Hello, I'm Nancy a certified Master Nutrition Therapist through the Nutritional Therapy Insitute in Colorado. I am also studying to be a Board-Certified Holistic Nutritionist. My passion for food and the healing powers it holds started well over a decade ago, when I was diagnosed with PCOS. I wa…
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FAQs:
What is PCOS?
Polycystic ovary syndrome (PCOS) is a condition in which the ovaries produce an abnormal amount of androgens, male sex hormones that are usually present in women in small amounts. The name polycystic ovary syndrome describes the numerous small cysts (fluid-filled sacs) that form in the ovaries. However, some women with this disorder do not have cysts, while some women without the disorder do develop cysts.
Ovulation occurs when a mature egg is released from an ovary. This happens so it can be fertilized by a male sperm. If the egg is not fertilized, it is sent out of the body during your period.
In some cases, a woman doesn’t make enough of the hormones needed to ovulate. When ovulation doesn’t happen, the ovaries can develop many small cysts. These cysts make hormones called androgens. Women with PCOS often have high levels of androgens. This can cause more problems with a woman’s menstrual cycle. And it can cause many of the symptoms of PCOS.
Treatment for PCOS is often done with medication. This can’t cure PCOS, but it helps reduce symptoms and prevent some health problems.
What is the Main Cause of PCOS?
The exact cause of PCOS is unknown. There’s evidence that genetics play a role. Several other factors, most importantly obesity, also play a role in causing PCOS. Higher levels of male hormones called androgens: High androgen levels prevent your ovaries from releasing eggs, which causes irregular menstrual cycles. Irregular ovulation can also cause small, fluid-filled sacs to develop on your ovaries. High androgen also causes acne and excess hair growth in women and people AFAB.
Is PCOS Serious?
Women with PCOS are more likely to develop certain serious health problems. These include type 2 diabetes, high blood pressure, problems with the heart and blood vessels, and uterine cancer. Women with PCOS often have problems with their ability to get pregnant (fertility).
What's the Difference Between PCOS and Endometriosis?
PCOS and endometriosis are different conditions, but both can cause ovarian cysts and infertility. Endometriosis is a condition where the lining of your uterus (endometrium) grows in other places like your ovaries, vagina or fallopian tubes. It typically causes pelvic pain or severe menstrual cramps. People with PCOS have irregular periods, unpredictable ovulation and other physical side effects due to excess male hormones.
Is PCOS an Autoimmune Disease?
Regardless of their similarities, technically, PCOS is not an autoimmune disease, it is an endocrine disorder. However, whether you have PCOS or autoimmune disease working on your immune system, blood sugar regulation, and gut health seem like a good way to manage your symptoms.
Can PCOS be Cured?
Polycystic ovary syndrome (PCOS) cannot be cured, but the symptoms can be managed. Treatment options can vary because someone with PCOS may experience a range of symptoms, or just 1.
Is PCOS Genetic?
PCOS sometimes runs in families. If any relatives, such as your mother, sister or aunt, have PCOS, the risk of you developing it is often increased. This suggests there may be a genetic link to PCOS, although specific genes associated with the condition have not yet been identified.
What Happens If PCOS is Left Untreated?
Because it is a syndrome, it includes a set of symptoms. The severity of each untreated PCOS symptom can vary widely from woman to woman. Some women may experience only one of the symptoms while other women may experience all of them.
Moreover, this is a syndrome that affects women of all ages — from adolescence to menopause. It also does not discriminate any specific race of women although research has shown that it tends to be more common with women of the Mediterranean descent.
Untreated PCOS symptoms:
- Chronic irregular menstrual cycles or lack of periods
- Difficulty conceiving (due to not ovulating)
- Obesity (20% greater than over ‘ideal’ weight)
- Adult acne
- Excessive unwanted hair growth (especially dark coarse hair on the face, chest, or abdomen)
- Male pattern baldness (hair loss or hair thinning)
- Insulin resistance or type 2 diabetes
Is PCOS an Endocrine Disorder?
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in reproductive age women, occurring in about 6% to 15% of women of childbearing age. Women with PCOS often notice abnormal periods, acne, difficulty getting pregnant, or hirsutism—coarse, dark hair growth on the face and chest. Symptoms usually begin shortly after puberty.
How Common is PCOS?
PCOS is one of the most common causes of female infertility, affecting 6% to 12% (as many as 5 million) of US women of reproductive age. But it’s a lot more than that. This lifelong health condition continues far beyond the child-bearing years.
Can I Have PCOS but not Have any Symptoms?
