PCOS 101: From Diagnosis To Treatment

Jennifer Walpole, registered nutritional therapist specialising in women’s health and fertility says…

Identify The Risk Factors

“PCOS only affects women of reproductive age. Studies have concluded that there is a similar prevalence of PCOS documented across the UK, US, Asia, much of Europe and Australia, affecting all races and ethnicities. However, a genetic link is known to be involved as this syndrome does run in families. We also know that obesity, whilst not a cause of PCOS, does exacerbate the condition. PCOS is thought to be the most common endocrine disorder found in women, affecting one in ten women in the UK. However, due to how varied the presenting symptoms are, many more may go undiagnosed.”

Understand The Hormone Connection

“The main defining characteristic of PCOS is known as hyperandrogenism (excess androgens, or male hormones such as testosterone). This is thought to cause follicle excess on the ovaries, resulting in anovulation and infertility/subfertility. Excess androgens not only have an effect on fertility, but also present in physical symptoms, which are usually more obvious and the first signs that a woman may be experiencing hormone imbalances and/or PCOS. Testosterone stimulates the production of oil in the skin and so women with PCOS may experience acne on their face, back, neck and chest. Excess androgens might also result in male pattern hair growth, known as hirsutism. Women may notice excess dark facial hair, for example. Women may also present with male pattern hair loss and increased weight, particularly around their abdomen.”

Know That Diagnosis Is Possible

“Diagnosis methods vary from country to country, which is why PCOS often goes undiagnosed. However, the NHS diagnosis criteria in the UK states that you must experience at least two out of three of the following: irregular of infrequent periods; high levels of androgens or signs of this such as hirsutism; or a scan to show the presence of polycystic ovaries. Polycystic ovaries can be detected through an ultrasonography and are diagnosed by the presence of 12 or more follicles on at least one ovary or an increased ovarian volume.” 

Understand The Role Of Insulin 

“Insulin resistance also plays a part in PCOS. The hormone insulin manages blood sugar levels in the body, and excess insulin can occur as a result of insulin resistance. Excess insulin reduces a hormone called SHBG (sex hormone binding globulin), which we need to control our sex hormone levels. Therefore, insulin resistance has a knock-on effect on our sex hormones. This is why blood sugar balance is so important when it comes to PCOS and hormone imbalances in general.  By reducing the intake of sugars (including healthy ones), insulin resistance can be managed effectively.”

Assess Other Areas Of Your Health

“Research has been carried out that highlights the increased risk of obstetric, cardiometabolic, oncology and psychological complications in PCOS women compared to their non-PCOS counterparts although these risks can change during a woman’s life. Possibly the largest researched complication of PCOS is the development of type II diabetes – the two are linked by insulin resistance.  More recently, studies have proven that women with PCOS were four times more likely to develop type 2 diabetes compared to their counterparts. Again, this can be managed effectively once the diagnosis is made through regular screening, so the prognosis is good.”
 
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Be Warned, Getting Pregnant May Be Trickier

“As many as one in five women in the UK that are diagnosed with infertility have PCOS. However, this doesn’t mean you will never get pregnant if you have PCOS, it may just take a little longer. In simple terms, during the monthly ovulatory cycle, the ovaries may fail to release an egg due to a build-up of follicles, leading to the disruption of the monthly cycle and infertility. The reason for this is because in many cases (not all), polycystic ovaries carry a higher number of follicles than that of normal ovaries. The imbalance of hormones (FSH and LH) prevents the selection of a dominant follicle from this increased pool, resulting in anovulation (which means ovulation does not occur). This usually results in a longer menstrual cycle of more than 35 days.” 

Cut Back On Sugar

“Focused nutrition support is paramount when it comes to managing PCOS and the associated complications. For example, blood sugar balance is imperative to manage insulin resistance. Following a low GL diet by making some relatively simple swaps when it comes to food choices has been shown to be beneficial. For example, swapping refined carbohydrates such as white pasta, rice and bread for wholegrain, brown and seeded varieties (complex carbs) is a good idea. Starchy carbohydrates like white potatoes should be limited to smaller portions and foods such as sweet potatoes make a good alternative. Whilst fruit is a fabulous snack, it’s best to go for a handful of low GL berries than very sweet pineapple, melon or dried fruits. Try to cut back on snacks, too, as these can release extra insulin into the bloodstream in between meals.”

