Navigating Adrenal Androgen Excess in PCOS
Medically Reviewed by Dr. Ivy Branin Naturopathic Doctor at Simplicity Health Associates.
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As a naturopathic doctor and expert in women's health and hormones, a topic that's incredibly important for many of my patients navigating the complexities of PCOS is adrenal health.
In this blog post, I'm going to share the exact supplements I recommend as part of a comprehensive naturopathic protocol, tailored for women who experience adrenal androgen excess PCOS. If you've been wondering about targeted support for this unique presentation of PCOS, you're in the right place!
Understanding Adrenal Androgen Excess and PCOS
When we talk about Polycystic Ovary Syndrome (PCOS), it's really a complex picture, impacting millions of women globally. You might often hear about PCOS in relation to insulin resistance or weight gain, and these are certainly common features for many. However, what's crucial to understand is that PCOS isn't a "one-size-fits-all" diagnosis. There's a significant subset of my patients who experience something we call adrenal androgen excess.
So, what exactly does that mean? In this distinct presentation of PCOS, it's not primarily the ovaries that are producing too many androgens (like testosterone). Instead, their adrenal glands become the main source of these excess hormones, particularly DHEA (Dehydroepiandrosterone). DHEA, on its own, has androgen-like properties, but it can also be readily converted into testosterone, contributing to many of the symptoms you might be experiencing.
This is a really important distinction because, as I often tell my patients, not everyone with PCOS fits the typical picture of being overweight or having central obesity. In fact, many women, especially those who are on the leaner side, often fall squarely into this adrenal androgen excess PCOS category. Of course, it's not exclusive to slender individuals; some overweight or obese patients can also have this characteristic.
What's particularly fascinating, and something I want to emphasize, is that it's not necessarily that these patients experience more stress than anyone else. It's truly about how their unique physiology works. For some reason, their adrenal glands just react a little differently when stress occurs, whether that stress is physical, emotional, or even perceived. When that stress signal hits, their adrenal glands respond by producing more DHEA. That's why, when I'm working with a PCOS patient, I always make it a point to test DHEA levels. It's absolutely essential for me to see if that's a factor contributing to higher testosterone, or if DHEA itself is causing symptoms. Understanding this helps us tailor the most effective approach for you.
Supplement Protocol for Adrenal Androgen Excess in PCOS
For all these products, you can easily purchase them through Fullscript. If you haven't set up your account with us yet, I highly recommend you do! You’ll save 10% off your first supplement order.
My Favorite for Cortisol Reduction & HPA Axis Support
First on my list is Phosphatidylserine. I typically dose around 300 mg at night. Phosphatidylserine does a really good job at reducing cortisol levels and helping to improve the HPA axis activation.
The Hypothalamic-Pituitary-Adrenal (HPA) axis is a crucial neuroendocrine system that regulates your body's stress response. By improving its activation, phosphatidylserine can help bring balance to the adrenal glands. Taking it at bedtime actually improves sleep quality as well, which is an added bonus!
Calming Support for Your Stress Response
Next up, and somewhat similar in its effects, is L-Theanine, like the one by Pure Encapsulations. Derived from green tea, L-Theanine offers a calming property, mostly because it also has the ability to modulate the HPA axis. I recommend taking this at bedtime as well. This one is 200 milligrams and is a great place to start for its stress-supportive benefits.
The Adaptogen That Won't Spike Testosterone
For adrenal support, I specifically recommend Rhodiola, particularly the liquid phyto-caps by Gaia. Rhodiola is an adaptogen, meaning it helps the body adapt to stress. What makes Rhodiola stand out for adrenal androgen excess PCOS is that it's one of the few adaptogens that doesn't have the downside of increasing testosterone.
This is a crucial distinction, as other popular adaptogens like ashwagandha, while calming for cortisol, can unfortunately elevate testosterone, which is counterproductive in PCOS. I typically prescribe Rhodiola as two caps upon waking, or one cap upon waking and a second cap around 3 or 4 p.m.
The Classic PCOS Formula for Insulin & DHEA
The last supplement on my protocol list is Sensitol by Designs for Health, a classic PCOS formula that remains highly relevant for adrenal androgen excess.
Sensitol contains a powerful combination of myo and D-chiro inositol, along with alpha-lipoic acid. This blend is beneficial for insulin resistance, a common thread in many PCOS cases, and crucially, it also helps to lower DHEA.
