Understanding PCOS: Symptoms, Causes, and Management

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects up to 1 in 10 people with ovaries, usually during their reproductive years. Despite how prevalent it is, many people struggle to fully understand the condition, its symptoms, and how to best manage it. Below I'll explore what PCOS is, its causes, symptoms, supplements, and practical tips for managing it.

What is PCOS?

Polycystic Ovary Syndrome (PCOS) is a hormonal condition that affects the way ovaries function. It can cause a wide range of symptoms, from irregular periods to fertility issues, and it’s associated with a variety of long-term health risks. Here's a quick breakdown of the key aspects of PCOS:

• Irregular or absent periods: People with PCOS often experience irregular menstrual cycles or missed periods due to ovulation issues.

• Excess androgen levels: Elevated levels of male hormones (androgens) can lead to visible symptoms like acne, hair thinning, or excess body and facial hair (known as hirsutism).

• Polycystic ovaries: Despite its name, not everyone with PCOS will have cysts on their ovaries. For those who do, these cysts are follicles that have not fully developed and released eggs during ovulation.

• Weight gain or difficulty losing weight: Many people with PCOS struggle with weight management, often due to hormone imbalances and insulin resistance.

• Insulin resistance: One of the major contributors to PCOS symptoms is insulin resistance. This occurs when the body’s cells do not respond effectively to insulin, leading to higher blood sugar levels, and increasing the risk of developing type 2 diabetes.

• Fertility issues: PCOS is a leading cause of infertility because it disrupts ovulation. Without regular ovulation, it becomes more difficult to conceive.

What Causes PCOS?

The exact cause of PCOS isn't fully understood, but it's believed to be a combination of genetic, environmental, and lifestyle factors. Some key contributors include:

1. Hormonal imbalances: PCOS is characterized by an imbalance of reproductive hormones, including higher levels of androgens and insulin, which can interfere with normal ovulation.

2. Insulin resistance: Many individuals with PCOS have insulin resistance, which means their bodies need to produce more insulin to regulate blood sugar levels. Excess insulin can cause the ovaries to produce more androgens, contributing to many of the symptoms of PCOS.

3. Inflammation: Low-grade inflammation is often present in people with PCOS and may contribute to insulin resistance and increased androgen production.

Symptoms of PCOS

PCOS can present with a wide range of symptoms, and not everyone will experience all of them. Some of the most common signs and symptoms include:

• Irregular or missed periods: The absence or unpredictability of ovulation can lead to cycles that are irregular, heavy, or absent.

• Excess hair growth: Often seen on the face, chest, and back (hirsutism) due to elevated androgen levels.

• Acne and oily skin: Hormonal changes can lead to more severe acne, especially around the face, chest, and upper back.

• Weight gain: Particularly around the abdomen.

• Thinning hair: PCOS can cause hair on the scalp to thin and fall out.

• Darkening of the skin: Often seen on the neck, groin, or under the breasts, a condition known as acanthosis nigricans.

• Mood changes: Anxiety and depression can often accompany PCOS, exacerbated by hormone imbalances and the physical symptoms of the condition.

How to Manage PCOS: Practical Tips

Follow a balanced diet

One of the most effective ways to manage PCOS is through diet, particularly focusing on carbohydrate intake. A lower-carb, balanced diet rich in fiber, lean proteins, and healthy fats can help manage insulin levels. I typically recommend women focus on the following macros:

• Protein: 0.6-1.1 gram of protein per pound of bodyweight

• Fat: 35% of diet

• Carbs: Remaining calories should come from carbs

Why Managing Carbs is Important for PCOS

Many individuals with PCOS experience insulin resistance, which means their body has trouble regulating blood sugar levels. Eating too many carbohydrates, especially refined or simple carbs, can lead to spikes in blood sugar and insulin, worsening PCOS symptoms. This is why a lower-carb diet is often recommended for managing PCOS.

But it’s important to note that going completely carb-free isn’t necessary or recommended. Carbohydrates are an important source of energy and play a crucial role in maintaining healthy thyroid function and overall mood. Complex carbohydrates—like those found in whole grains, vegetables, and legumes—are digested more slowly, leading to more stable blood sugar levels. This helps prevent the energy crashes and cravings associated with high-carb, processed foods.

Manage stress

Stress can exacerbate PCOS symptoms, particularly hormonal imbalances. Incorporating stress-management techniques like yoga, meditation, or deep breathing can help.

Exercise regularly

Physical activity can improve insulin sensitivity and help with weight management. Aim for a combination of strength training and cardiovascular exercises for the best results.

Get enough sleep

Sleep disturbances are common in PCOS, but getting enough rest is crucial for hormonal health. Aim for 7-9 hours of quality sleep per night.

Consider supplementation

In addition to lifestyle and dietary changes, certain supplements may support the management of PCOS symptoms.

While supplements can’t cure PCOS, they can help with insulin resistance, inflammation, and hormone imbalances. Here are 5 commonly recommended supplements for PCOS:

• Inositol (Myo-Inositol and D-Chiro Inositol): Inositol is a type of sugar alcohol that helps improve insulin sensitivity and supports ovarian function. Studies show that a combination of Myo-Inositol and D-Chiro Inositol can restore menstrual cycles, improve ovulation, and reduce androgen levels.

• Omega-3 Fatty Acids: Omega-3s, found in fish oil or plant-based sources like flaxseed, have anti-inflammatory properties. Omega-3 supplements can help lower testosterone levels, reduce inflammation, and improve insulin sensitivity.

• Vitamin D: Vitamin D deficiency is common in people with PCOS, and it’s linked to insulin resistance and hormone imbalance. Supplementing with Vitamin D can improve insulin sensitivity, ovulation, and regulate menstrual cycles.

• Magnesium: Magnesium supports insulin regulation, reduces inflammation, and helps with stress management. It can improve insulin sensitivity, alleviate menstrual cramps, and reduce stress, a common trigger for PCOS symptoms.

• N-Acetyl Cysteine (NAC): NAC is an antioxidant that supports detoxification and insulin sensitivity. NAC has been shown to improve ovulation, reduce androgen levels, and improve fertility in people with PCOS.

Consider medical support

In some cases, lifestyle changes alone aren’t enough to manage PCOS. Medications like hormonal birth control, anti-androgens, or metformin (to improve insulin sensitivity) may be prescribed by your healthcare provider.

PCOS is a complex condition that affects many aspects of health, but with the right approach, its symptoms can be managed effectively. Focusing on a balanced, lower-carb diet, regular exercise, supplements, and proper self-care can go a long way in managing insulin resistance, promoting hormone balance, and improving overall well-being. Remember, everyone's body is different, and finding what works for you is key to managing PCOS effectively.

By understanding PCOS and taking a proactive approach, you can empower yourself to live a healthy, fulfilling life despite the challenges it may bring.