What It Is
September is PCOS Awareness Month. Have you heard of it? If not, you aren’t alone. PCOS stands for polycystic ovary syndrome and one out of 10 women in their child-bearing years will be diagnosed with it. That means there are probably even more women who are suffering with it and haven’t been diagnosed, which is why it is so important to discuss it.
However, unlike the name implies, you don’t actually need cysts on your ovaries to be diagnosed with PCOS. What you do need is two out of these three diagnostic criteria:
Irregular menstrual cycles and/or no ovulation
High androgen production (DHEA, testosterone, androstenedione) or symptoms (thinning hair around your temples or top scalp, excess facial hair, acne)
12 or more follicles per ovary
Other non-diagnostic criteria include increased weight (especially around the mid-section), elevated levels of fasting insulin, glucose, and hemoglobin A1c, elevated luteinizing (LH) and anti-müllerian (AMH) hormones, and normal or decreased follicle-stimulating hormone (FSH).
Many of us are unaware of the number of cysts on our ovaries, not to mention lab values, so it’s good to bring up PCOS to your health practitioner if you have these symptoms:
Acne
Thinning hair at the temples or top of scalp (basically, male-pattern baldness)
Excess facial hair (known as hirsutism)
Irregular menstrual cycles (less than 10 cycles per year or cycles longer than 35 days)
Infertility
Skin tags
Weight gain around the midsection (i.e. visceral fat)
Acanthosis nigricans (darkening of the skin in body folds and creases such as the armpits, groin, and neck)
Since PCOS is a metabolic and hormonal issue, it is also associated with other health risks such as type 2 diabetes, gestational diabetes, insulin resistance, heart attack, high cholesterol, hypertension, metabolic syndrome, cancer, and sleep apnea.
What You Can Do
Fortunately, PCOS can be positively affected by lifestyle factors such as nutrition, exercise, sleep, stress management, and supplementation. The good news is that you don’t have to take on any of this alone. Seek out experts such as a registered dietitian and therapist to help you make these changes to regain your health.
Nutrition. Since PCOS is highly correlated with blood sugar dysregulation, eating a high fiber, low sugar diet with healthy fat and quality protein will be key. Good sources of fiber includes veggies, beans/lentils, nuts, seeds, fruit, and whole grains. Work on slowly increasing fiber to avoid excessive gas production and GI discomfort.
Exercise. A great way to regulate stress, hormones, and blood sugar is to move your body daily in a way that feels good to you. This can be as simple as walking and as short as 5 minutes. If you prefer working out with others, grab a friend for your walk or pick-up a sport like tennis or pickleball. There are many online exercise options too. Check out my YouTube channel for Pilates + Resistance Training workouts, plus these yoga workouts here and here.
Sleep. Get some… like 7-9 hours please. This is the time our body heals, plus it directly effects our stress hormone cortisol, which directly effects blood sugar and sex hormones. Focus on winding down an hour or two before bed by shutting down screens, dimming lights, and taking a bath, meditating, or reading. You can also promote better sleep by sleeping in a cool, dark room.
Stress. Such an annoying little bugger that wreaks havoc on everything, and is probably the root cause of many mental and physical health issues. Look for ways you can incorporate activities in your day that bring you peace, relaxation, or joy. This could be your movement activity, talking with a friend, watching a TV comedy show, or anything else you enjoy.
Toxins. These can really throw hormones for a loop. We can’t completely avoid them; however, we can make changes that reduce our exposure. Here are some ideas: swap out plastic food/drinking containers for glass, replace cooking utensils that are treated with non-stick chemicals, and switch out skin, hair, and cleaning products for ones with less chemicals (the Environmental Working Groups database is a great resource for this). Buying a water filter for your drinking water and washing produce to lessen pesticide residue is also helpful. Take it one small change at a time. It’ll make a big difference.
Supplements. It’s always good to work with a health practitioner on supplementation to ensure you are choosing high quality supplements that are right for you. Two that have been particularly helpful with PCOS include myo-inositol (2-4 grams/day) and vitamin D (4000 IU daily). Studies show myo-inositol is just as effective as the medication metformin in improving insulin sensitivity and promoting ovulation. Vitamin D has also been shown to decrease testosterone and improve insulin resistance.
I’d love to hear from you. Please comment below or send me an email with what you found to be most helpful about this post? Also, if you’d like to work with me on how to best support your hormones, including PCOS, please send me an email.