DHEA can sometimes be high as a protective mechanism related to insulin, making the combination of inositol and alpha-lipoic acid particularly important. The recommended dosage is two caps twice a day: two in the morning and two at bedtime.
Getting Started with Your Adrenal & PCOS Support
These supplements are powerful tools for your adrenal health journey with PCOS. You can easily access them through my Fullscript dispensary, where you'll find my ready-made supplement protocols for specific health concerns. As a new customer, you'll also receive 10% off your first order and free shipping on orders over $50.
Personalized Naturopathic Support for Your PCOS Journey
Navigating adrenal androgen excess in PCOS can be challenging, but you don't have to face it alone. If you're seeking a holistic and individualized approach to understanding and managing your PCOS, we're here to help. At Simplicity Health Associates, both myself, Dr. Ivy Branin, and Dr. Pauline Hoang, are passionate about empowering patients through comprehensive naturopathic care. We can work with you to understand your unique health picture, offer tailored dietary and lifestyle advice, and recommend specific supplementation strategies to foster optimal adrenal function, hormone balance, and overall well-being.
Frequently Asked Questions
How do I know if I have Adrenal Androgen Excess PCOS?
While some patients with this type of PCOS are on the slender side, others can be overweight or obese. The key is how your adrenal glands respond to stress, leading to elevated DHEA. I always recommend testing your DHEA levels if we suspect this is a factor for you. Common symptoms, like excess hair growth (hirsutism), acne, or hair thinning, can be present in any type of PCOS, so testing helps us pinpoint the root cause.
Does PCOS cause excess androgens?
Yes. Excess androgens are a hallmark of PCOS. While conventionally, we often think of the ovaries as the main source of these excess hormones (like testosterone), in the case of adrenal androgen excess PCOS, the adrenal glands are the primary contributors of hormones like DHEA, which then convert into testosterone.
Does PCOS cause overactive adrenal glands?
In a specific subtype of PCOS, known as Adrenal PCOS or adrenal androgen excess PCOS, the adrenal glands do become "overactive" in their production of androgens, particularly DHEA. It's not that PCOS causes them to be overactive in every case, but rather this specific adrenal dysfunction is a presentation or subtype of PCOS. This overactivity is often linked to how your adrenals respond to stress.
How can I reduce androgens in PCOS?
Reducing excess androgens in PCOS often requires a multi-faceted approach. My recommendations, like Phosphatidylserine, L-Theanine, Rhodiola, and Sensitol, are specifically chosen to help modulate the HPA axis, lower cortisol, and reduce DHEA/testosterone. Beyond supplements, lifestyle interventions such as stress management, a balanced diet, and regular exercise play a crucial role.
Which hormone is in excess in PCOS?
In PCOS, the primary hormones found in excess are androgens, often referred to as "male hormones," such as testosterone and DHEA (and DHEA-S). It's these elevated androgens that lead to many of the classic PCOS symptoms like hirsutism (excess hair growth), acne, and irregular periods. Insulin can also be in excess in many PCOS cases, and it plays a significant role in stimulating androgen production.
Can stress really cause my DHEA to be high?
Yes, absolutely. For individuals with adrenal androgen excess PCOS, their adrenal glands are "wired" to produce more DHEA in response to stress. It's not necessarily about more stress in your life, but rather how your unique physiology responds to it. These supplements are designed to help modulate that specific adrenal response.
How long does it take to see results from these supplements?
Healing is a journey, not a race. While individual results vary, many patients start noticing improvements in symptoms like energy, sleep, or skin within a few weeks to a couple of months. Consistent use and a holistic approach, including diet and lifestyle, are key for the best outcomes.
Book An Appointment
If you're concerned about remaining healthy, or may suspect that there is an underlying health concern, our team at Simplicity Health Associates are dedicated to helping you navigate this journey through personalized, holistic treatment plans.
About Dr Ivy Branin
Dr Ivy Branin is a Naturopathic Doctor in NYC who received her degree in Naturopathic Medicine from Bastyr University. She graduated with a bachelor’s degree in biochemical engineering and a minor in French from Rutgers University. After graduating from Rutgers, she worked for 3 years as a process validation engineer in the pharmaceutical industry in New York and Connecticut.
As a naturopathic doctor in NYC, Dr Branin does not approach disease with a “one-size fits all” perspective but rather sees each patient as an individual with their own potential for optimal health. She supports people in their desire to feel good and good about themselves using the naturopathic principles of dietary and lifestyle management, homeopathy, visceral manipulation, botanical medicine, and craniosacral therapy.