In today’s’ day and age, more and more women are being diagnosed with PCOS. Health professionals now say that 12-18% of women have PCOS with the youngest age being diagnosed is 11 years old. Of that, they anticipate that 20% of women with PCOS will develop type 2 diabetes by the time they turn 30 and 50% by the time they turn 40. This is an alarmingly high figure however lets’ start at the beginning.
What is PCOS: Polycystic Ovarian Syndrome
In Layman’s terms, it’s where a women ovaries are larger than normal and generally have many cysts/ follicles that rarely grow to maturity or produce eggs capable of being fertilized.
Basic biology: Once a month, the body prepares itself to release an egg, it creates a cyst/ follicle on the wall of the ovary this grows and develops and then when the egg is mature/ripe it is released into the fallopian tubes and moves it’s way down to the uterus.
In a woman with PCOS, the ovaries don’t produce the hormones necessary to develop the egg and as such it sits as an immature follicle on the ovary. This is one of the keys ways doctors diagnose this, they see what looks like a string of pearls on the ovary when an ultrasound is done on them.
The other symptoms of PCOS are
- Irregular menstruation
- No periods (Amenorrhea) in some cases for years
- Excessive hair growth on the face, stomach etc. and acne (due to increased testosterone)
- Loss of hair on the head
- Reduced fertility (difficult in becoming pregnant)
- Mood changes – including anxiety and depression
- Central Obesity (although this is not in all women with PCOS, even really thin women can have PCOS)
- Sleep apnea
- Pelvic pain
It can also affect heart, blood vessels and appearance.
The cause of PCOS is unknown but experts think that genetics play a role, as a woman with PCOS is likely to have a mum or sister with PCOS.
The main impact of PCOS on a women’s body is hormonal imbalance. , The ovaries make more androgens (male-type hormones) than normal, High levels affect the development of eggs and the bodies ability to release them for fertilization.
Typically women with PCOS also have issues with insulin. Insulin controls the body’s ability to convert sugar, starches and other foods into energy for the body to store or use. Most women with PCOS have high levels of insulin, as their bodies have trouble using it, the extra insulin causes the increase in androgens, which again affects the bodies’ ability to manage the insulin, and so it becomes a vicious circle.
If you suspect PCOS, Talk to your doctor, they will do a hormonal workup, discuss your medical history with you, and then refer you for ultrasounds and to an endocrinologist if required.
Your endocrinologist may conduct further tests after meeting with you and discussing your history and your goals (pregnancy, management, lose weight).
There is no cure for PCOS, instead, it can only be managed.
Depending on what you want to achieve, your symptoms and whether you want to become pregnant or not, the treatments vary.
The main thing is lifestyle modification, eat healthily and exercise regularly, try to aim for 10,000 steps a day. Eat wholegrain cereals, veggies and fruit while limiting processed and high sugar foods. This can help to lower the body’s blood glucose levels and improve the body’s use of insulin. If you reduce your body weight by even 10% this can be enough to restore menstrual cycles if your aim is pregnancy and improve your insulin resistance.
If pregnancy is not your aim, there are birth control pills. These can help restore menstrual cycles by reducing male hormones in the body and help to clear acne. Although if you do stop taking the pill, menstrual cycles can become irregular again.
Sometimes your doctor/endocrinologist may put you on the medication used by diabetics to control their insulin levels. The most common is metformin (Glucophage). It also slows the growth of abnormal hair. After a few months, it may help ovulation to return and this is the most common one used when women with PCOS are trying to become pregnant. It can also help with the reduction of BMI and cholesterol levels. This is not a miracle drug, you need to take control of your diet and start eating healthy to fully control this otherwise you could be on medication for life.
In the case that metformin and lifestyle change doesn’t help you become pregnant if that is your goal, then there are also other fertility medications that can possibly help. Clomiphene (KLOHM-uh-feen) (Clomid, Serophene) is the most common one used, this is given in tablet format. Next is Shots of Gonadotropins (goe-NAD-oh-troe-pins), more expensive than climbed and increased chance of multiple pregnancies. The next step after that is IVF.
In some cases, surgery can be performed to help clear some of the unmatured eggs from the ovary, this can help the body increase its ability to produce eggs. Unfortunately, the results may only improve for a few mths before it has to be done again.
Once women with PCOS become pregnant, there is an increased risk of
- Gestational Diabetes
- Premature Delivery
The long term concerns of this besides infertility is that if left unmanaged and if you remain overweight:
- You could develop type 2 diabetes.
- The risk of heart attack is 7 times higher in women with PCOS
- High LDL (bad ) cholesterol and low LDL (good) cholesterol
- Greater chance of developing Sleep apnea
- Greater chance of high blood pressure
- Increase the chance of endometrial cancer due to the lack of progesterone in the body.
If you are diagnosed with PCOS, it is not the end of everything, it just means you need to focus more on your health and ensuring that you remain within a healthy BMI range, exercise regularly to keep your cardiovascular system (heart) healthy.
The 28 day plan from the healthy mummy product range is a great first step in the right direction, it’s full of low GI recipes and foods that will help you start your weight loss, better health journey.
As a fellow PCOS sufferer, I have found that the 28 day plan and the recipes on this website have been invaluable in helping me lose weight and take control of my PCOS Symptoms.