One of the many joys that comes with having ovaries is being at risk for developing polycystic ovarian syndrome, otherwise known as PCOS. This is where fluid filled cysts develop on the ovaries, which causes the ovaries to produce abnormal amounts of testosterone. As if us women didn’t have enough to worry about! Now let’s take a deeper look at PCOS and what the recommendations for managing it are.
Many women are affected by PCOS, including me, Shirlene, one of New Leaf Nutrition®’s dietetic interns! Between 5 and 10% of women between the ages of 15 and 44 or of childbearing age, have PCOS. Though 5-10% may seem like a small number in terms of percentages, this actually is about 1 in 15 women! Many women have it and either don’t know it or haven’t been formally diagnosed, as most women find out that they have it after having problems with getting pregnant. The main cause of PCOS is not known, but genetics, insulin resistance, and inflammation have all been linked to excess amounts of testosterone. Studies have shown that PCOS runs in families. Someone could be at a higher risk if they have a mom, sister, or aunt with PCOS.
So, what are common symptoms associated with PCOS, you may be asking. Well, there are three main features of PCOS, which are having cysts in the ovaries, having high levels of male hormones, and irregular or missed periods. There are also other symptoms associated with PCOS, which include, acne, heavy bleeding during periods, excessive hair growth – typically on the chin, chest, belly, and back – weight gain, and male pattern baldness. All of which are symptoms that no woman wants to deal with. How can women with PCOS manage these symptoms and get some relief?
One of the most common ways that PCOS is managed is through medication. The typical medications used are hormonal birth control, anti-androgen medications, and Metformin. Hormonal birth control can make your cycles more regular and help clear up acne and reduce extra hair that has grown on your body and face. Anti-androgen medicine helps to block the effect of androgens and can help reduce hair loss, extra facial and body hair, and clear up acne. Metformin, most commonly known for its use in treating type 2 diabetes, can also be used. Many women with PCOS see insulin resistance, the main contributor to type 2 diabetes. It improves insulin’s ability to lower your blood sugar and can lower insulin and androgen levels. After a few months of using Metformin, some may also see a restart to ovulation, but it has little effect on acne or excessive hair. It may also help in losing weight and improving cholesterol levels. I am currently taking both hormonal birth control and an anti-androgen medicine, spironolactone to manage my PCOS since I was diagnosed about a year ago. But don’t worry if medications aren’t for you! I know that a lot of people would rather look for alternative treatments to medication. Research has even shown that lifestyle modifications should be the first thing to do when managing PCOS!
Alex at New Leaf Nutrition® can help determine whether your hormone ranges are appropriate using the DUTCH test, and, if they’re not, can provide guidance on how to optimize them – send us a message to see if the DUTCH test is right for you.
Although most, if not all of the symptoms associated with PCOS are annoying, one of the worst, in my opinion is weight gain and having difficulty losing weight. Excess amounts of testosterone in women has been linked to obesity. One study found that women with higher amounts of free floating testosterone in their blood were more likely to be overweight or obese. This weight gain or extra weight that we can’t lose makes us more susceptible to other health conditions, such as diabetes or heart disease, and can make it harder for our other PCOS symptoms to resolve. Insulin resistance is also a big contributor to this. When women with PCOS see a weight loss of 5-10%, they see a major improvement they see a major improvement in their symptoms. These reasons are why improving our diets and physical activity could help to manage symptoms.
Firstly, what kind of diet modifications can help? Many studies have found that low carb diets are most beneficial for people with PCOS because this helps to improve insulin resistance and contributes to weight loss. I have found that many dietitians recommend eating high quality, high fiber carbs along with some other generally healthy eating habits to help with insulin resistance and weight loss. I have found that for the most part, we should be eating whole grains, fruits and vegetables, and lean meats, which is really just a general healthy eating style, and not necessarily specific to PCOS, but it could improve symptoms and aid in weight loss. The Academy of Nutrition and Dietetics also suggests eating often throughout the day, about 4-5 times, without skipping meals. They also suggest having protein at each meal and snack because protein takes longer to digest and will keep you feeling full longer than if you just ate straight carbs. Now, what about physical activity? Getting at least 30 minutes of moderate intensity activity at least 3 days a week, especially when done with diet modifications, can help with weight loss and improvement in symptoms. The main goal is to improve symptoms and fertility. This is important to keep in mind when making changes. Our health should be our main priority, and we are rewarded by the changes to our body that we want to see.
-Shirlene Hilt, Fontbonne dietetic intern