What is PCOS?

You must have heard it before…but what does it actually mean?

PCOS stands for Polycystic Ovary Syndrome which is one of the most common female hormonal and metabolic condition affecting 1 in 10 women in the UK.

What are the symptoms?

PCOS affects women in different ways so the symptoms will vary depending on the individual:

• irregular or no periods (oligomenorrhea, amenorrhea)

• polycystic ovaries (numerous immature cystic follicles in the ovaries)

• excess androgens (male hormones) symptoms:

  • hair in unwanted areas such as chin, upper lip, chest, etc. (hirsutism)

  • oily skin, acne

  • hair loss, thinning hair (alopecia)

• difficulty to get pregnant, infertility

• irregular or no ovulation

• weight gain or difficulty losing weight

• obesity, insulin resistance and increased diabetes risk

• anxiety, depression and mood changes

• skin tags or darkened skin around the neck, armpits or groin (acanthosis nigricans)

How do I know if I have PCOS?

Usually, doctors will use the Rotterdam criteria to diagnose PCOS, which means women must fulfil 2 of the following 3 characteristics:

• irregular or no ovulation

• excess androgens

• polycystic ovaries

Doctors might investigate and test for:

• testosterone and other androgens levels (blood test)

• female hormones such as LH, FSH and oestrogens (blood test)

• cysts around the ovary (ultrasound)

• blood glucose and insulin (blood test)

• cholesterol (blood test)

What is the cause?

The exact cause of PCOS is unclear but it has been linked to insulin resistance, obesity, ovarian dysfunction, adrenal dysfunction, and hypothalamic-pituitary axis (HPA) dysfunction. Research also shows that there is a genetic predisposition (higher risk to develop the condition with a family history).

What is the treatment?

There is no cure for PCOS, but it is all about managing symptoms. Treatment should be individualised based on the person’s symptoms and goals. Conventional treatments include:

• contraceptive pill – to induce regular periods, to treat acne and hirsutism

• progestogen tablets – to trigger withdrawal bleeding

• clomiphene – to improve ovulation and fertility

• metformin – to lower insulin and blood sugar levels (used to treat type 2 diabetes)

• cyproterone acetate and spironolactone – to treat acne and hirsutism

While orthodox medicines might work, many studies have found that symptoms can be improved by focusing on lifestyle including diet, exercise, stress management and sleep. The main goals are:

1. to balance blood sugar levels and reduce insulin resistance

   • focus on whole fresh foods

   • eat 3 balanced meals a day that contain protein, healthy fats and vegetables

   • eat small amounts of slow carbohydrates (low GI, GL diet)

   • consider intermittent fasting

   • exercise

2. to reduce stress levels

   • get adequate sleep

   • try meditation, yoga, journaling, or other mindfulness activities

3. to reduce environmental hormone exposure

   • buy organic food (especially dairy), grass-fed meat, wild low mercury fish

   • consider trying natural body-care products and household cleaning products

   • avoid using plastic bottles and cling film

4. to reduce inflammation

   • include omega 3 rich foods in your diet as well as turmeric and ginger

   • decrease sugar and refined food (transfat) intake

5. to support the body’s detoxification process (liver and gut hormone clearance)

   • eat plenty of vegetables and fruits with a focus on cruciferous vegetables

   • increase fibre intake

Supplements to consider:

• inositol

• vitamin D and calcium

• chromium

• lipoic acid

• magnesium

• omega 3

Are you still feeling confused about PCOS or you need support? I’d be happy to help and answer your questions via email or call. Get in touch with me here.

Sources

Aversa, A., La Vignera, S., & Rago, R. (2020). Fundamental Concepts and Novel Aspects of Polycystic Ovarian Syndrome: Expert Consensus Resolutions. frontiers in Endocrinology.

NHS. (2019, February 1). Overview Polycystic ovary syndrome. Retrieved from NHS: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/

Romm, A. (2021). Hormone Intelligence. NewYork: HarperCollins.

Feldman Witchel, S., Oberfield, SE., Peña, SP. (2019). Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls, Journal of the Endocrine Society

Verity. (2017). Verity - The UK PCOS Charity. Retrieved from Verity: https://www.verity-pcos.org.uk/

Williams, T., Mortada, R., & Porter, S. (2016). Diagnosis and Treatment of Polycystic Ovary Syndrome. American Family Physician.