Managing PCOS

Polycystic ovarian syndrome (PCOS): Causes + Management

Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects 1 in 10 women who are of reproductive age (15–44 years old). Women with PCOS produce higher amounts of male hormones which can cause their body to skip menstrual periods and can impact their fertility [1]. PCOS can also cause facial hair growth, acne, and baldness. However, not everyone diagnosed will show symptoms as it varies from person to person. PCOS is associated with metabolic issues such as glucose intolerance and diabetes, high cholesterol, high triglycerides, depression, and sleep apnea.

The three key features of polycystic ovarian syndrome are:

• Cysts in the ovaries
• High levels of male hormones
• Irregular or skipped periods

Typically, doctors diagnose PCOS in women who have at least two of these symptoms. The presence of polycystic ovaries alone does not guarantee PCOS. In some cases, blood tests are needed to make an accurate diagnosis [2].

What causes PCOS?

While doctors still don’t know exactly what causes PCOS, it’s thought to be related to abnormal male hormone levels which negatively impacts the ovaries hormone production and ability to make eggs normally.

Genetics

Women with PCOS often have a family member who also has the condition. If any of your relatives have PCOS, it can increase your risk of developing it [2].

Resistance to Insulin

Insulin resistance can be found in 60–80% of women with PCOS. Insulin is a hormone produced by the pancreas which helps the body regulate its blood sugar. People with insulin resistance means that their cells cannot use insulin properly. When this happens, the body’s demand for insulin increases and the pancreas pumps out extra insulin to compensate. Extra insulin triggers the ovaries to produce more male hormones [2].

Management of PCOS

While there is currently no cure for PCOS, there are lifestyle changes you can make to manage the symptoms.

For a lot of women, when they are diagnosed with PCOS they are told to lose weight to manage their condition. However, for most women with PCOS they have described it as “impossible” to lose weight. PCOS significantly slows metabolism and, due to the high levels of insulin, it causes the body to store more fat [3]. It is not uncommon for them to engage in starvation-level diets and see little change to their weight. In fact, women with PCOS have a higher prevalence of eating disorders and disordered eating [3]. Therefore, the focus should be removed from weight loss and instead shifted towards engaging in healthy lifestyle changes that can improve insulin resistance as this can improve symptoms of PCOS.

Diet

General healthy eating principles should be followed for all women with PCOS, with no specific dietary type [3]. This would include eating three balanced meals a day with snacks to help maintain insulin levels. Include a variety of fruits and vegetables, beans, peas, and whole grains, low-fat dairy products, lean meats, poultry, seafood, and eggs. Foods which are high in fat and sugar, for example fried foods and baked goods, should be limited but it does not mean you have to cut these foods out entirely.

At present, there is no evidence suggesting to cut out food groups to manage PCOS. Many women try to cut out carbohydrates or go on a low-carb diet, only to end up bingeing due to the intense cravings. Aim for moderate amounts of carbohydrates throughout the day and opt for carbohydrates which are high in fiber (wholegrains, beans, fruits, starchy vegetables). High-fiber carbohydrates allow the body to break down the sugars more slowly, reducing the risk of high and low blood sugar.

Studies also recommend including omega-3s to help with reducing inflammation in women with PCOS to improve symptoms [4]. Omega-3s can be found in fatty fish such as salmon, tuna, mackerel, herring, trout, and sardines.

Exercise

Being physically active can increase the body’s cells’ response to insulin and take up glucose during and after activity, lowering blood sugars in the short term. It is advised to aim for 150 minutes of moderate physical activity a week. This includes walking, yoga, swimming, or aerobics. Include muscle-strengthening activities such as lifting weights, push-ups, sit-ups, and squats two to three times a week.

Medication

Doctor’s may recommend different medications to help alleviate symptoms such as hormonal birth control to help regulate and lighten periods as well as reduce excess hair growth. Metformin may also be prescribed to treat associated insulin resistance and support ovarian function.

Supplements

Inositol, in particular myo-inositol, is a supplement that can help improve PCOS symptoms, especially when paired with folic acid. It can improve insulin sensitivity and decrease androgen levels. It may also promote ovulation in women with fertility issues however more research is needed [5]. Make sure to discuss with your doctor before taking anything.

There’s no one-size-fits-all way to treat PCOS. The options go far beyond diet and exercise, so it is recommended to check in with a doctor to see what your options are.

All of the content presented by Tru Valu Supermarkets on our Medium channel, including written text, photographs, videos, and graphics, as well as other resources we might include is meant to educate and it should not be perceived as a substitution for professional medical advice, as well as diagnosis or treatment. Always consult your doctor or nutrition advisor before making major lifestyle and diet changes.

Tru Valu Supermarkets is one of Trinidad and Tobago’s leading supermarket brands. As a responsible supermarket chain we believe in educating and informing our customers to make responsible decisions each day to improve their wellness and wellbeing.

References

[1] W. M. Wolf, R. A. Wattick, O. N. Kinkade, and M. D. Olfert, “Geographical prevalence of polycystic ovary syndrome as determined by region and race/ethnicity,” International Journal of Environmental Research and Public Health, vol. 15, no. 11. MDPI AG, Nov. 20, 2018, doi: 10.3390/ijerph15112589.

[2] E. K. Barthelmess and R. K. Naz, “Polycystic ovary syndrome: Current status and future perspective,” Frontiers in Bioscience — Elite, vol. 6 E, no. 1. Frontiers in Bioscience, pp. 104–119, Jan. 01, 2014, doi: 10.2741/e695.

[3] H. J. Teede et al., “Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome,” Human Reproduction, vol. 33, no. 9, pp. 1602–1618, Sep. 2018, doi: 10.1093/humrep/dey256.

[4] K. Yang, L. Zeng, T. Bao, and J. Ge, “Effectiveness of Omega-3 fatty acid for polycystic ovary syndrome: A systematic review and meta-analysis,” Reproductive Biology and Endocrinology, vol. 16, no. 1. BioMed Central Ltd., Mar. 27, 2018, doi: 10.1186/s12958–018–0346-x.

[5] B. Kalra, S. Kalra, and J. B. Sharma, “The inositols and polycystic ovary syndrome,” Indian Journal of Endocrinology and Metabolism, vol. 20, no. 5, pp. 720–724, Sep. 2016, doi: 10.4103/2230–8210.189231.