What is PCOS?
Polycystic ovary syndrome (PCOS) is a condition that affects a woman’s hormone levels.
Women with this produce higher-than-normal amounts of male hormones (androgen). This hormone imbalance causes them to skip menstrual periods or have irregular periods, which makes it harder for them to get pregnant.
These hormone levels can sometimes cause excessive facial hair growth, acne, and/or male-pattern scalp hair thinning. PCOS is not completely reversible but there are a number of treatments that can reduce or minimise bothersome symptoms. Most women are able to lead a normal life without significant complications.
PCOS and fertility:
PCOS is one of the most common causes of female infertility. Many women discover they have it when they’re trying to get pregnant and are unsuccessful.
During each menstrual cycle, the ovaries release an egg into the uterus during ovulation. Women with polycystic ovary syndrome often fail to ovulate or ovulate infrequently, which means they have irregular or absent periods and find it difficult to get pregnant.
The exact cause of polycystic ovary syndrome (PCOS) is unknown, but it’s thought to be related to abnormal hormone levels.
Resistance to insulin
Insulin is a hormone produced in the body to control the amount of sugar in the blood. It helps the cells in your body turn sugar (glucose) into energy. Insulin resistance means the body’s tissues are resistant to the effects of insulin. The body therefore has to produce extra insulin to compensate.
High levels of insulin causes the ovaries to produce too much of the hormone testosterone. This interferes with the development of the follicles (the sacs in the ovaries where eggs develop) and prevents normal ovulation.
Insulin resistance can also lead to weight gain, which can make PCOS symptoms worse. Having excess fat causes the body to produce even more insulin.
Many women with PCOS are found to have an imbalance in certain hormones, including raised levels of testosterone.
The exact reason why these hormonal changes occur is not known. It’s been suggested that the problem may start in the ovary itself, in other glands that produce these hormones, or in the part of the brain that controls their production. The changes may also be caused by the resistance to insulin.
PCOS sometimes runs in families. This suggests there may be a genetic link to PCOS, although specific genes associated with the condition have not yet been identified.
Who is at risk of PCOS?
Between 5% and 10% of women between 15 and 44 have PCOS. Most women find out they have it in their 20s and 30s, when they have problems getting pregnant and see their doctor. But it can happen at any age after puberty.
Women of all races and ethnicities are at risk of PCOS. Your risk may be higher if you have obesity or if you have a mother, sister, or aunt with this syndrome.
Symptoms of PCOS:
Many women with PCOS find they’re able to manage their symptoms by controlling their diet and lifestyle choices.
If you experience symptoms, they’ll usually become apparent in your late teens or early 20s. Not all women with PCOS will have all of the symptoms, and each symptom can vary from mild to severe. Some women only experience menstrual problems or are unable to conceive, or both.
- irregular periods or no periods at all
- difficulty getting pregnant (because of irregular ovulation or failure to ovulate)
- excessive hair growth – usually on the face, chest, back or buttocks
- weight gain
- thinning hair and hair loss from the head
- oily skin or acne
You should talk to your GP if you have any of these symptoms and think you may have PCOS.
Can PCOS be cured?
Unfortunately it cannot be cured, but simple lifestyle changes can help to manage the symptoms and even improve them.
Because women with PCOS are often found to have higher than normal insulin levels, making changes to your diet can therefore have a big impact on the managing and improving the symptoms.
What should my diet look like?
High fibre foods can help combat insulin resistance by slowing down digestion and reducing the impact of sugar on the blood. This may be beneficial to women with PCOS.
Foods to include in your diet:
- High fibre vegetables, including: broccoli, cauliflower, Brussel sprouts, green and red peppers, beans and lentils, almonds, berries and sweet potatoes.
- Lean protein, such as fish and chicken.
- Foods that help reduce inflammation may also be beneficial, including: tomatoes, kale, spinach, olive oil, berries and fish high in omega 3 such as sardines and salmon.
Foods to limit or avoid:
- Sugary snacks and drinks – sugar is a carbohydrate and should be avoided wherever possible.
- It’s a good idea to reduce or remove inflammation-causing foods, such as fries, margarine, and red or processed meats from your diet.
- Refined carbohydrates cause inflammation, exacerbate insulin resistance, and should be avoided or limited significantly. These include highly-processed foods, such as: white bread, muffins, breakfast pastries, sugary desserts, sweets, white potatoes, and anything made with white flour.
- Pasta noodles that list semolina, durum flour, or durum wheat flour as their first ingredient are high in carbohydrates and low in fibre. These should be removed from your diet.
Other lifestyle changes to consider
PCOS, like many disorders, responds positively to proactive lifestyle choices. This includes exercise and daily physical movement, which can help to reduce insulin resistance when coupled with a limited intake of unhealthy carbohydrates. Many experts agree that at least 150 minutes per week of exercise is ideal.
In overweight women, the symptoms and overall risk of developing long-term health problems from PCOS can be greatly improved by losing excess weight. Weight loss of just 5% can lead to a significant improvement in PCOS. Women may experience improved ovulation with weight loss, so women who are obese or overweight and want to get pregnant may find GP-approved exercise especially important.
You can work out if you are overweight by checking your BMI. A normal BMI is between 18.5 and 24.9. Use this BMI healthy weight calculator to work out whether your BMI is in the healthy range.
As it seems to be with most health-related issues, there is no easy fix or quick win. You need to put in the effort to maintain a healthy lifestyle. Daily activity and a healthy diet with low sugar intake and containing low-inflammation foods is the key for managing and improving the symptoms of PCOS in many women.
Thank you: you can find out more about PCOS on the NHS website and thehealthline.com where we have taken some of this information. More detail about PCOS diet can be found here.