This abstract caught my eye because finasteride is sometimes used to treat the hirsutism (hair growth in women) that PCOS often causes. It has now been observed to have antipsychotic properties and is being proposed as a treatment for psychosis.
Antipsychotics are increasingly being used to treat depression, and at least 85% of women with PCOS have some kind of anxiety, depression, or other mood disorder associated with this diagnosis. If you have PCOS, please do not jump to the assumption that I am saying you are psychotic. What I am trying to point out here is that there is a huge mind-body connection in the syndrome that is often ignored. Physicians can be so compartmentalized with their treatments that they focus on the acne, the hair, the infertility…and completely ignore the moods, the mood swings, the associated disrupted eating patterns…and then they and their patients wonder why treatment is not successful.
I am posting this abstract to challenge anyone who treats PCOS to figure out what is going on in the brain of the woman with PCOS since it is, after all, the brain that controls hormones. Rather than mess with hormones and create even more problems, why aren't we going to the source and looking THERE for potential solutions? Let's make this the day we shift our thinking.
Bortolato M, Frau R, Orrù M, Bourov Y, Marrosu F, Mereu G, Devoto P, Gessa GL. Antipsychotic-like properties of 5-alpha-reductase inhibitors. Neuropsychopharmacology. 2008 Dec;33(13):3146-56. Epub 2008 Mar 19.
I chose the photo I did not to be funny, demeaning, or hurtful. I did it for the benefit of those who truly do not understand what many women go through because of their PCOS. Hair growth can be devastating and lead to horrible issues with self-image. Long ago it was often called"diabetes of the bearded ladies". If you can imagine what it's like to look in the mirror and feel as though you're losing your femininity, often at a time when you're trying to conceive and desiring to be attractive to your partner…it's a situation deserving of much more attention than it often gets by physicians.
A client recently handed me a supplement called"DIM" and told me her physician gave it to her. The physician said it would help her hyperestrogenemia. She had stopped taking it, and asked if I thought she should resume with it.
Here's the lowdown on DIM, which is the abbreviation for diindolylmethane.
DIM occurs naturally in cruciferous vegetables, such as cabbage, cauliflower, and Brussels sprouts. It was first researched for its cancer-fighting properties; we all know that these vegetables have this quality.
Soon after that, it was discovered that DIM influences estrogen metabolism, promoting the creation of estradiol, or beneficial estrogen (E2) and inhibiting the creation of estrone, or cancer-related estrogen (E1).
DIM may also be an anti-androgen. Although the research I was able to find looked at DIM in the prostate, not in women with PCOS, there is much information on websites selling DIM promoting it as a natural way to reduce facial hair.
If you are considering taking a DIM supplement, be sure to consider the following warnings found on the WebMD website: Special Precautions & Warnings:
Pregnancy and breast-feeding: Diindolylmethane is safe when consumed in the small amounts found in foods. But don’t take larger amounts. Not enough is known about the safety of larger amounts during pregnancy and breast-feeding.
Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Diindolylmethane might act like estrogen, so there is some concern that it might make hormone-sensitive conditions worse. These conditions include breast, uterine, and ovarian cancer; endometriosis; and uterine fibroids. However, developing research also suggests that diindolylmethane might work against estrogen and could possibly be protective against hormone-dependent cancers. But stay on the safe side. Until more is known, don’t use diindolylmethane if you have a hormone-sensitive condition.
The client who asked the question feels the supplement may actually have helped her facial hair. Note, this is a one-person observation and a testimonial only, it is NOT an endorsement of the supplement.
What I would recommend to this client, and to others who are interested in using DIM:
1. Start with your diet: eat more cabbage, cauliflower, brussels sprouts, and broccoli. (Click herefor a cauliflower curry recipe).
2. Be sure your diet contains adequate omega-3 fatty acids and is not high in omega-6 fatty acids (discussed many times in other posts on this blog). Omega-3 fatty acids found in both fish and flax have similar effects on estrogen metabolism.
3. Be scientific about the supplement use. Have your hormone levels measured for a baseline, and have them remeasured 6 months after consistent use of the supplement. Too many times, supplements are recommended without any way to evaluate whether or not they are having any effect. In the case of my client, the supplement was sold to her by her physician and there was never any followup scheduled to evaluate how well it was working. (You'd never do that with a blood pressure medication or antipsychotic, would you?!?!?)
4. Don't assume that once you start taking the supplement you do not need to follow a healthy diet. Supplements usually seem to work better in a healthy body where the biochemistry promotes their effectiveness.
5. Even though eating these foods has never been found to be dangerous to pregnant women, because the supplemental form is much more concentrated than what is found in food, it is strongly recommended not to take this supplement if you are trying to conceive or if you are pregnant. As it's been with us since we've been in existence, we are of the opinion that it is not appropriate to be treating hirsutism while you are trying to conceive. There is time for that later.: )
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Chen I, McDougal A, Wang F, Safe S. Aryl hydrocarbon receptor-mediated antiestrogenic and antitumorigenic activity of diindolylmethane. Carcinogenesis. 1998 Sep;19(9):1631-9.
Lord RS, Bongiovanni B, Bralley JA. Estrogen metabolism and the diet-cancer connection: rationale for assessing the ratio of urinary hydroxylated estrogen metabolites. Altern Med Rev. 2002 Apr;7(2):112-29.
Le HT, Schaldach CM, Firestone GL, Bjeldanes LF. Plant-derived 3,3'-Diindolylmethane is a strong androgen antagonist in human prostate cancer cells. J Biol Chem. 2003 Jun 6;278(23):21136-45. Epub 2003 Mar 27.
Tadi K, Chang Y, Ashok BT, Chen Y, Moscatello A, Schaefer SD, Schantz SP, Policastro AJ, Geliebter J, Tiwari RK. 3,3'-Diindolylmethane, a cruciferous vegetable derived synthetic anti-proliferative compound in thyroid disease. Biochem Biophys Res Commun. 2005 Nov 25;337(3):1019-25. Epub 2005 Oct 3.