Yes, it’s possible to have PCOS and not have any symptoms. Many people don’t even realize they have the condition until they have trouble getting pregnant or are gaining weight for unknown reasons. It’s also possible to have mild PCOS, where the symptoms aren’t severe enough for you to notice.
Can I Get Pregnant If I Have PCOS?
Yes, you can get pregnant if you have PCOS. PCOS can make it hard to conceive while also increasing your risk for certain pregnancy complications, but many people with PCOS do get pregnant on their own. Your healthcare provider will work with you to develop a treatment plan to help you ovulate. Your treatment plan could include medication or assisted reproductive technologies like in vitro fertilization (IVF). Talk to your healthcare provider to make sure you understand your treatment plan and how you can increase your chances of a healthy pregnancy.
4 Types of PCOS
Here are the different types of PCOS and what kind of PCOS do you have.
1. Insulin-resistant PCOS
This is the most common type of PCOS. This type of PCOS is caused by smoking, sugar, pollution, and trans fat. In this, high levels of insulin prevent ovulation and trigger the ovaries to create testosterone. If you have been told by your doctor that you are a diabetic on borderline and your glucose tolerance test was not normal. If you have increased levels of insulin and you are overweight, then you might be one having insulin resistance PCOD.
2. Pill-induced PCOS
This type is the second most common PCOS. It gets developed due to the birth control pills which suppress ovulation. For most women, these effects do not last long and they resume ovulating after the effect of the pill is over. But some women do not resume ovulating for months and years even after the effects of pills get over. During that time women should consult the doctor. If you experience regular and normal periods before starting with the pills then this might be a sign of Pill-induced PCOS. Or if your levels of LH are increased in the blood test then this could be a sign too.
3. Inflammatory PCOS
In PCOS due to inflammation, ovulation is prevented, hormones get imbalanced and androgens are produced. Inflammation is caused due to stress, toxins of the environment, and inflammatory dietary like gluten. If you have symptoms such as headaches, infections, or skin allergies and your blood tests show that you are deficient in vitamin D, your blood count is not normal, increased levels of thyroid then you might be one having inflammatory PCOS.
4. Hidden PCOS
This is a simpler form of PCOS, once the cause is addressed then it takes about three to four months to get resolved. Causes of Hidden PCOS: Thyroid disease, deficiency of iodine (ovaries need iodine), vegetarian diet ( it makes you zinc deficient and the ovaries need zinc) and artificial sweeteners. If you are already done with numerous natural treatments for PCOS and nothing seems like working then consult the doctor and gather more information about it
Signs and Symptoms of PCOS
The most common signs and symptoms of PCOS include:
- Irregular periods: Abnormal menstruation involves missing periods or not having a period at all. It may also involve heavy bleeding during periods.
- Abnormal hair growth: You may grow excess facial hair or experience heavy hair growth on your arms, chest and abdomen (hirsutism). This affects up to 70% of people with PCOS.
- Acne: PCOS can cause acne, especially on your back, chest and face. This acne may continue past your teenage years and may be difficult to treat.
- Obesity: Between 40% and 80% of people with PCOS have obesity and have trouble maintaining a weight that’s healthy for them.
- Darkening of the skin: You may get patches of dark skin, especially in the folds of your neck, armpits, groin (between the legs) and under your breasts. This is known as acanthosis nigricans.
- Cysts: Many people with PCOS have ovaries that appear larger or with many follicles (egg sac cysts) on ultrasound.
- Skin tags: Skin tags are little flaps of extra skin. They’re often found in your armpits or on your neck.
- Thinning hair: People with PCOS may lose patches of hair on their head or start to bald.
- Infertility: PCOS is the most common cause of infertility in people AFAB. Not ovulating regularly or frequently can result in not being able to conceive.
Causes of PCOS
The exact cause of PCOS isn't known. Factors that might play a role include:
1. Insulin resistance. Insulin is a hormone that the pancreas makes. It allows cells to use sugar, your body's primary energy supply. If cells become resistant to the action of insulin, then blood sugar levels can go up. This can cause your body to make more insulin to try to bring down the blood sugar level.
2. Too much insulin might cause your body to make too much of the male hormone androgen. You could have trouble with ovulation, the process where eggs are released from the ovary.
3. One sign of insulin resistance is dark, velvety patches of skin on the lower part of the neck, armpits, groin or under the breasts. A bigger appetite and weight gain may be other signs.
4. Low-grade inflammation. White blood cells make substances in response to infection or injury. This response is called low-grade inflammation. Research shows that people with PCOS have a type of long-term, low-grade inflammation that leads polycystic ovaries to produce androgens. This can lead to heart and blood vessel problems.
