Polycystic Ovary Syndrome (PCOS) is an endocrine disorder that affects the functioning of the ovaries. The condition affects women and those assigned female at birth (AFAB). It is fairly common and is thought to affect around 1 in 10 women in the UK.
PCOS Symptoms Due to the underlying hormonal imbalance in those with PCOS, there are a wide variety of symptoms that can be experienced. These symptoms vary in severity and from person to person. They include:
Irregular or no periods
Excessive hair growth
Difficulty getting pregnant
Thinning hair/loss of hair from the scalp
Oily, acne-prone skin
Weight gain
Diagnosis of PCOS To diagnose PCOS, other causes of the same symptoms first must be ruled out. PCOS can then be diagnosed if someone meets two of out the following three criteria:
There is an increase in the level of the “male hormones” (e.g. androgens), shown via a blood test, or physical signs (e.g. hair growth on face, acne, thinning scalp hair), should the blood test be normal.
Irregular, or no periods.
Polycystic ovaries, shown via a scan.
Management of PCOS Unfortunately, there is no cure for PCOS. However, symptoms can be managed and minimised. Because PCOS can present differently from person to person, management of the condition should be tailored specifically to each individual. Below are some common treatment options for some of the symptoms of PCOS.
For the treatment of irregular periods, oral contraceptives can be prescribed to induce regular periods, in those who are not wanting to become pregnant.
To help with excessive hair growth, medication (hormonal therapy) can be used alongside physical methods of hair removal (electrolysis and laser treatment being most effective).
As weight gain is a common symptom of PCOS, weight loss may be beneficial in those who are overweight. This is because overweight and obesity are thought to worsen the symptoms of PCOS. Weight loss may improve endocrine profile and increase the chance of ovulation and a healthy pregnancy. To achieve weight loss, the diet should be practical and sustainable and focus on the inclusion of fruit and vegetables, whole grains, and lean protein sources. Physical activity and concurrent behavioural therapy can also aid successful weight loss. The most important thing is to focus on healthy lifestyle choices, as opposed to weight loss at any cost.
Insulin resistance is fairly common in PCOS patients, which increases the risk of developing type 2 diabetes. Insulin resistance is an issue because it means the body produces extra insulin, to compensate for the insulin resistance. This, in turn, stimulates an increase in production of androgens like testosterone, thus worsening PCOS symptoms. However, lifestyle interventions can be used to help reduce insulin levels. It may be beneficial to:
Reduce the quantity of starchy carbohydrates during mealtimes i.e. by reducing the portion of rice or bread, and increasing the serving of vegetables. This will help with insulin levels after the meal.
Increase the ratio of fibrous carbohydrate to refined carbohydrates i.e. by switching from white rice to brown rice. One study indicated that this may reduce fasting insulin responses in those who are overweight.
In some individuals, supplementing lifestyle modification with pharmacological approaches (e.g. the medicine metformin, to reduce insulin levels; medicine to treat acne etc.) may have a significant impact.
Overall, as a result of the changed physiology, individuals with PCOS are at higher risk of developing type 2 diabetes and cardiovascular disease. Therefore, it is important to seek help and support as early as possible. Lifestyle changes can be effective in managing symptoms and a referral to a dietitian may be helpful.
If you would like to see a dietitian about managing PCOS, get in touch by emailing enquiry@citydietitians.co.uk.
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