What is PCOS aka Polycystic Ovary Syndrome?
Many years ago, BC (before children!) I made my annual visit to the gynaecologist. I had stopped taking my contraceptive (after 5+ years on it) as we had been thinking about getting pregnant. However, it wasn’t happening. So here we are six months later and the gyne is twisting the scope around looking at my innards on the screen. She pauses. Looks closer, shifts the scope in me, says “Oh” and takes some pictures. Shortly after, me decent again, we are sitting in her office and she starts asking some more questions. She shows me the pictures she took of my ovaries – pretty but pockmarked with cysts. I have Polycystic Ovary Syndrome (PCOS) she explains, along with basically what it means for my fertility and my long-term prognosis.
So me being me I go home and start really investigating what PCOS is.
My deep dive reveals that researchers don’t really know what the exact causes are. There seems to be a hereditary aspect, with insulin resistance and hormone regulation also key factors. As with so many conditions, early diagnosis and treatment make a big difference. The list of symptoms is both long and fairly distinctive. PCOS can cause either infrequent or very long periods, acne, weight gain, pelvic pain, headaches, sleep problems, excess androgen (male hormone) levels, and ovarian cysts caused.
While PCOS is common among women of reproductive age, I, however, suspect that my PCOS could have been diagnosed much earlier. I had suddenly developed teenage acne at nineteen. My blood tests revealed elevated androgen levels and I was put on the pill. No further investigation. I still suspect that if a little more testing and checking had been done my PCOS could have been diagnosed then.
My research was fruitful in some ways. There are ways to manage insulin resistance and hormone imbalance which include lifestyle and dietary changes and supplements are definitely to be considered in order to manage symptoms. However, truth be told, its trial and error and there’s no one-size-fits-all approach as I have discovered over the years.
So what to look for. Normally the symptoms develop in tandem with one’s first menstrual period. Yeah for puberty. Be aware that the symptoms are generally worse you’re overweight (obese). Obesity is suspected as a trigger in the later development of PCOS symptoms, with substantial weight gain considered a potential trigger.
So while the symptoms of PCOS vary, diagnosis is made when at least two of the below symptoms are present:
- Irregular periods are the most common symptom, which basically means irregular, infrequent or very long menstrual cycles.
- Excess androgen, which may cause acne, excess facial (or body) hair and male-pattern baldness.
- Polycystic ovaries, which means ovaries have characteristic cyst-like formations, resulting in an inability to function regularly.
Factors that might play a role include:
- Hereditary: current research suggests that heredity (certain genes) might be linked to PCOS with a 50% chance of developing PCOS if your mother has the condition.
- Excess insulin: women with PCOS make too much insulin causes the ovaries to react and make too many male hormones and also disrupting how ovaries mature and release eggs, creating irregular cycles.
- Elevated male hormone production: the ovaries produce abnormally high levels of androgen, resulting in hirsutism and acne.
- Low-grade inflammation: research shows that women with PCOS have a type of low-grade inflammation that stimulates polycystic ovaries to produce androgens, which can lead to heart and blood vessel problems.
What can you do about PCOS?
After some research and experimentation, these are the top four things that seem to make a difference across the board.
- Work hard at maintaining a healthy weight
If you are overweight the symptoms (and long-term prognosis) are worse. Sticking to a healthy weight is important as it can help decrease insulin resistance. Studies also seem to support that sustained weight loss may be the single biggest factor in the treatment of PCOS.
- Create good sleep habits
While sleep affects everyone’s stress levels, sleep disturbances are twice as common for women with PCOS. Focus on establishing a regular bedtime, ensure you get 8 to 10 hours of sleep every night and avoid stimulants or rich foods before bedtime. Sleep regulation is particularly important if you have Adrenal Androgen Excess PCOS, see more here.
- Reduce stress levels
Reducing stress can help regulate cortisol, the hormone that is critical to our having energy, stamina, and being tolerant of stress. Many women with PCOS have a “flipped” rhythm of cortisol, with the highest level at night and lowest one in the morning. Therefore it is very important to create time in your day-to-day routine for relaxation, make sure to take a walk and get sunshine at midday and practice some self-care.
- Limit (or avoid) endocrine disruptors
Endocrine disruptors are chemicals (dioxins, pesticides, BPA, phthalates, glycol ethers) that mimic female and male sex hormones found in canned foods, soaps and makeup, that disrupt the body’s natural hormonal function and cause confusion in the reproductive system.