5. Heredity. Research suggests that certain genes might be linked to PCOS. Having a family history of PCOS may play a role in developing the condition.
6. Excess androgen. With PCOS, the ovaries may produce high levels of androgen. Having too much androgen interferes with ovulation. This means that eggs don't develop on a regular basis and aren't released from the follicles where they develop. Excess androgen also can result in hirsutism and acne.
Complications of PCOS
Complications of PCOS can include:
- Infertility
- Gestational diabetes or pregnancy-induced high blood pressure
- Miscarriage or premature birth
- Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat buildup in the liver
- Metabolic syndrome — a cluster of conditions including high blood pressure, high blood sugar, and unhealthy cholesterol or triglyceride levels that significantly increase your risk of heart and blood vessel (cardiovascular) disease
- Type 2 diabetes or prediabetes
- Sleep apnea
- Depression, anxiety and eating disorders
- Cancer of the uterine lining (endometrial cancer)
Obesity commonly occurs with PCOS and can worsen complications of the disorder.
How PCOS is Treated
Treatment for PCOS depends on a number of factors. These may include your age, how severe your symptoms are, and your overall health. The type of treatment may also depend on whether you want to become pregnant in the future.
If you do plan to become pregnant, your treatment may include:
1. A change in diet and activity. A healthy diet and more physical activity can help you lose weight and reduce your symptoms. They can also help your body use insulin more efficiently, lower blood glucose levels, and may help you ovulate.
2. Medications to cause ovulation. Medications can help the ovaries to release eggs normally. These medications also have certain risks. They can increase the chance for a multiple birth (twins or more). And they can cause ovarian hyperstimulation. This is when the ovaries release too many hormones. It can cause symptoms such as abdominal bloating and pelvic pain.
If you do not plan to become pregnant, your treatment may include:
- Birth control pills. These help to control menstrual cycles, lower androgen levels, and reduce acne.
- Diabetes medication. This is often used to lower insulin resistance in PCOS. It may also help reduce androgen levels, slow hair growth, and help you ovulate more regularly.
- A change in diet and activity. A healthy diet and more physical activity can help you lose weight and reduce your symptoms. They can also help your body use insulin more efficiently, lower blood glucose levels, and may help you ovulate.
- Medications to treat other symptoms. Some medications can help reduce hair growth or acne.
Doctors Who Can Treat PCOS
Physicians in several specialties can best diagnose and treat polycystic ovary syndrome. The type of doctor that will be best for you will depend on your symptoms and needs, as well as the types of specialists available in your area. Doctors who can treat PCOS include:
Family doctors: Your own primary care physician can take the lead in your PCOS care, and will likely draw in other specialists to help treat and resolve hormone and menstrual cycle irregularities as well as acne and hair growth concerns, metabolic challenges such as weight gain, and infertility.
Endocrinologists: With advanced training in a wide variety of hormone-related medical problems, these specialists diagnose and treat PCOS as part of their medical focus but some focus on treating this condition specifically, which would be ideal for those in bigger cities or with access to a teaching hospital.
Obstetrician/gynecologists: Because menstrual and fertility problems can be your first warning signs of PCOS, many women start their journey with their gynecologist. Depending on your needs and other symptoms, your gynecologist might continue to treat you or refer you to an endocrinologist to coordinate your care.
Reproductive endocrinology and infertility specialists: These doctors have advanced training in menstrual disorders, ovulation problems, and infertility issues. You may work with one of these specialists in order to gain specific help so you can conceive and have a baby.
Functional medical specialists: Practitioners who seek to determine the underlying cause of your specific symptoms by evaluating your genetic, biochemical and lifestyle patterns and then working with you to lessen the symptoms through lifestyle adjustments so you can achieve a healthy equilibrium. Since much of PCOS is hormone-based, there’s a good chance that an expert in functional medicine might work for you. However, this doctor shouldn’t replace your primary doctor but rather she/he will work as a team with your primary health provider so all your needs are met.
How to Lose Weight with PCOS
Here are 12 helpful tips for losing weight with PCOS.
1. Reduce your carb intake
Decreasing your carb consumption may help manage PCOS because of carbs’ impact on insulin levels.
2. Get plenty of fiber
Because fiber helps you stay full after a meal, a high fiber diet may promote weight loss in people with PCOS.
3. Eat enough protein
Protein helps stabilize blood sugar and increases feelings of fullness after a meal. It may also aid weight loss by reducing cravings, helping you burn more calories, and regulating hunger hormones.
4. Eat healthy fats
Having plenty of healthy fats in your diet may help you feel more satisfied after meals and tackle weight loss and other symptoms of PCOS.
