PCOS, Electrolytes, & Hormone Balance - PCOS Diva
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PCOS, Electrolytes, & Hormone Balance

electrolytesBy Amy Medling, founder of PCOS Diva

Hydration is more than just drinking water for thirst, beautiful skin, and good digestion. Yes, good hydration is making sure your body is not only getting the optimum amount of liquids for daily function, but also involves balancing how much you absorb and excrete. The latter part has everything to do with electrolytes. How are hydration, electrolytes, and Polycystic Ovarian Syndrome (PCOS) connected? Hormones, of course. 

Importance of Electrolytes

Electrolytes are particles that carry electrical charges and mainly come in the form of everyday minerals like sodium, potassium, calcium, and magnesium. Their main function is to make sure the amount of water you store and lose is optimal for your muscles and organs. 

Electrolytes and Adrenal Fatigue

Importantly for women with PCOS, electrolytes impact how well our adrenal system functions

Our adrenal glands are responsible for producing many of the hormones (such as cortisol) the body uses every day. The hormones produced affect our response to stress as well as how the body regulates electrolyte levels, keeping our sodium, magnesium, and other electrolytes in the blood balanced.

However, interventions such as abrupt (and unhealthy) changes in diet, use of certain medications, excess stress, or chronic illnesses can cause the body to over or under produce some of these hormones, causing a hormonal imbalance. 

Because our hormones affect our electrolyte levels, a hormonal imbalance could cause an electrolyte imbalance. Likewise, adrenal fatigue – when the body’s adrenal glands can’t keep up with the demand for hormones – can also cause our electrolyte balance to go out of sync.

Stress and electrolyte imbalances

“Psychological stress also activates the sympathetic-adrenomedullary system which stimulates rennin release leading to increases in angiotensin II and aldosterone secretion. Aldosterone activates MR which in turn may lead to vascular injury and inflammation, and ultimately heart disease, renal disease, and stroke.”

One of the key hormones the body uses to regulate electrolytes is aldosterone. 

Aldosterone is a steroid that is responsible for keeping the sodium-potassium-water balance in the blood. This hormone works by mainly preserving sodium content. When the body thinks it needs more sodium, it releases aldosterone and puts the body into “sodium conservation” mode: forcing the body to absorb more sodium and reduces the amount of sodium lost in sweat. 

Sodium and potassium are two minerals that play a big role in blood pressure regulation, so if the balance of any of the two minerals are “off,” a person can end up with high or low blood pressure. 

As with everything, there is nothing wrong with aldosterone, except if you produce too much of it, and this happens when you are chronically stressed

Stress has been shown to cause our adrenals to produce too much aldosterone. When you have too much aldosterone, you can end up with excess sodium and lower levels of potassium. This excess ends up in the bloodstream, forcing our heart to pump harder, which then results in high blood pressure. 

More than hypertension, studies have also linked excess sodium content (because of aldosterone over-stimulation) with a number of cardiovascular diseases and even heart failure. This is the reason why low sodium diets exist; to counter the pro-sodium effect of aldosterone.PCOS Diva Revive

Aldosterone and PCOS

Hormonal imbalances and stress are an everyday struggle for those with PCOS. This makes us more at risk for electrolyte imbalances. In fact, recent studies have pointed out that the insulin resistance people with PCOS experience is likely due to an increase in aldosterone levels. Research has also shown that those who overproduce aldosterone, also suffer from low HDL and potassium levels. 

Other symptoms of too much aldosterone production include frequent urination, excessive sweating, and hot flashes.

Low Aldosterone, Hyperkalemia, and Salt Cravings

Not only is overproducing aldosterone bad for you, but so is having too little of it. 

As it turns out, low aldosterone levels can be linked to low sodium levels, and the salt craving we get is a sign that our body is in need of sodium. In a way, aldosterone acts as a messenger, telling your kidneys to keep enough salt for the body’s internal processes. 

When you don’t produce as much aldosterone, especially due to adrenal fatigue, the kidneys will simply excrete too much salt. To compensate, your brain would then encourage you to eat salty foods.

Another problem brought about by low aldosterone levels is having too much potassium

In the same way aldosterone tells the kidneys to retain enough sodium, the steroid also tells the kidneys to eliminate excess potassium. This can lead to a condition called hyperkalemia, where the body has too much potassium in circulation. Some of the symptoms associated with hyperkalemia are lethargy, muscle pain and cramps, chest pains, and arrhythmia or an unusual heart beat.

Speaking of hyperkalemia, certain drugs can cause the body to accumulate potassium. One of these drugs is spironolactone. Many women with PCOS use sprironlocatione “off-label” to help reduce androgens.  Spironolactone is a steroid used to treat edema and hypertension and promotes urination. It mainly works by acting as an aldosterone antagonist. Basically, the drug lowers aldosterone levels in patients who are producing too much. As mentioned earlier, low aldosterone levels can lead to hyperkalemia. In the case of those with PCOS and insulin resistance, the risk of hyperkalemia increases when you have Type 2 diabetes.

Adding Electrolytes

Now you know how shifts in your electrolytes (namely sodium and potassium) can be due to over-stimulation of aldosterone. Frequent urination, excessive sweating and pseudo-hot flashes are all signs you may need some electrolytes. A blend with sodium, potassium, magnesium, and chloride is best. PCOS Diva offers an electrolyte formula called Revive.  But note that if you have sodium-sensitive hypertension, you should not take PCOS Diva Revive and it not recommended for patients with a pacemaker, nor for patients with high blood sodium or potassium levels.PCOS Diva Revive


Amy MedlingAmy Medling, best-selling author of Healing PCOS and certified health coach, specializes in working with women with Polycystic Ovary Syndrome (PCOS), who are frustrated and have lost all hope when the only solution their doctors offer is to lose weight, take a pill, and live with their symptoms. In response, Amy founded PCOS Diva and developed a proven protocol of supplements, diet, and lifestyle programs that offer women tools to help gain control of their PCOS and regain their fertility, femininity, health, and happiness. 




  1. Miller KC, Stone MS, Huxel KC, Edwards JE. Exercise-associated muscle cramps: causes, treatment, and prevention. Sports Health. 2010;2(4):279-283. doi:10.1177/1941738109357299
  2. Jung AP, Bishop PA, Al-Nawwas A, Dale RB. Influence of Hydration and Electrolyte Supplementation on Incidence and Time to Onset of Exercise-Associated Muscle Cramps. J Athl Train. 2005;40(2):71-75.
  3. Cascella T, Palomba S, Tauchmanovà L, et al. Serum aldosterone concentration and cardiovascular risk in women with polycystic ovarian syndrome. J Clin Endocrinol Metab. 2006;91(11):4395-4400. doi:10.1210/jc.2006-0399
  4. Xanthakis V, Vasan RS. Aldosterone and the risk of hypertension. Curr Hypertens Rep. 2013;15(2):102-107. doi:10.1007/s11906-013-0330-y
  5. Kubzansky, Laura D, and Gail K Adler. “Aldosterone: a forgotten mediator of the relationship between psychological stress and heart disease.” Neuroscience and biobehavioral reviews vol. 34,1 (2010): 80-6. doi:10.1016/j.neubiorev.2009.07.005
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