Written by Nourished Not Deprived Practitioners

Polycystic Ovary Syndrome

What is Polycystic Ovary Syndrome?
Polycystic Ovary Syndrome (PCOS) is a female affected condition caused by an imbalance of reproductive hormones.[1-2] This imbalance in hormones leads to cysts (eggs that have failed to grow properly) forming on the ovaries which are responsible for growing and releasing eggs as part of a normal menstrual cycle. [1-2] This can increase ones risk of diabetes, heart disease and pregnancy complications… but, there are things that can be done to reduce this risk!
PCOS affects 1 in 10 women! It can be a painful and also stressful condition, causing many changes within a female’s body. [1-2] These changes of course cause discomfort, distress and confusion for women affected, however, the good news is the PCOS CAN be managed through various strategies that we will discuss in this post..so keep on reading my friends!


Diagnosis
To be diagnosed with PCOS two out of three of the following criteria are needed:

  1. Ovulatory dysfunction or menstrual irregularity- this includes missing periods or having a menstrual cycle greater than 35 days.
  2. Hyperandrogenism (excess androgens)- tested through a physical exam which checks for hirsutism (excess hair on body, hair loss from scalp, acne) and menstrual irregularity or the Free Androgen Index blood test.
  3. Polycystic ovaries- this is when an ultrasound is used to check for cysts on your ovaries, more than 12 cysts of 2-9mm on one ovary indicates a polycystic ovary.

Causes of PCOS
While we are still unsure of the causation of PCOS, potential causes include genetics, increased body weight, an unbalanced diet, and insulin resistance. [2-3]
One of the main causes is hyperandrogenism which basically is a long fancy word which means your body produces more testosterone (a hormone predominately known as a male hormone) then what is considered ‘normal’. [4] As women with PCOS have a higher than normal testosterone level, this leads to a hormonal imbalance that can sometimes be discovered via a specific blood test – the Free Androgen Index.
As noted above, a possible cause of PCOS is insulin resistance, however we are still unsure if insulin resistance causes PCOS or if PCOS causes insulin resistance… quite the ‘chicken before the egg?’ situation here.
If you are insulin resistant this basically means that your body is unable to use something called GLUCOSE (which is a fancy word for carbohydrates) to make energy as well as it should. This means all of this excess insulin and glucose is running around the body, which is something we do not want. This excess insulin causes your ovaries and adrenal glands to signal a mechanism that increases androgens. [2-3] This is something that we can focus on managing through diet.


Symptoms of PCOS
Certain symptoms of PCOS include: [1,3]
● More hair on face, chest, back or stomach
● Hair loss
● Acne
● Weight gain, swollen belly or difficulty losing weight
● Infertility or reduced fertility
● Irregular or absent menstrual periods
● Mental health issues such as depression


Is PCOS a serious medical concern?
The severity to which a woman may experience PCOS varies from individual to individual; although some women do not require medical or nutritional intervention due to mild symptoms, some do.
As PCOS increases a woman’s risk of developing conditions such as insulin resistance and type 2 diabetes it is important that women with this condition are aware of the treatment that is available to them.


How can I manage my PCOS symptoms?
Now although there is no gold standard ‘PCOS diet’ there are guidelines in which we can follow to better ones diet and their symptoms. [3,5-7]
First port of call is just generally improving ones diet quality as best we can. There are many benefits for your body by eating more nutrient rich foods with PCOS. In our consultations at Nourished we usually focus on helping our women include more fruits,
vegetables, wholegrains, healthy fats (unsaturated fats), and ensuring you get enough lean protein in the diet. The benefits of doing this include improving hormone imbalances which cause PCOS, improving ovulation, decreasing androgens and placing one into remission with their insulin resistance. Inflammation can be reduced by choosing high fibre foods.
Lastly, reduction in hirsutism score (which is excessive hair growth on your body) has been found to occur in women who improve their diet quality, so that’s cool!


