PCOS

This section of my blog is devoted to learning and understanding more about Polycystic Ovarian Syndrome (PCOS). I am NOT a PCOS expert or an MD. While I can comment on a carbohydrate-controlled diet, the following information is that found in A Patient’s Guide to PCOS by Walter Futterweit, MD [1].

After discovering I had elevated glucose readings at a diabetes conference in San Jose, I was diagnosed with PCOS in April of 2010. I have always struggled with my weight, acne, regular menses*, etc. It wasn’t until I was diagnosed with PCOS, however, that my symptoms dating back 13 years were all related. It is important to understand that ALL women’s PCOS symptoms and struggles are not alike.

Discovering PCOS

Most women learn of their PCOS due to irregular periods, infertility, and/or hair problems (hair thinning or excessive bodily hair growth). Most women with PCOS (75%) are overweight or obese.

What is PCOS?

Women with PCOS excrete excessive amounts of male hormones (mostly testosterone). It is important to note that polycystic ovaries are a symptom or sign of the problem, not the cause. Therefore, some women (like myself), may have very few, if any, cysts on their ovaries. PCOS is not a disease in the sense of a single health problem, but instead, a combination of various symptoms that share an underlying cause.

Symptoms of PCOS

Irregular periods, excessive hair growth on face and body, scalp hair thinning, acne, excess weight, sugar cravings, inability to lose weight, darkening of skin (particularly on the nape of the neck), skin tags, gray-white breast discharge, sleep apnea, pelvic pain, depression, anxiety, sleep disturbances, and other emotional disorders. Some women have only a few symptoms, while others have most every symptom. The symptom severity can also vary from woman to woman. A PCOS diagnosis should be made by an endocrinologist.

What causes PCOS?

The following causes are the most commonly proposed among health professionals [1]:

  1. A defect in the hypothalamus leading to exaggerated LH pulses that stimulate the ovaries to secrete more than normal amounts of male hormones
  2. A defect in the ovarian production of testosterone and other male hormones due to abnormal enzyme action on the pathways leading to testosterone
  3. High insulin levels (hyperinsulinemia) as a result of insulin resistance, which further strengthens the effect of LH on the ovaries (see #1).
  4. Genetic causes: 40% of women with PCOS have a sister with PCOS and 35% have a mother with PCOS

What is Insulin Resistance Syndrome (IRS)

Insulin Resistance Syndrome is most commonly referred to as metabolic syndrome and syndrome X.

Insulin Resistance, weight, and PCOS

Overweight and obesity are closely intertwined with insulin resistance. Weight gain is frequently associated with worsening PCOS symptoms, insulin resistance, and insulin resistance syndrome (IRS). Many times it iss impossible to determine which came first, the weight gain or insulin resistance. Losing 7-10% of body weight can reduce PCOS symptoms, such as insulin resistance. However, it is more difficult to lose weight if you are insulin resistant. When organs and tissues lose sensitivity to insulin (the hormone that lowers blood glucose in the body), a normal amount of insulin is no longer sufficient to regulate blood glucose levels in the body, and the pancreas must put out more insulin to properly regulate itself. As insulin levels rise, the ovaries secrete more male hormones and PCOS symptoms worsen.

A rise in blood sugar is answered by a secretion of insulin. During each cycle of increasing blood sugar and insulin secretion, the insulin is converting excess blood sugar to triglycerides and fat, and weight accumulates quickly. Thus, the more insulin resistant you become the more weight you gain and the more weight you gain, the more insulin resistant you become.

Insulin resistance can be hard to diagnose because it cannot readily be detected by any convenient lab testing.

What tests or information help diagnose PCOS?

A history of irregular menses, ovarian ultrasound (although this test is not sufficient for PCOS diagnosis), testosterone level, luteinizing hormone (LH), sex hormone binding globulin (SHBG), prolactin level, dehydroepiandrosterone sulfate (DHEAS), 17-alpha-Hydroxyprogesterone (17-OHP), lipid profile, glucose level, insulin level, 2-hour glucose tolerance test, TSH, T4, C-reactive protein, urine microalbumin, and/or adrenocrticotropic hormone (ACTH) [1].

Eating right with PCOS

Unfortunately, women with PCOS simply do not burn calories as quickly as those without PCOS. Yet, weight management may be one of the most powerful ways to reduce negative PCOS symptoms.

Tips to eat right:

– Include protein with most meals and snacks as protein helps slow the absorption of sugar into the blood.
– Balance meals and include complex carbohydrates, lean protein, and heart-healthy fats in each of your meals
– Avoid high-carbohydrate and high sugar meals and snacks as they cause big swings in blood sugar and insulin levels
– Reduce meal size and include small snacks throughout the day
– Eat regular meals. Skipping meals can cause blood glucose to rise
– Utilize low glycemic index foods
– Reduce calories to produce weight loss, if necessary (8-9 calories per pound of body weight)

Is there a cure for PCOS?

No. But you can control the symptoms to the point of being symptom-free.

*While symptoms tend be similar in PCOS sufferers, the treatment and action plans are different based on individual needs. If you suspect you may be suffering from PCOS, seek medical attention.

