What is PCOS and How Can You Manage its Symptoms and Risks?
Since you're reading this, I'll take a wild guess that you either suspect you have Polycystic Ovary Syndrome (PCOS) or have recently been diagnosed with it. A lot of women find the diagnosis (or the prospect of it) very confusing and scary, and my hope is that this article will help you feel more empowered around this common condition that affects how your ovaries work.
PCOS is a condition that many women experience without even realising it. We don't fully understand the exact causes of PCOS. While researchers aren't entirely sure what causes polycystic ovary syndrome (PCOS), they do know that it results from a combination of genetic and environmental factors. Some evidence suggests that factors such as insulin resistance, hyperandrogenism (too many male hormones), environmental influences, and genetic and epigenetic factors may play a role in the development of PCOS.
So, what are the main features of PCOS? Well, there are three to be precise.
The first one is irregular or absent periods, which means that your ovaries are not releasing eggs regularly (or at all!). This can lead to difficulty conceiving or even infertility. Having said this, you should use contraception because you absolutely CAN get pregnant with PCOS.
The second feature is hyperandrogenism, which means having too many "male hormones" like testosterone in your body. This can cause symptoms such as acne, thinning hair on the scalp, as well as dark and thick hair in unusual areas for women like the face, chest, and back.
The third feature is enlarged ovaries that contain many fluid-filled sacs called follicles, which surround the eggs. But where do these follicles come from? The hormone imbalance that you get with PCOS means that your ovaries can't release eggs like they should. Instead, your ovaries collect immature follicles. So despite its name, you don't actually have cysts if you have PCOS, you have immature follicles that build up giving a ‘string of pearls’ appearance on an ultrasound.
If you have at least two of these three features, you might be diagnosed with PCOS. Some other conditions may present with a similar symptom profile, so your doctor will carry out the necessary tests to see what's going on. So if you suspect you may have PCOS or are experiencing any of these symptoms, don't hesitate to speak with your doctor. They can help you identify if you have PCOS and suggest treatment options to help you manage the condition.
Although the diagnosis of PCOS is mostly concerned with physical symptoms, there are many other problems that can come from the hormone imbalance that comes with PCOS. Women often struggle with:
- Craving certain foods, especially stuff that's loaded with sugar or carbs
- Eating when they're feeling emotional or having trouble with their eating habits
- Binge eating
- Feeling anxious or down in the dumps
- Being really tired and having trouble concentrating aka ‘brain fog’
Aside from the symptoms of PCOS, many women with this condition worry about their risk of developing health issues related to their heart and metabolism. Sadly, having PCOS means you could be more likely to develop glucose intolerance, type 2 diabetes, gestational diabetes, high levels of unhealthy fats in the blood, inflammation throughout the body, liver problems, high blood pressure, and blood clotting disorders. To make matters worse, factors like having a large amount of body fat and insulin resistance can further aggravate these issues.
What are the solutions?
It's not all bad news, though, because there are things that you can do to help manage your symptoms and long-term risks. By making changes to your nutrition, lifestyle, and exposure to certain environmental factors, you can improve your symptoms, increase your chances of getting pregnant and having a healthy pregnancy, and reduce those scary long-term risks. Nutrition and lifestyle change is a key part of treatment, with or without medication. Dietary and lifestyle changes have been shown in research to reduce or correct the underlying hormonal issues that drive PCOS, leading to (1,2):
- More regular menstrual cycles
- Improved fertility
- Improved insulin sensitivity
- Reduced levels of "male hormones"
- Weight loss
- Improved cholesterol and blood fats
- Reduced low-level chronic inflammation
- Improved mood regulation
There isn't just one diet that's perfect for every woman with PCOS. Studies have shown that different ways of eating can work well, and there are different strategies to help with different symptoms. So, the key is to find a lifestyle and nutrition plan that will help you address the root cause of your health issues. It's also important to pick a plan that is realistic and doable for you.There's no cure for PCOS, so it's important not to fall for any quick-fix diets that are impossible to stick to in the long run. If you want to make changes, think about whether they're actually doable for you in the long term. And don't get discouraged if it all seems like too much to handle. If you work with someone who can help you make small, sustainable changes over time, it can make a big difference in whether you're successful or feel like you've failed yet another diet.
Get support from an experienced dietitian. A dietitian can help you figure out the best nutrition and lifestyle changes that will work for you. Remember, everyone's different, so what worked for your friend may not work for you. But don't worry, a dietitian can also help you make those changes happen. Just knowing what to do isn't always enough to actually do it, so having someone in your corner can make a big difference.
- Kim CH, Lee SH. Effectiveness of Lifestyle Modification in Polycystic Ovary Syndrome Patients with Obesity: A Systematic Review and Meta-Analysis. Life (Basel). 2022 Feb 18;12(2):308. doi: 10.3390/life12020308.
- Cowan, S., Lim, S., Alycia, C. et al. Lifestyle management in polycystic ovary syndrome – beyond diet and physical activity. BMC Endocr Disord 23, 14 (2023). https://doi.org/10.1186/s12902-022-01208-y