How can we practically ‘eat more nutrient dense foods’ though?
● Start with regularity! Eating regular meals INCLUDING breakfast (I see you breakfast skippers).
● Include more fruits and vegetables (aim for 1-2 extras per week) start small and build + aim for the rainbow when you can!
● Include more fibrous foods in your meals and snacks! (eg. wholegrain bread, vegetables, beans, fruit, crackers, muesli bars etc…)
● Reduce processed foods and processed meats where possible
● Choose healthy fats such as unsaturated fats (olive or canola oil, avocado, nuts)


Are there Supplements that can help manage PCOS ?
Yes! [9] However, supplementation should be an individualized discussion with your Dietitian. However there are some supplements that our Nourished Dietitians look into when it comes to Supplementation for PCOS:
● Inositol- may improve fertility, metabolic hormones and reduce excess androgens.
● Fish oils- may help in reduction of inflammation and assistance in regulating blood sugar levels.
● Vitamin D- vitamin D deficiency is linked to various metabolic and hormonal disorders. If deficient, supplementation may improve insulin sensitivity and menstrual regulation.
Here at Nourished we work with many women who have struggled with their PCOS and have had no idea how to manage what was going on for them. So one of our current goals is to educate as many of you as possible on knowing that there are tools and things we can do to better your circumstances!
If you’re still unsure, a Dietitian’s job is to help you implement strategies that are specific to you, which with something like PCOS can be quite necessary. Feel free to get in touch with us if you have any questions on how to better manage your PCOS.


Resources:

  1. Queensland Health [Internet]. Brisbane, QLD: Queensland Government; 2021
    [cited 2022 May 1]. Available from:
https://www.health.qld.gov.au/news-events/news/7-signs-you-might-have-polycystic-ovarian-syndrome
  1. Meier RK. Polycystic Ovary Syndrome. Nurs Clin North Am. 2018;53(3):407-420.
    Doi: 10.1016/j.cnur.2018.04.008
  2. Dietitians Australia [Internet]. Deakin, ACT: Dietitians Australia; 2022 [cited 2022
    May 1]. Available from:
    https://dietitiansaustralia.org.au/health-advice/polycystic-ovary-syndrome-pcos
  3. Goodarzi MO, Dumesic DA, Chazenbalk G, Azziz R. Polycystic ovary syndrome:
    etiology, pathogenesis and diagnosis. Nat Rev Endrocrinol. 2011;7(4):219-31.
    Doi: 10.1038/nrendo.2010.217
  4. Moran LJ, Ko H, Misso M, Marsh K, Noakes M, Talbot M, et. al. Dietary
    composition in treatment of polycystic ovary syndrome: a systematic review to
    inform evidence-based guidelines. Hum Repod Update. 2013;19(5):432. Doi:
    10.1093/humupd/dmt015
  5. Farschi H, Rane A, Love A, Kennedy RL. Diet and nutrition in polycystic ovary
    syndrome (PCOS): pointers for nutritional management. J Obstet Gynaecol.
    2007;27(8):762-73. Doi: 10.1080/01443610701667338
  6. Monash University [Internet]. Melbourne, VIC: Monash University; 2022 [cited
    2022 May 1]. Available from:
https://www.monash.edu/__data/assets/pdf_file/0004/1412644/PCOS_Evidence-Based-Guidelines_20181009.pdf
  1. Schenk S, Harber MP, Shrivastava CR, Burant C, Horowitz JF. Improved insulin
    sensitivity after weight loss and exercise training is mediated by a reduction in
    plasma fatty acid mobilisation, not enhanced oxidative capacity. J Physiol.
    2009;587(20):4949-4961. Doi: 10.1113/jphysiol.2009.175489
  2. Arentz S, Smith CA, Abbott J, Bensoussan A. Nutritional supplements and herbal
    medicines for women with polycystic ovary syndrome; a systematic review and
    meta-analysis. BMC Complement Altern Med. 2017;17(1):500. Doi:
    10.1186/s12906-017-2011-x
    10.Yu HF, Chen HS, Rao DP, Gong J. Association between polycystic ovary
    syndrome and the risk of pregnancy complications: A PRISMA- compliant
    systematic review and meta-analysis. Medicine (Baltimore). 2016;95(51):e4863.
    Doi: 10.1097/MD.0000000000004863
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