Keeping with the theme of last week's topic, let’s talk about PCOS. This blog is based on my own research, if you think you may have PCOS, seek guidance and advice from a healthcare professional! PCOS, or polycystic ovarian syndrome, is the most common endocrine disorder among women in their reproductive years. It is a hormone dysfunction disorder that causes women not to ovulate due to several factors that we will go into now. 

It is not fully understood, but the general consensus among healthcare professionals is that you must exhibit certain criteria to be diagnosed with PCOS. The official diagnosis of PCOS requires two out of three of the following traits: 1) irregular periods, 2) high androgen symptoms like acne and body hair, and 3) polycystic ovaries which must be confirmed with an ultrasound. Some other common traits of females with PCOS are obesity, alopecia, pregnancy complications, and at the most extreme end of the spectrum, cancer.

To give you a summary of what is going on within the body of someone with PCOS, we must start in the ovaries. Ovaries are basically a storage unit for the lifetime supply of eggs a woman will have from puberty to menopause. Each egg is stored within a follicle and will follow the instruction of different hormones released from the pituitary gland in the brain. Each month, the pituitary gland will secrete follicle stimulating hormone (FSH) and luteinizing hormone (LH). These hormones are released into the bloodstream and make their way to the ovaries to instruct 100s of eggs to begin maturation, expanding their follicle size. As these eggs mature, the follicles will secrete estrogen and once the estrogen reaches a certain level, the pituitary gland sends a surge of LH to the ovaries. This surge of LH will cause the most mature follicle to release its egg, putting ovulation into motion. The free egg then travels through the fallopian tube to await fertilization while the other eggs dissolve, and if fertilization does not occur, the uterine lining is shed via menstruation. Women with PCOS are not able to complete this process to reach ovulation. In most cases, the pituitary gland will release too much LH due to the amount of follicles present, disrupting the cycle. This results in follicles being unable to mature and cysts if the mature egg is not shed. This can also cause metabolic changes like insulin resistance and complications linked to that like diabetes, weight gain, and high blood pressure and cholesterol. 

Unfortunately, there is no cure for PCOS, however it can be manageable. If applicable, lifestyle interventions may help like weight loss, diet changes, and supplements, while some women will need medical intervention. 

Let’s talk about diet and supplementation. A low glycemic index diet has been shown to help with menstrual regularity compared to women following a standard healthy diet and holds some merit in managing the symptoms. A 2019 study showed that this diet improved menstrual regularity in 80% of the participants with PCOS. This may be because low glycemic foods are slow digesting and cause gradual increases in blood sugar and insulin rather than the spikes and falls they might experience with higher glycemic index foods. Some examples of low glycemic index foods are steel cut oats, whole grain breads, sweet potatoes, most fruits, most legumes, etc. (Here is a link with more information: https://www.nhrmc.org/~/media/testupload/files/low-gylcemic-meal-planning.pdf?la=en). However, this doesn’t mean you need to stay away from high glycemic index foods completely! Pairing them with a lean protein or healthy fat will help stabilize blood sugar in the event you do eat something with a higher glycemic index. Lastly, when it comes to diet, make sure you are eating enough and eating regularly! Going long periods of time without eating can cause your blood sugar to drop, causing massive spikes in blood sugar when you do finally eat. There are also a few supplements that have been shown to help with the symptoms of PCOS. Inositol is the number one supplement with beneficial effects. Inositol is similar to glucose and can be found in whole grains and citrus fruits. A 2016 systematic review found that supplementing Inositol improved hormonal and reproductive disturbances in women with PCOS. Another 2017 study showed it can improve the metabolic profile of women with PCOS. Inositol has also been shown that it can reduce androgens that cause associated symptoms. Next supplement is Omega 3, I’m sure we all could use a little Omega 3 in our lives. A systematic review in 2018 showed that supplementing Omega 3 showed improvements in insulin resistance, total cholesterol, LDL cholesterol, and triglyceride levels. The last supplement we are going to talk about is Vitamin D. There isn’t much research suggesting that Vitamin D will help improve or reduce the symptoms of PCOS, however, women with PCOS tend to have a Vitamin D deficiency and need supplementation. Though, research in 2019 has shown that pairing a Vitamin D supplement with a daily probiotic may be helpful in treating symptoms. 

I have had so many ladies ask me how they can manage their PCOS because of issues they are experiencing with their weight. If you are feeling like exercise just isn’t enough and PCOS is making it hard for you to reach your goals, you are not alone! Managing your symptoms may be the key you need to make your journey just a little bit easier.  If you decide to implement any of this information into your diet or supplementation, refer to your doctor beforehand. I hope this helps!