Weight is one of the single biggest factors in symptom reduction. I am not going to lie its super hard to loose wieght and you will have to come to terms with the fact that you are going to have a much harder time losing weight (and keeping it off). Fun fact – women with PCOS enjoy the side effect of our bodies not burning fat first thing in the morning, unlike everyone else we are programmed to store fat!
What diet is best for PCOS?
It’s all about whole foods. While I am a supporter of the Low GI, Low GL programme from Patrick Holford, it is your choice. My reason for liking it is I spent many years working in the health shop industry, managing health shops and by far the diet that got the best feedback and gave the best long-term sustainable results was this one. I have also found that it has been the most sustainable for me as I don’t feel horribly restricted. I have made some of my own tweaks as I have got to grips with my PCOS.
What to do in a nutshell:
- It’s all about eating real food, nothing your great gran wouldn’t recognise and as fresh as possible
- Cut out refined carbohydrates (white bread, white rice, pastries, pasta, breakfast cereals) and balance your carb and protein intake
- Eat more foods with anti-inflammatory properties (berries, fatty fish, green leafy veg, nuts and tomatoes)
- Up your iron and magnesium intake (nuts, legumes, tofu, seeds, whole grains and dark green leafy veg)
- Make sure to get plenty of fibre to help with digestion (oats, barley, rye, berries, pears, pulses and veggies)
- Cut out coffee and replace it with green, liquorice and/or schizandra tea
There are a large number of supplements to consider, and this is not a comprehensive list. However, these are the 10 that I have tried myself.
- A B vitamin complex with inositol to help support nervous system health and promote the generation of energy in the body.
- A chromium & cinnamon supplement helps to regulate blood sugar and thereby assist with insulin resistance by helping your body metabolize sugar.
- Theanine (also found in green tea) to assist with anxiety and help modulate the system’s response to stressful events.
- Rhodiola Rosea is an adaptogen, it is great for reducing fatigue and stress particularly in those with stress unrelated to exercise.
- Zinc boosts the immune system and I found it really helped with clearing my acne.
- Borage oil helps with hormone balance, I found it helped me with painful breasts and reducing period pain.
- Calcium with Vit D. Vitamin D is vital for the endocrine system, while early research seems to indicate a correlation between calcium and an improvement in period regulation and ovulation.
- Maca root powder/capsules are traditionally used to boost fertility and libido. I love adding the powder to my smoothies. Maca root may help balance hormones and lower cortisol levels. I really found it boosted my mood and made me feel great.
- Chasteberry (Agnus Castus) is a traditional remedy has been used for centuries and helps with breast tenderness, irritability, mood swings and period pain.
- Probiotics have been a lifesaver for me. Apparently, we PCOS ladies have much less diversity of gut microbiomes compared to healthy ladies. So why take them, well firstly a healthy gut equals healthy skin, secondly they help reduce inflammation and finally they boost immunity.
Be cautious and talk with your doctor.
Please please, I can’t stress this enough, always check with your doctor before starting any alternative therapy and find a doctor who is prepared to work with you to make a treatment plan. There are no miracle cures. Sorry! While there is quite a lot of research about natural treatments for PCOS, in many cases more research is required before concrete conclusions can be drawn. Whatever route you go there is no substitute for a good treatment plan and regular consultation with your doctor/specialist on your PCOS treatment journey.
Long-term be aware of the following complications:
While I don’t want to scare you, you need to be aware of the long-term issues you may face.
- Type 2 diabetes or prediabetes
- Sleep apnea
- Depression, anxiety and eating disorders
- Cancer of the uterine lining (endometrial cancer)
I was very blessed, my fertility issues only lasted another 8 months. However, PCOS carries some very real risks when it comes to pregnancy. My gyne warned me that I would have higher risk pregnancies, meaning a greater risk of miscarriage or premature birth and delivery complications. During my pregnancies, I also had to be checked regularly in case I developed gestational diabetes or pregnancy-induced high blood pressure.
Luckily I was persistently healthy and had horribly low blood pressure during my pregnancies. And though my first delivery was nothing less than eventful (I will write about it one day) my journey with PCOS continues to challenge, frustrate and exhaust me. Here’s to beating it back into mild submission for another month and trying to stick to doing what won’t aggravate it daily.