PCOS – What Is PCOS? (PolyCystic Ovarian Syndrome)

PCOS (Polycystic Ovarian Syndrome) is one of the most common gynaecological complaints that women’s health specialists see in their clinics – its becoming an increasing problem amongst women of today. So what is it?

Polycystic Ovarian Syndrome (PCOS) is a reproductive disorder characterised by multiple cystic growths on the ovaries. PCOS develops when the ovaries are stimulated to produce excessive amounts of male hormones (androgens), particularly testosterone. This happens through the release of either excessive luteinising hormone (LH) by the pituitary gland or from high levels of insulin in the blood (hyperinsulinaemia) in women whose ovaries are sensitive to this stimulus. It can also be the result of oestrogen dominance.

What Causes PCOS?

PCOS has a complex set of symptoms, with research to date suggesting that insulin resistance is a leading cause. Dr Andrew Orr, a women’s health and fertility specialist from Shen Therapies says: “The majority of patients with PCOS (some say all) have insulin resistance. Insulin resistance is a common finding among both normal weight and overweight PCOS patients. Many years ago it was thought that you had to be overweight to have PCOS, but now we know that many normal and underweight women have too. Their elevated insulin levels contribute to or cause the abnormalities seen in the hypothalamic-pituitary-ovarian axis that lead to PCOS. Specifically, hyperinsulinaemia causes a number of endocrinological changes associated with PCOS too. Anyone with polycystic ovaries does have a more than 50% chance of developing diabetes later on as well.”

What Are The Symptoms Of PCOS?

PCOS is the most common cause of oligomenorrhoea (irregular or infrequent periods) and amenorrhoea (no periods), although 20-25% of normally menstruating women have PCOS. These women may have reduced fertility and an increased risk of miscarriage.

Common signs and symptoms of PCOS include:

• Irregular menstrual cycles ” i.e. oligomenorrhoea or amenorrhoea
• Infertility, generally resulting from chronic anovulation (lack of ovulation)
• Elevated serum (blood) levels of androgens (male hormones), specifically testosterone, androstenedione, and dehydroepiandrosterone sulphate (DHEAS)
• Central obesity ” “apple-shaped” obesity centred around the lower half of the torso
• Androgenic alopecia (male-pattern baldness)
• Acne, oily skin, seborrhoea
• Hirsutism (excess hair growth)
• Acanthosis nigricans
• Prolonged periods of PMS-like symptoms
• Sleep apnoea
• Multiple cysts on the ovaries
• Enlarged ovaries, generally 2-3 times larger than normal, resulting from multiple cysts
• Chronic pelvic pain
• BGL dysregulation ” e.g., hypoglycaemic episodes, diabetes, etc
• Hypothyroidism

What Are The Risk Factors For PCOS?

Major causative factors and risk factors that can contribute to the incidence of PCOS include:

• Insulin resistance
• Obesity
• Family history of PCOS
• Family history of diabetes
• Stress
• Nutritional deficiencies
• High glycaemic load diet
• Sedentary lifestyle

Diet and Lifestyle – The Key To Managing PCOS

Dr Orr says that dietary and lifestyle changes are a must in the management of PCOS. “The world health organisation recommends that dietary and lifestyle changes are the number one treatment for PCOS along with other therapies. By consuming reduced amounts of low GI (glycaemic index) carbohydrates, keeping protein levels up to maintain muscle mass and eating ‘good’ fats, insulin levels are reduced, allowing fat stores to be accessed as fuel for energy production (thermogenesis). The wellness/zone/paleo style diets that we promote in our clinic help women with PCOS to maintain steady blood sugar and insulin levels, assisting in weight loss and maintaining body mass for those who are underweight.”

A diet comprised of mainly low-GI foods combined with regular exercise will also help to combat the effects of insulin resistance – this is why the diets are the best diets to follow. Women with PCOS should ideally get rid of grains altogether. Dr Orr advises that they should also avoid refined carbohydrates including sugar, sweets, fruit juices, white breads and pasta. These foods have a high glycaemic index and are damaging in any amount for PCOS sufferers.

A typical diet for those with PCOS should be one that is:

• High in vegetables (non-starchy)
• A small amounts of low-GI fruits
• Essential fatty acids and lean protein sources, which provides essential phytonutrients, antioxidants, magnesium and helps to control inflammation and hormonal dysregulation.

Smoking cessation is the highest priority for smoking patients. Regular resistance training, or high interval exercise, is a must too (starting slowly and increasing as patient’s fitness improves).