What is PCOS?
What is PCOS?
Polycystic ovarian syndrome (PCOS) is one of the most common hormone disorders, and it affects about 1 in 10 women.
Some of the key signs and symptoms of PCOS include:
Irregular or absent periods
Difficulty getting pregnant
Weight gain (often around the waist)
Hirsutism (excess body hair)
Male-patterned baldness / loss of hair (think receding hairline)
Multiple small cysts on the ovary
Blood sugar imbalances
Insulin resistance (occurs in 90% of women with PCOS and is currently thought to be a cause rather than a symptom)
Skin tags
Not everyone experiences the same symptoms, and we don’t need all of them to have PCOS. In fact, having just one of the symptoms above can sometimes be enough for a diagnosis from your GP.
No two cases of PCOS are the same - that is why there is no one protocol for PCOS.
If you think you are experiencing any of these signs or symptoms, please do speak to your GP. This is vital to understand any potential increased risk of cardiovascular disease, certain autoimmune conditions, mood disorders and fertility issues, which are commonly associated with PCOS.
What causes PCOS?
PCOS is a complex hormonal and metabolic disorder and a number of factors can exacerbate symptoms. These include changes in sex hormone levels, changes in insulin production, diet, hormone-affecting toxin exposure, stress, sleep and exercise and more!
Research indicates three common drivers for the majority of PCOS symptoms:
High androgen levels - a group of sex hormones that includes testosterone (often nicknamed male hormones, even though it’s normal for women to have a small level androgens)
Insulin resistance - where the body no longer responds to insulin when blood sugar starts to increase (similar to what happens in the early stages of diabetes)
High LH:FSH levels - both hormones created by the pituitary gland and are involved in preparing for ovulation
Unfortunately, it is not yet clear exactly what causes these three drivers in the first place. However, PCOS appears to have a genetic link, as it often runs in families, but specific genes associated with the condition have not yet been identified.
What are the key nutritional considerations?
While there isn’t a drug or certain diet that can ‘cure’ PCOS, there are plenty of lifestyle and diet recommendations to help manage symptoms and reduce the risk of developing complications associated with PCOS including diabetes, obesity, heart disease, endometrial cancer etc.
Research repeatedly cites the Mediterranean diet as the leading option for those with PCOS, given its anti-inflammatory nature.
Given how individual the symptoms of PCOS are and how individual everyone’s risk factors are for developing diseases later in life, the corresponding ‘PCOS symptom support and complication mitigation plan’ needs to also be individual i.e. a one size fits all approach isn’t going to work.
Note - We are all different and what works for one person may not work for another, so please seek guidance and advice before changing your diet to work out the right way forward for you.
Key take-aways
PCOS affects 1 in 10 women
Everyone will have different drivers for their PCOS
It’s critical to identify your individual drivers before trying to manage the symptoms
A mediterranean-style diet has been shown to relieve PCOS symptoms for some individuals, given its anti-inflammatory nature
Where can you get help?
If you feel you need support with your PCOS symptoms you can get in touch with your GP and ask to be referred for help. There is also some great information on the British Dietetic Association (BDA) website on how to implement a lot of the principles surrounding the Mediterranean diet.
However, if you would like more personalised support with your PCOS and what dietary and lifestyle changes might be appropriate for you, please get in touch. Use the link below to arrange a free call where we can get to know each other so I can understand where you are in your journey and we can chat about the best route forward for you. It’s also a chance for you to ask any questions about working with me.
Other resources:
https://www.bda.uk.com/resource/polycystic-ovary-syndrome-pcos-diet.html
https://www.mypcoskitchen.com/
PCOS by Colette Harris and Dr Adam Carey.
Period Repair Manual by Dr Lara Briden
References
Ashraf, S. Nabi, M. Rasool, S. Rashid, F. Amin, S. (2019). ‘Hyperandrogenism in polycystic ovarian syndrome and role of CYP gene variants: a review’, Egyptian Journal of Medical Human Genetics, 25.
Balen, A. Ning, N. Brezina, P. Leong, M. Shoham, Z. Wallach, E. Zhao, Y. (2013). ‘How to recognize PCOS: results of a web-based survey at IVF-worldwide.com’, Reproductive BioMedicine Online, 26 (5), pp. 500-505.
Barrea, L. Frias-Toral, E. Verde, L. Ceriani, F. Cucalón, G. Garcia-Velasquez, E. Moretti, D. Savastano, S. Colao, A. Muscogiuri, G. (2021) ‘PCOS and nutritional approaches: Differences between lean and obese phenotype’, Metabolism open, 12.
Bednarska, S. Siejka, A. (2017). ‘The pathogenesis and treatment of polycystic ovary syndrome: what's new?’, Adv Clin Exp Med., 26(2), pp. 359–367.
De Leo, V. Musacchio, M. Cappelli, V. Massaro, G. Morgante, G. Petraglia, F. (2016). ‘Genetic, hormonal and metabolic aspects of PCOS: an update’, Reproductive Biology and Endocrinology, 14 (38).
Escobar-Morreale, HF. (2022). ‘Defining PCOS: A syndrome with an intrinsic heterogeneous nature’, in Diamanti-Kandarakis, E. (eds.) Polycystic Ovary Syndrome, Netherlands: Elsevier, pp. 3-13.
Mumusoglu, S. Yildiz, B. (2020). ‘Polycystic ovary syndrome phenotypes and prevalence: Differential impact of diagnostic criteria and clinical versus unselected population’, Current Opinion in Endocrine and Metabolic Research, 12, pp. 66-71.
NHS. (2023). Polycystic Ovary Syndrome. [online]. Available at: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/ (Accessed: 10th January 2023).
Sheehan, MT. (2004). ‘Polycystic ovarian syndrome: diagnosis and management’, Clin Med Res., 2(1), pp. 13-27.
Royal College of Obstetricians & Gynaecologists (RCOG). (2014). Long-term Consequences of Polycystic Ovary Syndrome. [e-book] [no publisher]. Available through: Royal College of Obstetricians & Gynaecologists website (Accessed: 10 January 2023).
Zeng, X. Xie, Y. Liu, Y. Long, S. Mo, Z. (2020). ‘Polycystic ovarian syndrome: Correlation between hyperandrogenism, insulin resistance and obesity’, Clinica Chimica Acta, 502, pp. 214-221.
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