PCOS 101

If you have two or more of the following, you may receive a diagnosis of PCOS:

1. Increased levels of androgen hormones (hyperandrogenism). This can be identified through a blood test or by the presence of symptoms such as acne, excess facial/body hair, or scalp hair loss
2. Irregular menstrual cycles (or no periods at all)
3. The appearance of cysts on the ovaries when incomplete ovulation occurs (this is viewed on an ultrasound). You do not need to have an ultrasound if you fulfil criteria 1 and 2.

• Irregular menstrual cycles
• Fertility problems
• Skin problems (acne, dandruff, oily skin)
• Excess body hair (especially on your face)
• Difficulty losing weight

What causes PCOS? To be honest, we’re not really sure. Genetics is often suggested as a cause, as is insulin resistance. Recent research suggests that insulin resistance is a major underlying cause of PCOS, as 70-80% of people with this condition have insulin resistance.

So what is insulin resistance and how does it affect PCOS?

• When foods containing carbohydrates are eaten, the carbohydrate is broken down to glucose and enters the bloodstream. This will cause your blood glucose levels (BGLs) to rise. As these levels rise, a hormone called insulin is released.
• Insulin helps to carry the glucose into the body’s cells to be used as energy. The BGLs will then return to normal levels.
• In insulin resistance, the cells do not take up glucose from the bloodstream as efficiently as they should. The body responds to this by producing more insulin to normalise BGLs.
• This increase in circulating insulin can cause the ovaries and adrenal glands to produce an enzyme that stimulates androgen production.
• Increased androgen production is one of the three key diagnostic criteria for PCOS.

Can you cure your PCOS? Not exactly. But you can manage the symptoms and effectively send it into remission. You can do this by following some simple dietary and lifestyle advice.

It is important to note that this doesn’t always work for everyone. Medications are available and are very useful for some!

1. Weight loss may help some people – but not all! A small weight loss of 5-10% can help improve insulin resistance and assist with the normalisation of menstrual cycles. Lean PCOS (where you have no weight to lose) is very much a real thing, and weight loss does not help with this population of people!
2. Check your carbohydrate intake and portion size! Having large portions of carbohydrate rich foods makes your pancreas work harder to produce more insulin, worsening insulin resistance. It’s important to check portion sizes and focus on consuming the right type of carbohydrates, which brings me to…
3. Choosing low glycaemic index (GI) carbohydrates! Doing this means that your body doesn’t have to produce as much insulin as quickly because these carbohydrates break down more slowly. This helps to improve insulin control.
4. Physical activity can assist with insulin resistance. Aim for 30 minutes of moderate intensity physical activity on most days of the week. Increasing incidental activity, such as walking to the shops instead of driving or taking the stars instead of the lift can also be beneficial.