pcos1

What is polycystic ovary syndrome (PCOS)?

Life Cycle

PCOS is a hormonal condition.
Hormones are chemical messengers that control the way the body works.
PCOS is a common condition with up to 1 in 5 women of child bearing age affected. In PCOS two hormones, insulin and male type hormones are produced in higher levels, which results in problems such as:

  • Periods less regular (more or less often)
  • Emotional problems (anxiety or depression)
  • Hair growth on face, stomach, back
  • Acne or pimples
  • Easy weight gain
  • Delays getting pregnant
  • Diabetes
  • More risk factors for heart disease

Not all women with PCOS will have all of these symptoms as PCOS can vary between women and changes with age. The name of this condition, polycystic ovary syndrome, suggests that the problem is mainly with the ovaries. This is not correct. It is the increased levels of male type hormones that cause the ovaries to work differently causing many of the problems listed above.

PCOS does not go away and women with it have a higher risk of conditions such as diabetes, and increased risk factors for heart disease. PCOS is treatable and as women get older some of the symptoms become less severe.

 

DIAGNOSIS

Two out of three of the following are needed for a diagnosis

Normally, it takes a couple of years after periods start for them to settle into a regular pattern. Therefore, a diagnosis of PCOS cannot be made during that time. Also, girls on the contraceptive pill may need to wait until they are off the pill for three months to get a clear diagnosis (there will be a need to take another form of contraception during that time).

WHAT CAUSES PCOS?

PCOS occurs in all groups but also appears to follow family and ethnic lines, which means it is more common in certain groups such as Indigenous, Asian and North African women. Also lifestyle patterns such as the way we eat and exercise can make the condition better or worse. Increased weight also increases the likelihood of developing PCOS.

MALE TYPE HORMONES AND INSULIN

Male type hormones

Male type hormones also known as testosterone and androgens are found in all women in small amounts. Women with PCOS produce slightly higher levels (but not as high as men).

Insulin

Insulin’s most important job is to help control the sugar (glucose) levels in the body by helping to get it into the cells to be used for energy, or to send it into storage, if not needed. This way the level of glucose in the blood is always kept the same.

  • Insulin works like a key to let glucose (energy) into the body cells
  • In PCOS many women have insulin resistance, where the cell won’t let insulin work properly, resulting in higher levels of insulin in the blood
  • Higher insulin levels can make people gain weight easier and may increase appetite
  • Insulin is able to do its job better if women with PCOS exercise regularly
  • Higher insulin levels can eventually lead to pre-diabetes and to diabetes type 2

WHAT DO THE OVARIES DO?

The main job of the ovaries, which are small oval shaped organs in the pelvic area, is to assist women to get pregnant by producing an egg each month. Often, in women with PCOS the eggs don’t fully develop. This is the main cause of the difficulties getting pregnant.

DIFFICULTIES GETTING PREGNANT

Most women with PCOS do not have problems getting pregnant but some will.
Also once pregnant some women may have more difficulties such as miscarriages and problems during birth.
The best way to increase your chances of getting pregnant is

  • Plan your family earlier in life if possible as our fertility is higher under the age of 35 years
  • Be really healthy by eating well and being as active as possible
  • Lose a few kilos if overweight

This can help your periods become more regular and help to produce an egg which is ready to become fertilised.
The healthier you are before getting pregnant the better your chances of getting pregnant and having a healthy pregnancy and a healthy baby.
It is ideal to lose some weight if overweight and to make sure you are eating a balanced diet with a rich variety of foods such as fruits and vegetables, and being as active as possible. You should also take folate supplements.
If after trying these things you are still unable to get pregnant your doctor can discuss medical therapies.

REGULAR PERIODS

It is common for women with PCOS to have periods that do not come for many months or which come too often.
The best ways to help your periods to become more regular is by:

lifestyle change (getting active and losing a few kilos if overweight).
Having regular periods helps keep the uterus healthy, so if you have less than four periods a year, discuss this with your doctor.

LIFESTYLE

The most successful way to treat PCOS is by living a healthy life. The way you eat, exercise and generally stay healthy is the best way to reduce your symptoms. When making change to your lifestyle, avoid short term fat diets or changes you can’t keep up for long, make sure you are ready to change and that you have support around you.
Importantly, set small achievable goals that you can manage such as

  • Always taking the stairs not the lift
  • Try a pedometer and work out ways to increase your steps each day
  • Or changing to low fat milk
  • Or swapping juice for water

Keep an eye on your weight and aim for prevention of weight gain or slow steady small weight losses.

POLYCYSTIC OVARY SYNDROME 13 EATING SUCCESS TIPS

  • Cook your food in a healthy way, for example steam fish instead of frying it
  • Eat mostly fruit and vegetables with some meat that is not too fatty
  • Eat mainly when you are hungry and only enough until you feel just full
  • Watch out for eating when you are tired and stressed
  • Drink mostly water when thirsty, as many drinks including juices contain a lot of sugar
  • Use cooking oils like olive oil, canola and groundnut oil rather than butter or vegetable oils
  • Use fish and unsalted nuts and green vegetables often
  • Keep the amount of rice/pasta/bread not too large eg 1 cup of cooked rice/pasta or 2 slices of bread per meal

Exercise Regular exercise greatly helps women with PCOS in many ways, such as improving mood and preventing weight gain, diabetes and heart disease. Try and find ways to exercise that you enjoy such as walking with friends and make it a regular part of your routine.

CONCLUSION

PCOS is a very common condition caused by changes in two main hormones; insulin and male type hormones.
It affects women differently with symptoms such as

  • Emotional challenges
  • Increased body hair
  • Acne
  • Weight gain
  • Problems getting pregnant and irregular periods

PCOS does not go away and in the longer term increases the risk of diabetes and heart disease risk factors. The best way to manage PCOS is by developing a good relationship with health professionals such as GPs, by living a healthy lifestyle, with a good diet and regular exercise.