5. Eat fermented foods
Healthy gut bacteria may play a role in metabolism and weight maintenance. Studies suggest that people with PCOS may have fewer healthy gut bacteria than those without this condition. Emerging research also suggests that certain probiotic strains may have positive effects on weight loss.
6. Practice mindful eating
People with PCOS may have tried many diets and are three times more likely to have eating disorders than people without PCOS. Mindful eating is one potential solution. It promotes an increased awareness of bodily cues such as hunger and fullness. Mindfulness-based approaches to food may help address potentially problematic eating behaviors — especially binge eating and emotional eating.
7. Limit processed foods and added sugars
Another tip to lose weight with PCOS is to cut down on your intake of less nutritious foods. Processed foods and added sugars may raise blood sugar levels and increase your risk of insulin resistance, which is linked to obesity . People with PCOS may process sugar differently than those without it. Research shows that women with PCOS experience larger spikes in blood sugar and insulin levels after consuming the same amount of sugar as women without this condition.
8. Reduce inflammation
Inflammation is your body’s natural response to infection or injury. But chronic inflammation, which is common in people with PCOS, is linked to obesity. Sugar and processed foods may contribute to inflammation.
9. Exercise regularly
Exercise is a well-known strategy for increasing weight loss. In one small 12-week study, 16 women did 45–60 minutes of cardio 3 times per week. Those with PCOS lost 2.3% of their body fat, compared with 6.4% in the control group. While people with PCOS lost less fat than those without this condition, the exercise regimen did result in loss of belly fat and improvements in insulin sensitivity. Weight training has also been shown to be beneficial for people with PCOS.
10. Get enough sleep
Sleep is increasingly acknowledged as central to overall health. If you have PCOS, you may experience sleep disturbances, including excessive daytime sleepiness, sleep apnea, and insomnia. Lack of sleep has been shown to increase the activity of hormones that drive hunger, such as ghrelin and cortisol, which may cause you to eat more throughout the day. In fact, insufficient sleep is associated with a higher risk of having overweight or obesity.
11. Manage your stress
Because stress is a risk factor for weight gain, managing or reducing stress may help you manage your weight. Stress increases levels of cortisol, a hormone that your adrenal glands produce. Chronically high cortisol levels are linked to insulin resistance and weight gain. Chronic stress also increases your risk of gaining belly fat. In turn, belly fat increases inflammation, which triggers your body to make more cortisol, creating a vicious cycle. To lower your cortisol levels, focus on stress management practices.
12. Consider supplements
If you have PCOS, several supplements may help you manage your weight and symptoms. Myo-inositol is a supplement that may lead to weight loss in people with PCOS. Inositol is a type of sugar that helps improve insulin sensitivity. Myo-inositol is a specific form of inositol. Interestingly, one review of 15 studies found that inositol supplementation could be linked to a reduction in BMI. Carnitine, an amino acid found in meat, may also lead to weight loss.
How to Treat PCOS Naturally
PCOS can’t go away naturally, but you can manage PCOS symptoms long-term using a combination of lifestyle changes and natural remedies.
These natural remedies include alternative therapies, dietary supplements, and herbs that address everything from fertility to insulin sensitivity. The best natural remedies for PCOS go beyond symptom management and address the hormonal imbalances at the root of your issues.
1. Eat mostly whole foods.
Processed foods and sugars can worsen symptoms of hormonal disorders like PCOS. Eat a diet rich in whole foods like healthy whole grains, fresh fruits and vegetables, nuts, and legumes for healthier blood sugar levels and a reduced risk of hormonal imbalances.
2. Get enough protein.
Protein curbs food cravings and keeps you satiated longer than carbohydrates or fats. Diets higher in protein can also help balance your glucose metabolism, a major cause of PCOS symptoms.
3. Watch out for carbohydrates
Sugars are carbs, and anyone struggling with PCOS or a metabolic syndrome like diabetes or heart disease has to watch their consumption of sugars. Too many carbs can make it harder to regulate blood sugar levels, leading to worsened PCOS symptoms.
4. Up your fiber intake.
Fiber helps regulate blood sugar levels, promotes a healthy gut microbiome, and reduces bloat. As a PCOS treatment, increasing your fiber intake by eating more fruits and veggies, legumes, and whole grains is one of the best natural ways to improve your symptoms.
5. Pay attention to your iron.
Heavy periods can sometimes cause iron deficiency anemia, but many women with PCOS have the opposite problem: iron overload. Too much iron in the body can worsen insulin resistance. If you’re worried about your iron levels, talk to your physician about monitoring bloodwork.
