.

 

Robyn Well, like, can I address this while I'm on those medications? And you can support your health at any time, regardless of whether you're on meds or not.

 

However, you cannot truly reverse this or deal with the underlying causes while you're on the meds.

 

Yeah, you can support yourself. So maybe you have like less side effects from these medications or you kind of prepare your lifestyle to wean off these medications or whatever your choice happens to be. But you can not take medications like birth control, like metformin, like spironolactone, and also fix the underlying root causes. You just can't do both at the same time.

 

Despina Yeah. We can't expect just to take the pills and not be addressing our diet or exercise or stress and just expect that the pills would just come in and fix everything on their own without changing anything. Unfortunately, stuff doesn't work like that.

 

But yeah, if you're going to take the pills, make sure that you're taking a holistic approach. And then coming off the pill, whatever you're on, if you're a pill.

 

But yeah, I think we've covered quite a bit of stuff and some really great tips. A valuable episode once again.

 

What final piece of what what's your biggest tip or your final piece of advice that you would give our listeners who are going through hirsutism now or just on their PCOS journey, to give them a bit of extra motivation?

 

Robyn I think it's really important to realize you're not alone.

 

It can seem like you're the only woman in the world who has to shave their face. And you can see people on Instagram, you can see your co-workers, people on the street, and you assume that they don't have these issues. But a lot of us do. A lot of us do. And it is incredibly embarrassing. It can be isolating. But the more you surround yourself with a community of women who get it, whether it's a group program, whether it's a Facebook group, whether it's finding people local to you who have PCOS or whatever, and just being friends with them or whatever, you know, you're not alone.

 

Find other people who get it and it becomes much, much easier to accept your body where it is and also deal with the issues that you're experiencing.

 

Despina Exactly.

 

I think what you said is really important. I think having a community around you really keeps you keeps you going on this journey because this is going to be those low times where you just like, what's the point?

 

We've all been there. It's going to happen. But having that community, that support system, really that keeps you on track, keeps you motivated. And just on course, to just keep doing what you're doing, just improving every day, day by day, making small steps with your diet, your lifestyle and eventually the symptoms will reverse and you'll feel a lot better with your with your self-esteem and happiness and you'll just have more energy. All this kind of stuff just it all takes time.

 

But PCOS doesn't happen overnight. You don't wake up one day and you've just got PCOS. It happens gradually and then like all the symptoms just become exacerbated.

 

So we have to take it day by day, make the changes and just be patient. But having a support system is really important.

 

So finally, how can listeners connect with you? So you mention your coaching programs. But you can recap with your social media as well and any other stuff to mention and will link them in the show notes.

 

Robyn For sure.

 

So definitely my website is a great place to go. I have several articles on hirsutism over there, thehormonediva.com.

 

I also love to hang out on Instagram posts and stories. I find that is just super fun. So definitely go and find me over there I'm @thehormonediva there any social platform, it's the hormone diva, YouTube, Facebook, Instagram, etc.. I'm over there as thehormonediva. Come and chat with me. I love getting DMs as well, so please feel free to approach. And when you do, when you start following me and get in my community, when I have more information about that membership. Oh my gosh. It's so juicy. I can't wait. I will be able to share it with you.

 

Despina Awesome!

 

I will have everything linked to the show notes and I highly recommend that you go check out Robyn follow her on everything. Send her a message. Just tell her that you listened to this episode and just reach out. I'm sure she'll appreciate it. Thank you so much for taking time out of your day to come on the podcast once again. I really enjoyed chatting with you and I hope our listeners learnt about hirsutism and gained some great tips and now motivated to crack on and make those changes.

 

Robyn Definitely. Thanks so much for having me.

Connect with Robyn Srigley:

The Hormone Diva | YouTube | Facebook | Twitter | Instagram

Show Notes

Ovasitol by Theralogix's https://www.pcosoracle.com/ovasitol-pcos/

Tria Laser

despina-pavlou-sidebar

Hey there! I am Despina Pavlou, founder of PCOS Oracle and online coach. I want to share with you the diet and lifestyle changes I made to naturally reverse my PCOS and achieve hormonal balance. I believe using my holistic approach you too can take back control from PCOS.

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