An Expert’s Guide To Dealing With PCOS

Understand The Hormone Connection

“PCOS is a common hormonal condition, affecting one in every ten women in the UK, although more than half don’t have symptoms. Women with PCOS have increased levels of a certain hormone called androgens – this imbalance can impact how often you ovulate and how frequent your periods are. One of the things that makes understanding PCOS so difficult is the language surrounding it. Sometimes, people who have PCOS have small, multiple cysts that form on their ovaries. However, this isn’t always the case – you can be diagnosed with PCOS and never have cysts on your ovaries. Not everyone experiences the same symptoms of PCOS, but the three main features are: irregular or absent periods; high androgen levels which can result in hair growth on your face, arms and chest; and polycystic ovaries, i.e., fluid-filled sacs and follicles that surround your eggs when seen on an ultrasound scan. Other symptoms can include fertility issues and weight gain.”

Think About Blood Sugar

“There is a close link between PCOS and insulin resistance, which means your body is less able to deal with sugar, which can increase your risk of type 2 diabetes. Plus, people with high levels of androgens are also more likely to gain weight around their middle, which is linked to increased fat around the organs. In addition, those with PCOS are more likely to develop high cholesterol. Some people find losing 5% of their bodyweight – if overweight – drastically improves PCOS symptoms. The Mediterranean diet has been shown to improve insulin resistance, while a low-GI diet (based on how foods affect your blood sugar) is also shown to reduce androgen levels in women with PCOS, as well as excess body hair and emotional health.”

Chat To Your GP As A Starting Point

“PCOS can make getting pregnant trickier because, if you don’t have a regular cycle, you may not ovulate every month, which is vital if you want to conceive. However, don’t be disheartened, as many women with PCOS get pregnant either naturally or with the help of fertility treatment, such as medication that encourages ovulation. If you don’t plan on having a baby soon, your GP may suggest looking into hormonal birth control such as the combined pill. It could also be worth exploring medication to ensure your uterine lining doesn’t build up and get too thick – options include the coil or a progesterone tablet taken for two weeks every one to three months.”

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Forget The Different Types

“You may have heard there are different ‘types’ of PCOS – such as pill-induced PCOS and PCOS driven by inflammation – but new guidelines suggest that fixating on these types is likely to be more confusing than helpful. Instead, it’s best to think of PCOS as a syndrome with several symptoms that deserve individual attention, emphasising the importance of a proper diagnosis. As a result, you may end up seeing professions from different specialities (e.g. dermatology, gynaecology and endocrinology), for symptoms ranging from acne and an irregular cycle to sleep disturbances. It can be tricky to join the dots to get a proper diagnosis, which can lead to disjointed medical advice and treatment, often leaving women frustrated. Recent studies suggest that one in four women with PCOS remains undiagnosed.”

Ignore The Weight Myth

“One of the biggest myths is that PCOS only affects those who are overweight. The truth is the condition can affect people of all sizes. While it is true excess body weight is a risk factor, PCOS also affects two out of ten people in the so-called ‘healthy’ body weight range with a BMI of less than 24.9. I always encourage my PCOS clients to focus on what they can add to their diet rather than what they should remove. Yo-yo dieting and calorie deprivation increases levels of the stress hormone cortisol, which is already dysregulated in those with PCOS.”

Eat More Plants

“There’s no cure for PCOS, but symptoms can be managed through lifestyle changes. In fact, all national and international guidelines recommend lifestyle changes as the first line of treatment for PCOS, even before medication. The first, and arguably most important, step is to eat more plants – fruit, vegetables, wholegrains, legumes, nuts and seeds, and herbs and spices. This will reduce inflammation, normalise blood sugar, lower insulin resistance and promote healthy gut bacteria. As a starting point, focus on adding more colour to your plate.”

Approach Supplements With Caution

“There are thousands of supplements on the market targeted at women with PCOS, often supported with little evidence. Instead, consider getting your vitamin D levels tested, as a deficiency is common in women with PCOS. There is also some evidence that vitamin D supplementation may improve insulin sensitivity and reproductive function. Also get your iodine levels checked, which play a key role in thyroid function. PCOS is associated with an increased prevalence of thyroid issues. Other supplements that may be helpful include omega-3 fatty acids, especially for those with insulin resistance and raised cholesterol, as well as inositol, chromium, magnesium and zinc.”

Move Your Body Regularly

“Resistance training is particularly helpful for improving body composition and reducing androgen excess in those with PCOS. Regular movement – even a short walk for 15 minutes after a meal – can help increase your body’s sensitivity to insulin and reduce anxiety and depression. Interestingly, women with PCOS often show greater muscle strength, irrespective of body composition, compared to those without the condition. PCOS is the most common cause of menstrual disorders among Olympic sportswomen.”

Get An Early Night

“Aim to get seven to nine hours of restorative sleep every night. Rest lowers levels of cortisol, which studies show are higher in those living with PCOS. Sleep is critical for hormonal health, and sleep disturbances are common in PCOS.”

Know Your Triggers

“As PCOS is a lifelong condition, understanding my body and individual triggers has been key for me. Avoiding caffeine and alcohol has been a game-changer, as has following a plant-based diet. I include movement in my day and go for long walks or practise yoga and have learnt to manage stress – including setting boundaries. I now have regular cycles with normal markers on blood tests, although I still experience flare-ups of certain symptoms, such as acne, when I neglect self-care, especially during periods of stress.”

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