PCOS - The Basics
Polycystic Ovary Syndrome, or PCOS, is an endocrine disorder which affects up to 1 in 10 women worldwide. It is the most common female hormone condition and presents differently in every individual. In this blog post we will highlight the symptoms of PCOS, how it is diagnosed and how it can be managed.
Symptoms
As PCOS is a syndrome, which means a collection of symptoms, this means those with PCOS may all present differently with their own symptom profile. Below are some of the symptoms of PCOS, though not all people with PCOS will have all of these symptoms and the severity of symptoms can vary between individuals.
Symptoms of PCOS include:
Irregular periods, eight or fewer in a year and sometimes none at all
Problems getting pregnant
Finding it hard to lose weight
Having more hair than usual, often on your top lip, chin, around your nipples and in a line down from your tummy button – this is called hirsutism
Thinning hair and hair loss
Acne
Patches of dark thick skin in your armpit or around your groin or neck
Sleep apnoea
Anxiety, depression, mood swings and low-self esteem
Diagnosis
Symptoms of PCOS will usually become apparent in your late teens or early 20s, at which point it is recommended to speak to your GP. Following presentation of symptoms your GP will request blood tests to measure hormone levels and may request an ultrasound scan.
The GP can look to diagnose if you have PCOS by using the Rotterdam criteria, by assessing if you exhibit any of the following:
Absent or infrequent periods (indicating your ovaries are not regularly releasing eggs)
Evidence of excess androgens (e.g. male hormones such as testosterone)
Scans to show you have polycystic ovaries (large or multiple small follicles)
Only 2 of the 3 criteria need to be met, once any other conditions have been ruled out. If you do meet the criteria your GP and other health professionals can work with you to control your symptoms using a combination of lifestyle changes and medication.
Treatment
Lifestyle modification is often recommended as first line treatment for women with PCOS. This can include ensuring you are eating a healthy, varied diet but also adding more movement into your routine, prioritising rest and reducing stress.
Incorporating moderate exercise as a treatment is recommended due to its beneficial effects in relation to insulin resistance, independent of weight loss. Moderate physical activity, 3-5 times a week, as recommended for everyone, not just women with PCOS, has been shown to improve insulin sensitivity and overall health. In women with PCOS regular exercise may improve reproductive outcomes including ovulation and menstrual cycles as well as weight management, and insulin resistance.
Rather than focusing on what you ‘should’ remove from your diet if you have PCOS, focus on what you can add in. Try to consume regular meals and snacks to maintain insulin levels and normalise hormone levels. Incorporate protein into your meals through meat, fish, eggs, tofu, soy, legumes, pulses and nuts. Protein has been seen to contribute to reduced levels of androgen hormones and insulin, as well as helping with symptom management of PCOS. Add omega-3 fatty acids as they can help with the chronic inflammation associated with PCOS, particularly DHA which is found in oily fish, seaweed and algae. Enjoying complex carbohydrates such as wholegrain bread, oats, muesli and other grains can help slow down the breakdown and absorption of glucose into the bloodstream.
People with PCOS are more sensitive to the impacts of stress and tend to have elevated levels of cortisol (a stress hormone). Cortisol can influence insulin sensitivity, impact fertility and increase cyst production. Getting enough sleep can help manage our cortisol levels. Be mindful of your caffeine intake and try to avoid blue light from phones or laptops for a couple of hours before bed. Practices such as journalling, yoga and meditation can help reduce the physiological response to stress and lower the production of stress hormones. There is some evidence to suggest that acupuncture can help with androgen regulation and improve ovulation in people with PCOS.
References
BDA, 2016. Polycystic Ovary Syndrome – the fundamentals[online]. Available from: https://www.bda.uk.com/resource/polycystic-ovary-syndrome-the-fundamentals.html. Accessed 11 June 2021.
BDA, 2019. Polycystic Ovary Syndrome (PCOS) and diet: Food Fact Sheet[online]. Available from: https://www.bda.uk.com/resource/polycystic-ovary-syndrome-pcos-diet.html. Accessed 11 June 2021.
Farschi,H., Rane,A., Love,A., Kennedy,R.L., 2007. Diet and nutrition in polycystic ovary syndrome (PCOS): Pointers for nutritional management. Journal of obstetrics and gyncaecology. 27(8), 762-773.
Harrison,C.L., Lombard,C.B., Moran,L.J., Teede,H.J., Exercise therapy in polycystic ovary syndrome: a systematic review. Human reproduction update, 17(2), 171-183.
Johansson, J. & Stener-Victorin, E. (2013) Polycystic Ovary Syndrome: Effect and Mechanisms of Acupuncture for Ovulation Induction, Evidence Based Complementary and Alternative Medicine, 762615. Available online at: https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC3773899/
NHS, 2019. Diagnosis Polycystic ovary syndrome[online]. Available from: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/diagnosis/.Accessed 11 June 2021.
Sinha, S. S., Jain, A. K., Tyagi, S., Gupta, S. K., & Mahajan, A. S. (2018). Effect of 6 Months of Meditation on Blood Sugar, Glycosylated Hemoglobin, and Insu- lin Levels in Patients of Coronary Artery Disease. International journal of yoga, 11(2), 122–128. doi:10.4103/ijoy.IJOY_30_17