22 Comments

  1. Erin McGlynn
    May 10, 2010 / 10:13 am

    I also have PCOS and I’m struggling to get my weight down the natural way (I’m not on Metaformin yet) I decided to wait and see how my diet goes. Looking forward to reading more about PCOS/Insulin Resistance on your site soon!

  2. May 26, 2010 / 9:12 pm

    is it possible to have PCOS and still be underweight?
    im not sure if I have it…but I haven’t gotten a period in almost 2 years. The docs. think it is because I run a lot (5 days a week for about an hour, sometimes more on the weekend). I have my first gyno appt. coming up, but I keep getting diagnosed with amenorrhea, is that a wrong diagnosis?

    • June 7, 2010 / 12:07 pm

      Hi!
      I too was “underweight” when I was having period issues. I was an avid swimmer for 18 years with about 3-5% body fat at the time. Finally my gyno recommended some blood tests and although they weren’t 100% pointing to PCOS they clearly stated that my LH and testosterone levels were leaning me towards it. I will have to say that adding some more “good fat” to my diet and getting to a healthier weight helped immensely, but I didn’t take their recommendation seriously until I started thinking about having kids (and that took 3 years). To be honest I don’t know that I would worry about it until you’re getting ready to have kids and then it’s important to lead a balanced healthy life through and through (even if it means adding a few pounds, which I hated). The result is SO worth it in the end though, motherhood is A-mazing!

  3. June 2, 2010 / 9:50 am

    Thanks for all of this great information. Your passion to help others understand more about this topic is amazing!! 🙂

  4. June 2, 2010 / 9:46 pm

    This is really great information! I have suspected for a long time that I have PCOS but the doctors can’t seem to figure things out. Inconclusive test results are the story of my life!!

  5. June 29, 2010 / 4:57 am

    I too have PCOS and struggle with my weight badly! I find blogging about it though and keeping positive is keeping me on track and have now lost 10kg even though it has taken quite sometime. I need to lose about 10kg more but I am taking my time and I know I’ll get there! Thanks for spreading the word about PCOS. 🙂

  6. August 24, 2010 / 5:25 pm

    This is so interesting. My sister and I both have this but she has it worse. I feel so bad for her.

  7. March 23, 2011 / 6:45 pm

    A close friend of mine recently found out that she has PCOS. Do you have any good resources for her? She is also trying to have kids.

  8. June 23, 2011 / 9:44 pm

    Thank you for the great information! I stumbled across you site (oven-fried pickle recipe) and saw that you had a PCOS tab. I was recently diagnosed with PCOS….discovered because I was having fertility issues. I’m still gathering as much information as I can….I guess I’m going to have to control the symptoms from now on. 🙂 Anyway, thanks again for the great insight! 🙂

  9. Cartellist Cyster
    July 2, 2011 / 6:26 pm

    Hi

    I’m 20 and from South Africa. I self-diagnosed myself 7yrs ago, and it was confirmed only a year ago by my “not-so-brilliant” doctors.

    It’s a struggle trying to stay in shape, and the worst part is the hirsutism and depression, but I’m on Glucophage (Metformin) and folic acid now; which have proved useless.

    Hope you all have better PCOS management than I do. Good Luck!

  10. Ashley
    August 2, 2011 / 5:09 pm

    Nicole,

    I actually found your blog from your siggy on the nest cooking board. I was looking for cooking blogs and found yours. I’ve made 2 recipes so far that are wonderful and were a big hit in my house. Here I was perusing your sights for 2 weeks and never even noticed the PCOS tab (hello, ding dong!). I cried sitting here reading this because I felt like this is the most help I’ve gotten nutritionally. I was diagnosed with PCOS 2 years ago and have been with an RE since March. We are on hold on the baby front right now (just not emotionally there). I know getting weight off will help but no one seems to understand how hard it is with PCOS. So, it’s nice to not feel so alone out there. Thank you from the bottom of my heart! I have a feeling I’ll be making a lot of your recipes!

    Ashley

    • Nicole
      Author
      August 2, 2011 / 5:19 pm

      Ashley, thank you! That made my day! You’re not alone…just know that! And I hope you love the recipes 🙂

  11. Karen Dickson
    March 5, 2012 / 12:42 pm

    I am 51 years old and was diagnosed 31 years ago when it was PCOD (polycycstic ovarian disease). I had the irregular periods, pelvic pain, facial hair growth, discoloration of the skin, unexplained weight gains and the list goes on. I did the fertility treatments to no avail and my ovaries got so bad that I finally had a total hysterectomy 7 months ago. I really wish that there were resources such as yours when I was diagnosed. I was told I had the condition, but was not told what I could do to help myself with it. I was always told to lose weight, but no one would tell me how in the heck I could do that when it was a chore to lose just 5 pounds! My weight has not fluctuated much in 18 years and I still can’t seem to lose any. I am excited about following your tips for eating right and maybe my body will finally allow me to take the pounds off! Thank you for all the information that you put out there to help others. It is wonderful to know that others will not have to go through what I have and there is light at the end of the tunnel!!!

    • Nicole, RD
      Author
      March 5, 2012 / 3:02 pm

      Karen: I’m so sorry to hear about your struggles. Your sweet note means a lot to me. 🙂 All my best!

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