Overhaul Your Diet To Help With Acne

“Managing acne through the diet is key to reducing this symptom of PCOS. The three areas that can really help manage this are by reducing insulin levels, reducing levels of insulin like growth factor (IGF-1) and reducing inflammatory foods. Increase your fibre intake and increase plant-based protein whilst reducing excessive animal protein intake, dairy (especially milk, which increases IGF-1), and processed foods. Also consider increasing your oily fish consumption to two to three portions per week. Exercise can also help manage the root cause of acne as it can help lower insulin levels and IGF-1.”

Top Up On Supplements 

“The most studied supplement that can help manage PCOS is myo-inositol, sometimes referred to as vitamin B8. Whilst the body can make small amounts of this vitamin-like substance, supplementation has been shown to be beneficial to improve reproductive outcomes, reduce androgen levels and improve insulin sensitivity. There is also some evidence for the use of vitamins A, D, E and omega-3 for the management of PCOS. Wild Nutrition has a great formula – Food-Grown Polycys Complex – that I often recommend to patients with PCOS. It contains inositol as well as chromium and zinc, which can be helpful with PCOS-induced acne.” 

Angelique Panagos, registered nutritional therapist specialising in hormonal health says…

Know The Term PCOS Can Be Misleading

“PCOS is one of the most common endocrine disorders that affects millions of women and is said to be one of the leading causes of menstruation irregularities and subfertility. However, the name PCOS is confusing, as the characteristics of polycystic ovaries as seen on an ultrasound are an increased amount of small unmatured follicles, not cysts, existing on the ovaries. This is a symptom of PCOS and not the cause. You can also have polycystic ovaries and not have PCOS. As it is a syndrome, you can have a collection of symptoms and even though it is a gynaecological disorder, it is a systemic disorder which means it can increase your chances of developing other health problems too."

Understand Symptoms Can Vary

“We are all biochemically individual, so your PCOS symptoms can be totally different to someone else with PCOS. However, some of the most common symptoms include infrequent, irregular periods; absent periods; difficulty or inability to fall pregnant due to irregular or lack of ovulation; miscarriage; excess hair growth on the face, chest, back and belly; weight gain; recurring acne; hair loss from the head or thinning hair; oily skin; weight gain around the tummy; and sleep disorders. It’s important to note that you should look to treat and balance the whole body and not just look to ‘fix’ one symptom at a time.”

Accept The Causes Are Also Not Fully Understood

“Researchers aren’t entirely clear on the exact cause of PCOS, although we do know it involves a combination of environmental, lifestyle and genetic factors. Insulin is thought to be a driver as well as insulin resistance, which is high in women with PCOS. This can lead to an elevated production of testosterone from the ovaries, which is a root cause for a lot of the symptoms. We need to look at the link with stress and all hormones, including insulin, our gut health, the way we prioritise sleep and the food that we eat on a regular basis. Just because we are predisposed to a condition does not mean we are going to develop it.” 

Seek Medical & Lifestyle Help

“If you have been diagnosed with PCOS, do your research and make the best-informed decision for your own health and work with a registered nutritional therapist who can work alongside your doctor and support you while you receive treatment. Making lifestyle factors a priority is key, but medical treatments for PCOS include the birth control pill (although this will not regulate your cycle; it will cause a bleed while you are taking it, but you may have the same irregular cycles when you come off); medication such as matformin, which is commonly used to regulate insulin for those with insulin resistance or type 2 diabetes; medications such as clomid and letrozole used in fertility; and medication to reduce excess hair growth.”

Ditch Fad Diets

“We are all biochemically individual and while many women who have PCOS battle to maintain their weight and are overweight or even obese, which can further exacerbate the condition, not all do. Some have what’s referred to as ‘lean PCOS’, and because of that are sometimes overlooked and go undiagnosed for years. If you have PCOS and have gained weight you would like to shift, ditch fad diets, which will never work in the long term and can cause additional stress on the body, which leads to further hormonal imbalances. If you want to lose weight, the first step is to improve blood sugar regulation, which will improve insulin resistance, reduce raised testosterone levels and improve ovulation and menstruation.”

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Angelique holds Eating for Energy Masterclasses throughout the year. To find out more and book a ticket, click here; for more information visit AngeliquePanagos.com. For more information or to book a consultation with Jennifer, visit JenWalpole.com.

DISCLAIMER: Features published by SheerLuxe are not intended to treat, diagnose, cure or prevent any disease. Always seek the advice of your GP or another qualified healthcare provider for any questions you have regarding a medical condition, and before undertaking any diet, exercise or other health-related programme.