6. Cut back on caffeine.
Too much caffeine can elevate levels of the stress hormone cortisol in the body. This can mean even higher blood sugar levels, weight gain, and inflammation. If you need a bit of a boost, green tea is best for PCOS. Green tea supports healthy weight management in women struggling with obesity and can decrease levels of male sex hormones like testosterone in the body.
7. Avoid alcohol.
Drinking too much can raise levels of estrogen in the body. Estrogen dominance can lead to unwanted hair growth, irregular periods, and hormonal acne. Women with PCOS are also at a higher risk of fatty liver disease with or without alcohol use.
8. Maintain a healthy body weight.
Medical advice for PCOS patients typically includes advice about maintaining a healthy body weight. It can be a challenge to lose weight with PCOS when your insulin levels and metabolism are affected. Diets that follow guidelines we described, lifestyle changes that include regular exercise, high-quality supplements, and a good support network can all help you get there.
9. Get good sleep.
Low-quality sleep can hamper progress made with PCOS symptoms. Practice good sleep hygiene with a consistent sleep schedule and a calm sleep environment. If you’ve made changes and still feel fatigued in the morning, talk to your doctor. You could be dealing with a sleep disorder like obstructive sleep apnea.
10. Find a good exercise routine.
Regular exercise can boost your mood, support a healthy weight, and improve glucose metabolism. High-intensity internal training (HIIT) and strength training come with added benefits for improved insulin resistance, but the right PCOS workout for you depends on your symptoms.
11. Manage your stress levels.
Chronic stress can increase inflammation, impact your metabolism, and increase your risk for developing anxiety and depression. Managing stress using techniques like mindfulness or regular exercise is good for PCOS and your mental health.
12. Check out some alternative therapies.
Alternative therapies like acupuncture, yoga, or even controlled martial arts like tai chi or qigong can be another way to manage stress and reduce chronic pain from PCOS. Reduced stress using these methods may also improve outcomes for conditions like type 2 diabetes and heart disease.
How to Get Pregnant with PCOS
You have several options to help your chances of getting pregnant if you have PCOS:
1. Losing weight. If you have overweight or obesity, losing weight through healthy eating and regular physical activity can help make your menstrual cycle more regular and improve your fertility. Find a personalized healthy eating plan using the MyPlate Plan tool.
2. Medicine. After ruling out other causes of infertility in you and your partner, your doctor might prescribe medicine to help you ovulate, such as clomiphene (Clomid).
3. In vitro fertilization (IVF). IVF may be an option if medicine does not work. In IVF, your egg is fertilized with your partner's sperm in a laboratory and then placed in your uterus to implant and develop. Compared to medicine alone, IVF has higher pregnancy rates and better control over your risk of having twins and triplets (by allowing your doctor to transfer a single fertilized egg into your uterus).
4. Surgery. Surgery is also an option, usually only if the other options do not work. The outer shell (called the cortex) of ovaries is thickened in women with PCOS and thought to play a role in preventing spontaneous ovulation. Ovarian drilling is a surgery in which the doctor makes a few holes in the surface of your ovary using lasers or a fine needle heated with electricity. Surgery usually restores ovulation, but only for 6 to 8 months.
Preparing for Your PCOS Appointment
For PCOS, you may see a specialist in female reproductive medicine (gynecologist), a specialist in hormone disorders (endocrinologist) or an infertility specialist (reproductive endocrinologist). Here's some information to help you get ready for your appointment.
What you can do
Before your appointment, make a list of:
- Symptoms you've been having, and for how long
- Information about your periods, including how often they occur, how long they last and how heavy they are
- All medications, vitamins, herbs and other supplements you take, including the dosages
- Key personal and medical information, including other health conditions, recent life changes and stressors
Questions to ask your health care provider
Some basic questions to ask include:
1. What tests do you recommend?
2. How does PCOS affect my chance of getting pregnant?
3. Are there any medicines that might help improve my symptoms or chance of getting pregnant?
4. What lifestyle changes can improve symptoms?
5. How will PCOS affect my health in the long term?
6. I have other medical conditions. How can I best manage them together?
Don't hesitate to ask other questions as they occur to you.
What to Expect from Your PCOS Specialist
Your health care provider is likely to ask you a number of questions, including:
1. What are your symptoms? How often do they happen?
2. How bad are your symptoms?
3. When did each symptom begin?
4. When was your last period?
5. Have you gained weight since you first started having periods? How much weight did you gain, and when did you gain it?
6. Does anything seem to improve your symptoms? Make them worse?
7. Are you trying to get pregnant, or do you wish to become pregnant?
8. Has any close blood relative, such as your mother or a sister, ever been diagnosed with PCOS?
Sources:
The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 (in the United States) immediately.