What is PCOS?

PCOS stands for Polycystic Ovary Syndrome, which in itself is confusing because women with the condition do not always have cysts on their ovaries! PCOS is the most common endocrine-metabolic disorder in women, with one in 10 women being affected in the UK. It is a leading cause of infertility.

Our ovaries are responsible for producing follicles, which become eggs to be released each month, and for producing our reproductive hormones oestrogen and progesterone. With PCOS, this follicle maturation process is disrupted causing either delayed ovulation or preventing it entirely. This in turn can cause irregular periods or even them vanishing entirely!

“PCOS is not a gynaecological disease – it is an inflammatory endocrine disorder characterised by  reproductive, hormone & metabolic abnormalities” – Nicole Jardim

To confuse matters even further, it is referred to as a syndrome because it is not a single condition, but rather a collection of symptoms with various causes. For this reason, cysts on the ovaries alone do not mean a woman has PCOS! Rather, several other factors must be present in order to receive a correct diagnosis.

PCOS symptoms you should know about

As we now know, cysts alone cannot be the only symptom used to identify whether a woman has PCOS. Other common symptoms include:

  • Irregular or missing periods
  • Fertility issues
  • Excessive and unwanted hair growth
  • Insulin resistance
  • Insomnia
  • Ovulation pain
  • Weight gain
  • Hair loss (male pattern baldness)
  • Acne, especially along jaw line
  • Mood imbalance

What is the PCOS diagnosis process?

There is no standalone test that can diagnosis PCOS, which is one reason it can take so long for women to receive this diagnosis and therefore go a long time without getting the correct support.

In order to receive a medical diagnosis, you must have at least two of the following three criteria:

  • Irregular periods (cause by irregular ovulation – oligoovulation)
  • Blood tests with high testosterone (hyperandrogenism)
  • Scans showing polycystic ovaries (i.e. at least 12 follicles 2-9mm)

However, women may not meet this criteria and still have PCOS, which why it is important to seek support of women’s health specialists. Blood tests can helpful not only to identify whether testosterone levels are raised but also whether luteinising hormones are elevated.

What causes PCOS?

Whilst the exact cause is unknown, we do believe that PCOS would have been an evolutionary advantage historically, causing women to have fewer babies and therefore increase life expectancy. However, as a result of our modern lifestyles this protective factor is now having a detrimental effect on our reproductive system. We also know that there is a genetic link, so it is good to know your mother’s experience!

There are four different identified causes of PCOS – Insulin Resistant, Post-Pill, Inflammatory or Adrenal PCOS.

We know that the hormone insulin, which regulates our blood sugars, can be dysregulated in many women with PCOS. When we have too much, it affects the sensitive balance of the hormones responsible for maturing and releasing the follicles. High insulin also causes the ovaries to make more testosterone and less sex hormone-binding globulin (SHBG), which helps to control testosterone levels, which links with the issues with hair growth.

What treatments are available?

Whilst there is no “cure” for the syndrome, fortunately there is a lot that can be done to improve things for women with PCOS! These tips are shared as a guide, but it is important to work with an experienced practitioner when wanting to address the symptoms:

  • Supplement with Myo-Inositol – this is a nutrient that supports insulin resistance.
  • Balance your blood sugars – whilst complex carbs are not the enemy, focusing on good quality proteins and good fats, with lots of veg, is vital.
  • Omega 3’s – these help to keep testosterone low.
  • Improve Vitamin D – get outside when you can or supplement if you live somewhere with little sunlight.
  • Reduce your toxic load – especially BPA’s as they disrupt your hormones.
  • Do something for yourself every day – high cortisol (stress hormones) really mess with our insulin. Taking time for yourself is vital!

These are just some of my top tips to managing PCOS. My experience shows me that with the right support many women can find significant improvement with their symptoms through taking a lifestyle approach to their diagnosis.