Guide to PCOS
What is PCOS:
Polycystic ovary syndrome (PCOS) is a common hormonal disorder among women during their reproductive years. PCOS affects a woman’s ovaries- the reproductive organs that produce estrogen and progesterone (the hormones that regulate the menstrual cycle). The ovaries also produce a small amount of male hormones called androgens.
The Cause:
The exact cause of PCOS isn't known. Factors that might play a role include:
Excess insulin, the hormone produced in the pancreas that allows cells to use sugar, your body's primary energy supply. If your cells become resistant to the action of insulin, then your blood sugar levels can rise and your body might produce more insulin. Excess insulin might increase androgen (the male hormone) production, causing difficulty with ovulation.
Low-grade inflammation. In short, your white blood cells' production of substances to fight infection. Research has shown that women with PCOS have a type of low-grade inflammation that stimulates polycystic ovaries to produce androgens, which can lead to heart and blood vessel problems.
Heredity- your genes might be linked to PCOS.
Excess androgen produced by your ovaries which can result in hirsutism and acne.
Is PCOS serious?
If it isn't treated, over time it can lead to serious health problems, such as diabetes, heart disease and even cancers! Most women with PCOS grow many small cysts on their ovaries, which themselves aren't harmful, but can lead to hormone imbalances if not properly controlled.
First signs of PCOS:
irregular periods or no periods at all
difficulty getting pregnant (because of irregular ovulation or failure to ovulate)
excessive hair growth (hirsutism) – usually on the face, chest, back or buttocks
unexplained weight gain
thinning hair and hair loss
oily skin or acne around the chin/ jawline
The Pill and PCOS:
Birth control is not a cure for PCOS, but it can help treat and relieve some of the symptoms. However, finding the one that is right for you (combined, which contains estrogen and progestin, or progestin-only) can be challenging, and there may be reasons why you are able to take one, but not the other—or none at all. I personally was not able to take any- in fact, testing out a few different brands/ combinations only made my symptoms worse.
Birth control performs three main functions to treat PCOS:
1. It protects the uterus by ensuring regular ovulation
2. It helps reduce excessive male hormone (androgen) levels in the blood, particularly testosterone.
3. It protects against unwanted pregnancy in women whose ovulation cycles are often difficult to track.
Things that helped me:
Managing stress: Our lives are filled with stress- work, family, social circles, money, personal struggles, etc. Changing up your workouts (you can read more below), incorporating meditation (even just 5 minutes a day), talking to someone about difficult situations, breathing in your nose and out your mouth to help slow down breathing and help you relax are all helpful techniques to lower cortisol levels and help manage stress.
Cutting back on high-intensity workouts: Over-exercising can lead to hormonal imbalances, including changes to your testosterone and cortisol (our stress hormone) levels. It can also drive overeating and the body can begin to burn muscle instead of fat. You can read more about my transition here! I suggest cutting back on HIIT and cardio and start incorporating more pilates, yoga and sculpting.
Quitting Coffee: Most of you are probably rolling your eyes at this one, but this was worth the withdrawal symptoms. I honestly don't need any caffeine at all anymore and have become extremely sensitive to it- even a cup of matcha. I'm not going to lie, the first week or so was hard. I had headaches and was extremely tired throughout the day. The 3pm slump was real and all I wanted was sugar or something to "wake me up". The truth is that caffeine and sugar aren't giving you this magical energy- they are temporary stimulants that negatively effect your hormones.
Eliminating added sugar: This is very important! Sugar is intrinsically linked to estrogen, a hormone responsible for many processes in the body. Estrogen has many beneficial effects, including regulating the reproductive system as well as helping optimize the action of insulin- the hormone that prevents high blood sugar levels. For women especially, a diet full of excessive sugar – which includes all refined carbohydrates, not just the sweet stuff – can lead to significant hormonal imbalance. I personally cut out all sugars when I was diagnosed with PCOS, including healthy ones such as honey, maple syrup, coconut sugar, etc. I ate mixed berries for breakfast as they are naturally high in fiber and the fruit that's lowest in sugar. After learning to control my PCOS. I began adding in other fruits and natural sweeteners in moderation.
Focusing on proper nutrition: Eating a well balanced diet of non-starchy veggies, healthy fats and lean proteins worked best for my body and focussing on ingredients rather than numbers (i.e calories). Below is a sample day of eating that I personally follow. If you are still unsure of where to begin with your PCOS and how to manage it, I work with private clients on holistic nutrition sessions!
Sample Day of Eating:
7:00 am: Wake up & immediately have a cup of hot water, 1/2 lemon, 1 scoop collagen powder, 1 tsp apple cider vinegar
8:00 am: Green juice, no fruit- celery, cucumber, spinach, kale, lemon, ginger
9:00 am: Coconut yogurt, mixed berries, chia seeds, flax seeds, cacao nibs
10:30 am: Matcha or green tea
12:30pm: Salad with lean protein and healthy fat - mixed greens, cucumber, tomato, bell pepper, red onion, broccoli, grilled chicken, avocado with lemon, olive oil, balsamic, salt & pepper
3:30/4 pm: carrots, celery with 3 tbsp hummus
7:00 pm: Roasted veggies (zucchini, asparagus, cauliflower) with fish of choice (salmon, branzino, etc.) drizzled with olive oil and lemon
What my OBGYN told me...
Re: The Pill: She prescribed me multiple brands with various strengths of hormones. Unfortunately, none worked for my body and each pill came with different uncomfortable symptoms (acne, moodiness, increased hunger and weight gain, etc.). I was told that the pill was my only way to control my PCOS and while there isn't a cure, this was my best option. Truthfully, I was young and wish I did more research before agreeing to go on the pill. Knowing what I know now, I would have refused and tried to treat PCOS holistically.
Re: Pregnancy: The infertility rate with PCOS is very high- most women will usually have difficulty getting pregnant and will require treatment to improve chances for pregnancy. Some women will ovulate occasionally, while others won't at all. This is where the pill becomes helpful and will regulate your body's ability to ovulate and prepare for pregnancy when ready. After doing my own research and speaking with another doctor, I have my doubts about this statement.
I hope this was helpful to whomever is curious about this topic and/or dealing with the diagnosis. Feel free to leave a comment about your experience, questions or concerns!
*I am not a doctor and am writing this blog post from my personal research and opinion. If you have any medical questions, you should contact your physician.