If you thought this blog was helpful or know someone who would benefit from reading it, please like it and share it with them.
With love, Steph
References:
Azadi-Yazdi, M., Karimi-Zarchi, M., Salehi-Abargouei, A., Fallahzadeh, H., & Nadjarzadeh, A. (2017). Effects of Dietary Approach to Stop Hypertension diet on androgens, antioxidant status and body composition in overweight and obese women with polycystic ovary syndrome: a randomized controlled trial. Journal of Human Nutrition and Dietetics, 30(3), 275-283. doi: 10.1111/jhn.12433.
Fruzzetti, F., Perini, D., Russo, M., Bucci, F., & Gadducci, A. (2017). Comparison of two insulin sensitizers, metformin and myo-inositol, in women with polycystic ovary syndrome (PCOS). Gynecology Endocrinology, 33(1), 39-42. doi: 10.1080/09513590.2016.1236078.
Gerli, S., Papaleo, E., Ferrari, A., & Di Renzo, G. C. (2007). Randomized, double blind placebo-controlled trial: effects of myo-inositol on ovarian function and metabolic factors in women with PCOS. European Review for Medical and Pharmacological Sciences, 11(5), 347-354.
Jamilian, M., Foroozanfard, F., Rahmani, E., Talebi, M., Bahmani, F., & Asemi, Z. (2017). Effect of Two Different Doses of Vitamin D Supplementation on Metabolic Profiles of Insulin-Resistant Patients with Polycystic Ovary Syndrome. Nutrients, 9(12), 1280. doi: 10.3390/nu9121280.
Kamenov, Z., Kolarov, G., Gateva, A., Carlomagno, G., & Genazzani, A. D. (2015). Ovulation induction with myo-inositol alone and in combination with clomiphene citrate in polycystic ovarian syndrome patients with insulin resistance. Gynecological Endocrinology, 31(2), 131-135. doi: 10.3109/09513590.2014.964640.
Kazemi, M., McBreairty, L. E., Chizen, D. R., Pierson, R. A., Chilibeck, P. D., & Zello, G. A. (2018). A Comparison of a Pulse-Based Diet and the Therapeutic Lifestyle Changes Diet in Combination with Exercise and Health Counselling on the Cardio-Metabolic Risk Profile in Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial. Nutrients, 10(10), 1387. doi: 10.3390/nu10101387.
Mohammad, M. B. & Seghinsara, A. M. (2017). Polycystic ovary syndrome (PCOS), diagnostic criteria, and AMH. Asian Pacific Journal of Cancer Prevention, 18(1), 17–21. doi: 10.22034/APJCP.2017.18.1.17
Nybacka, A., Hellstrom, P. M., & Hirschberg, A. L. (2017). Increased fiber and reduced trans fatty acid intake are primary predictors of metabolic improvement in overweight polycystic ovary syndrome: Sub-study of randomized trial between diet, exercise and diet plus exercise for weight control. Clinical Endocrinology (Oxford), 87(6), 680-688. doi: 10.1111/cen.13427.
Papaleo, E., Unfer, V., Baillargeon, J.P., De Santis, L., Fusi, F., Brigante, C.,… & Ferrari, A. (2007). Myo-inositol in patients with polycystic ovary syndrome: a novel method for ovulation induction. Gynecology Endocrinology, 23(12), 700-703. doi: 10.1080/09513590701672405.
Perelman, D., Coghlan, N., Lamendola, C., Carter, S., Abbasi, F., & McLaughlin, T. (2017). Substituting poly- and mono-unsaturated fat for dietary carbohydrate reduces hyperinsulinemia in women with polycystic ovary syndrome. Gynecology and Endocrinology, 33(4), 324-327. doi: 10.1080/09513590.2016.1259407.
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and Sterility, 81(1), 19-25. doi: 10.1016/j.fertnstert.2003.10.004.
Sordia-Hernandez, L, H., Ancer Rodriguez, P., Saldivar Rodriquez, D., Trejo Guzman, S., Servin Zenteno, E. S., Guerrero Gonzalez, G. & Ibarra Patino, R. (2016). Effect of a low glycemic diet in patients with polycystic ovary syndrome and anovulation - a randomized controlled trial. Clinical Experimental Obstetrics Gynecology, 43(4), 555-559.