What is Polycystic Ovarian Syndrome (PCOS)
Polycystic Ovarian Syndrome (PCOS) is a common hormonal disorder that affects millions of women worldwide, impacting their overall well-being, reproductive health, and emotional balance. While its exact cause remains a mystery, understanding PCOS can empower you to take control of your symptoms and live a healthier life. In this blog, I dive into what causes PCOS, the common symptoms, how it is diagnosed and how you can effectively address these symptoms through lifestyle, nutrition, and medical interventions.
What Causes PCOS?
PCOS develops when a woman's ovaries produce higher-than-normal amounts of androgens (male hormones), disrupting the normal functioning of the ovaries. Instead of releasing eggs during the menstrual cycle, many women with PCOS develop small fluid-filled sacs, known as cysts, on their ovaries. The exact cause of this hormonal imbalance is unclear, but several factors are believed to contribute to its development:
1. Insulin Resistance: Many women with PCOS have insulin resistance, meaning their bodies struggle to use insulin effectively, leading to increased insulin production. Elevated insulin can trigger the ovaries to produce more androgens, worsening PCOS symptoms.
2. Hormonal Imbalances: PCOS is characterised by an imbalance of reproductive hormones, especially elevated androgens. These hormonal shifts can prevent ovulation and lead to irregular periods and other symptoms.
3. Inflammation: Chronic, low-grade inflammation is common in women with PCOS and may contribute to insulin resistance and increased androgen production.
4. Genetics: There is a genetic component to PCOS, meaning that if your mother or sister has PCOS, you may be more likely to develop it.
Common Symptoms of PCOS
PCOS can present differently in each woman, but some of the most common symptoms include:
Irregular Periods: Infrequent, prolonged, or absent menstrual cycles are a hallmark of PCOS, caused by the lack of regular ovulation.
Excess Hair Growth (Hirsutism): Due to high androgen levels, women with PCOS often experience unwanted hair growth on the face, chest, back, or abdomen.
Acne and Oily Skin: Androgen excess can also lead to skin problems, including stubborn acne and excessively oily skin.
Weight Gain and Difficulty Losing Weight: Many women with PCOS struggle with weight gain, particularly around the abdomen, due to insulin resistance.
Thinning Hair or Male-Pattern Baldness: Hair loss on the scalp or thinning hair can also be associated with PCOS.
Infertility: PCOS is one of the most common causes of infertility in women, as irregular ovulation makes conception difficult.
Mood Swings and Depression: Hormonal imbalances in PCOS can contribute to emotional instability, anxiety, or depression.
How is PCOS Diagnosed?*
There are a number of factors considered in a PCOS diagnosis.
Irregular Menstrual Cycles (as defined as):
Normal in the first year post menarche as part of the pubertal transition
More than 1 to less than 3 years post menarche: under 21 or over 45 days
More than 3 years post menarche to perimenopause: under 21 or over 35 days or less than 8 cycles per year
More than 1 year post menarche: over 90 days for any one cycle
Primary amenorrhea by age 15 or over 3 years post thelarche (breast development).
Elevated testosterone (under 1.3nmol/L) and/or free testosterone (under 20pmil/L). If testosterone or free testosterone are not elevated, androstenedione and dehydroepiandrosterone sulfate (DHEAS - over 6umol/L) may be used.
The presence of hirsutism alone should be considered predictive of biochemical hyperandrogenism and PCOS
Female pattern hair loss
Acne
Weight gain
Follicle number per ovary (detected through ultrasound). Note that in patients with irregular menstrual cycles and hyperandrogenism, an ovarian ultrasound is not necessary for PCOS diagnosis.
How Can You Address PCOS Symptoms?
While there’s no ‘cure’ for PCOS, many women successfully manage their symptoms through a combination of lifestyle changes, medical treatments, and nutritional strategies.
1. Adopt a Balanced Diet
Focusing on a nutrient-rich, low-inflammatory diet can make a significant difference. Consider the following dietary tips:
Limit Processed Foods and Sugars: These can spike insulin levels, aggravating PCOS symptoms.
Prioritise Vegetables, Whole Grains and Lean Proteins: These help to stabilise blood sugar levels and reduce inflammation.
Include Anti-Inflammatory Foods: Omega-3-rich foods like salmon, walnuts, and flaxseeds, along with antioxidant-packed vegetables can helpcombat inflammation.
2. Exercise Regularly
Regular physical activity can help lower insulin resistance, manage weight, and improve mood. Aim for a combination of strength training and cardiovascular exercises for the best results.
3. Manage Stress
Chronic stress can exacerbate hormonal imbalances, leading to worsening symptoms. Incorporate stress-reduction techniques such as yoga, meditation, or deep-breathing exercises into your daily routine.
4. Consider Nutritional Supplements
Certain supplements can support hormone balance and address insulin resistance. Some popular options include:
Inositol: Often recommended for women with PCOS, inositol supports insulin sensitivity and may help regulate menstrual cycles.
Omega-3 Fatty Acids: These are anti-inflammatory and can support hormone balance.
Vitamin D: Many women with PCOS have low vitamin D levels, and supplementing may improve symptoms.
Magnesium: Often depleted in our diet, magnesium can help buffer stress and aid with sleep.
Spearmint tea may also assist to reduce testoterone levels
5. Medical Interventions
In some cases, your healthcare provider may recommend medications to manage PCOS symptoms, however these are a band-aid and do not address the cause of your hormone imbalance. In essence, it delays the problem until later which is never a good thing. Oral Contraceptive Pills are often prescribed to ‘regulate’ your menstrual cycle and reduce androgen-related symptoms like acne and excess hair growth. Metformin may be prescribed to address insulin resistance.
Other Considerations: Emotional and Mental Health
Living with PCOS can be emotionally challenging, especially when dealing with physical changes like acne, hirsutism, menstrual irregularities or weight gain. Many women also experience anxiety or depression due to the hormonal imbalance. Seeking support from a healthcare professional, therapist, or support group can be incredibly helpful in managing the emotional aspects of PCOS.
Conclusion
PCOS may feel overwhelming at times, but with the right approach, you can manage your symptoms and improve your quality of life. By adopting a healthy diet, exercising regularly, managing stress you can take control of your PCOS journey. Remember, every woman's experience with PCOS is unique, so finding what works best for your body is key.
If you're struggling with PCOS symptoms, don't hesitate to reach out for support. Whether it's discussing nutrition, supplements, or lifestyle changes, I can help guide you towards a healthier, balanced life.
There are also amazing resources via Jean Hailes and Monash University. If you have (or think you may have) PCOS, I recommend these resources to you.
I understand what you are going through, as someone who was undiagnosed with PCOS for many years I know what its like. I made the mistake of taking the Oral Contraceptive Pill to regulate my cycle, but what that really did was dull the signs my body was trying to tell me and ended up with Premature Ovarian Insufficiency at 39. I now work with numerous clients with PCOS and can help you avoid the mistakes I made.
Book your 1:1 consult with me here
Reference
*Monash University. (2023). International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2023: Summary. Retrieved from https://www.monash.edu/medicine/mchri/pcos/guideline