So, what exactly is Poly Cystic Ovary Syndrome?
PCOS stands for Polycystic Ovary Syndrome. Many people it is a disease that affects only the ovaries when in actual fact it is a syndrome with a large amount of symptoms mostly affecting our hormones.
PCOS affects up to 10% of all women and it is believed there is also a huge amount of women who are not diagnosed yet.
PCOS is characterized by high levels of androgens (“male” hormones), including testosterone, androstenedione, dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEA-S).
78% of women suffering from PCOS also have some degree of insulin resistance which leads to type 2 diabetes over time.
What causes PCOS?
Doctors do not fully understand the cause of PCOS yet. There is definitely a genetic link to the disorder. Most studies indicate that insulin stimulates the ovaries to secrete testosterone and blocks the liver’s production of SHBG (sex-hormone binding globulin), which leads to an increase in circulating testosterone. These hormones actually lead to some of the hallmark symptoms of PCOS (facial hair, acne, male-pattern hair loss).
However, it is not yet known whether elevated insulin levels lead to increased production of androgens by the adrenal glands, or whether elevated androgens lead to insulin resistance, It’s a chicken or egg situation.
You can reduce the risks from ongoing insulin resistance and chronic inflammation by modifying lifestyle factors such as diet, exercise, sleep, and stress.
What are the symptoms?
Irregular or missed periods
- 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, especially cystic acne
Anxiety or depression
Elevated blood sugar levels
Darkening of the skin or “skin tags” around your neck or armpits
Disordered eating—especially binge eating disorder
How is PCOS diagnosed?
To be officially diagnosed with Poly Cystic Ovary Syndrome you need to have 2 out of the 3 following symptoms:
- Irregular or absent ovulation or menstruation
- Elevated levels of androgenic hormones (diagnosed by a blood test or signs and symptoms such as facial hair, acne, or hair loss)
- Presence of ovarian cysts
If you think you may have PCOS, consult your gynaecologist or primary care doctor.
They may order blood tests as well as A pelvic ultrasound to check for the presence of ovarian cysts.
Many of my clients tell me that their doctor did not perform any tests and ask me what tests should they get done. So here is a list for you
- 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
Some secondary tests may be done, such as:
- Follicle stimulating hormone (FSH) – will be normal or low with PCOS
- Luteinizing hormone (LH) – will be high in PCOS
- Estrogens – may be normal or elevated
- DHEAS – will most likely be elevated
- Androstenedione – will most likely be elevated
A few tests may help rule out other conditions with similar signs and symptoms:
- Thyroid-stimulating hormone (TSH) – 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
If you are diagnosed with PCOS, some blood tests may be done to check and monitor your general health and detect any complications that might develop:
- Lipid panel – to help determine risk of developing cardiovascular disease; risk is associated with a low HDL, high LDL, high total cholesterol and/or elevated triglycerides
- Glucose or HbA1c – can be used to screen for, diagnose and monitor diabetes.
- Vitamin D – which is ofen low in women with PCOS
- Vitamin Bs – this can be compromised in women with PCOS
So, what can I do?
Most doctors will tell you to “just lose weight.” Unfortunately, most doctors don’t understand why that is nearly impossible for women with PCOS . . . and it’s not because of a lack of willpower. Many of my clients have told me that their doctors think they’re lying about how little food they’re truly eating.
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 recipe.