So, What is PCOS?

PCOS stands for Polycystic Ovary Syndrome. Unfortunately, when you mention this condition to people will automatically think it is a condition that only affects our ovaries.  In actual fact, it is a syndrome that affects our entire metabolism and with a large number of symptoms.

This syndrome affects 10% of all women of all ages (although many doctors think that a large number of women remain undiagnosed). In fact, as we grow older symptoms also change and it is a condition we carry with us even into menopause. But there is light at the end of the tunnel, and most importantly I want to focus on the good news. It is possible to manage this condition through proper nutrition, supplements, and lifestyle changes.

To be diagnosed PCOS we use the Rotterdam Criteria. This is to say, that if you have 2/3 of the following you can be diagnosed with PCOS:

1. a missing or irregular period
2. An ultrasound showing there are more than 12 cysts on each ovary
3. High androgens (including testosterone, DHT, DHEA, and DHEA-S.

This means that you can actually have polycystic ovary syndrome without having any ovaries on your cysts.

So, what causes PCOS?

Doctors do not fully understand the cause of Polycystic ovary syndrome yet. However, we do know that there is a genetic link to the disorder. This is to say that if your mother had it you are more likely to have it yourself too. Similarly, there are many theories about what causes PCOS and one of the theories that seem most promising is that you would have been exposed to certain hormones or chemicals whilst still in your mother’s belly.

In addition, we also know that 95% of women with PCOS have insulin resistance. I discuss insulin resistance in a lot of detail in my group program.  Insulin stimulates the ovaries to produce testosterone.  These hormones actually lead to some of the hallmark symptoms of PCOS (facial hair, acne, male-pattern hair loss, stubborn belly fat, and more).

However, we do not know whether high insulin levels actually lead to increased production of androgens by the adrenal glands, or whether it is the high levels of androgens that make insulin resistance worse. It’s a chicken or egg situation.

In short, you can reduce the risks of insulin resistance and inflammation by changing your lifestyle. When I work with clients we focus on their nutrition, exercise, sleep, and even what supplements are suited for their individual root cause.

What are the symptoms?

Symptoms include…

• Irregular or missed period

• Hair thinning or loss on your head

• Weight gain or difficulty losing weight
• Increased belly fat

• Strong cravings for carbohydrates/sugar

• Unwanted facial hair

• Acne

• Infertility

• Anxiety or depression

• Elevated blood sugar levels

• Fatigue

• Darkening of the skin or “skin tags” around your neck or armpits

• Disordered eating—especially binge eating disorder

How can I get diagnosed with PCOS?

Through the Rotterdam criteria:

1. Irregular or absent ovulation or Period
2. High levels of androgenic hormones (Through a blood test or signs and symptoms such as facial hair, acne, or hair loss)
3. Presence of ovarian cysts

If you think you may have PCOS, consult your gynecologist or primary care doctor. Furthermore, I even encourage you to advocate for yourself. Ask your doctor to refer you to an endocrinologist who can run blood tests and ask for a pelvic ultrasound to check for the presence of ovarian cysts.

So, What Blood tests do I need to ask my doctor for?

• Testosterone – this is often the initial test to determine whether you are producing excess male hormones
• Sex hormone-binding globulin (SHBG) – may be low in PCOS
• Anti-Müllerian hormone (AMH) – this is often high in PCOS
• Follicle-stimulating hormone (FSH)
• Luteinizing hormone (LH)
• Progesterone
• Estrogens
• DHEAS
• Androstenedione
• hs – CRP (to test for inflammation)

Other important tests for PCOS:

• Thyroid-full panel – to rule out a thyroid disorder
• Cortisol – to rule out Cushing syndrome
• Prolactin – to rule out hyperprolactinemia
• 17-hydroxyprogesterone – to rule out the most common form of congenital adrenal hyperplasia
• Human chorionic gonadotropin (hCG) – to rule out pregnancy
• IGF-1 – to rule out excess growth hormone
• Lipid panel – to help determine the risk of developing cardiovascular disease.
• Glucose or HbA1c – can be used to screen for, diagnose and monitor diabetes.
• Vitamin D – which is often low in women with PCOS
• Vitamin Bs – this can be compromised in women with PCOS

So, what can I do?

I am sure you are tired of hearing “just lose weight”  from your doctors. Firstly, I am here to tell you that I completely understand how hard it is. Secondly, weight is a symptom of PCOS and not the cause.

Unfortunately, most doctors don’t understand how difficult it is. . . and it’s not because of a lack of willpower. In fact, this weight bias from medical professionals many times leads to a disordered relationship with food. So, I am here to tell you I believe you! I actually even created a low-cost masterclass to help out those who cannot afford to do my full program.

Fortunately, there are a number of ways to manage PCOS naturally, including food, supplements, lifestyle, sleep, and stress management.

When I treat clients in my practice with PCOS, we focus on balancing blood sugar and improving insulin resistance, supporting the adrenals and thyroid, balancing sex hormones, and reducing inflammation. Each case is different and I do not offer a one size fits all approach but feel free to book a consultation

Don’t forget to follow my Instagram page for PCOS-friendly recipes.