What alternatives are there to manage PCOS/PMOS in my partner?

Question

Hello doctor,

I am reaching out for advice regarding my partner, who was diagnosed with PCOS or PMOS at an early age. She was initially prescribed medication to help manage her condition, along with recommendations for exercise. However, the medication caused her periods to occur weekly, which led her to discontinue the treatment.

Since stopping the medication, her menstrual cycle has normalized, but she is now dealing with severe fatigue, difficulty sleeping at night (often staying awake until late morning), and constant daytime tiredness.

We would appreciate your insight on the following:

Could her sleep issues and fatigue be related to her PCOS/PMOS or the medication she previously took?
What steps can she take to improve her sleep cycle and energy levels?
Are there safe alternatives to manage PCOS or PMOS without triggering irregular bleeding?

Given the urgency of these concerns, we would like to request a brief telemedicine consultation to discuss potential solutions.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

PCOS (polycystic ovary syndrome), now known as PMOS (polyendocrine metabolic ovarian syndrome) can indeed contribute to fatigue, sleep disturbances, and hormonal imbalances. Below is a breakdown of your concerns:

Yes, PCOS or PMOS can impact sleep and energy levels in the following ways-

Elevated androgen and insulin levels can interfere with melatonin (the sleep hormone), potentially causing insomnia or poor sleep quality.
A common feature of PCOS (polycystic ovary syndrome)/PMOS (polyendocrine metabolic ovarian syndrome) is insulin resistance, which can cause blood sugar fluctuations, leading to energy crashes and fatigue.
Women with PCOS are more likely to experience sleep apnea and other sleep disturbances.
Some hormonal treatments can temporarily disrupt the body’s natural rhythm. Although she has stopped the medication, her body may still be adjusting.

Here are some suggestions to help improve her sleep and energy.

Go to bed and wake up simultaneously every day, including weekends.
Avoid blue light from phones, tablets, and computers, as it can suppress melatonin production.
Reduce or eliminate stimulants, particularly in the evening.
Morning or afternoon exercise can help regulate hormones and improve energy levels.
Practices like meditation, deep breathing, or herbal teas (such as chamomile) may help promote relaxation and better sleep.

Safe ways to manage PCOS/PMOS without triggering irregular bleeding:

If hormonal treatments cause excessive bleeding, non-hormonal approaches may be more suitable.

A low-carbohydrate, high-protein diet can improve insulin sensitivity and support overall hormonal balance.
Myo-inositol and D-chiro-inositol can help balance hormones naturally and improve ovarian function.
Both support hormone regulation and sleep, and can help with fatigue.
Spearmint tea may reduce excess androgens, while ashwagandha is known to help manage stress and improve sleep.

Given the impact these symptoms are having on her daily life, a telemedicine consultation with an endocrinologist or gynecologist would be beneficial. A doctor may also recommend assessing insulin, thyroid, and hormone levels if a sleep disorder is suspected.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.