This section of my blog is devoted to learning and understanding more about Polycystic Ovarian Syndrome (PCOS). I am NOT a PCOS expert or an MD. While I can comment on a carbohydrate-controlled diet, the following information is that found in A Patient’s Guide to PCOS by Walter Futterweit, MD .
After discovering I had elevated glucose readings at a diabetes conference in San Jose, I was diagnosed with PCOS in April of 2010. I have always struggled with my weight, acne, regular menses*, etc. It wasn’t until I was diagnosed with PCOS, however, that my symptoms dating back 13 years were all related. It is important to understand that ALL women’s PCOS symptoms and struggles are not alike.
Most women learn of their PCOS due to irregular periods, infertility, and/or hair problems (hair thinning or excessive bodily hair growth). Most women with PCOS (75%) are overweight or obese.
What is PCOS?
Women with PCOS excrete excessive amounts of male hormones (mostly testosterone). It is important to note that polycystic ovaries are a symptom or sign of the problem, not the cause. Therefore, some women (like myself), may have very few, if any, cysts on their ovaries. PCOS is not a disease in the sense of a single health problem, but instead, a combination of various symptoms that share an underlying cause.
Symptoms of PCOS
Irregular periods, excessive hair growth on face and body, scalp hair thinning, acne, excess weight, sugar cravings, inability to lose weight, darkening of skin (particularly on the nape of the neck), skin tags, gray-white breast discharge, sleep apnea, pelvic pain, depression, anxiety, sleep disturbances, and other emotional disorders. Some women have only a few symptoms, while others have most every symptom. The symptom severity can also vary from woman to woman. A PCOS diagnosis should be made by an endocrinologist.
What causes PCOS?
The following causes are the most commonly proposed among health professionals :
- A defect in the hypothalamus leading to exaggerated LH pulses that stimulate the ovaries to secrete more than normal amounts of male hormones
- A defect in the ovarian production of testosterone and other male hormones due to abnormal enzyme action on the pathways leading to testosterone
- High insulin levels (hyperinsulinemia) as a result of insulin resistance, which further strengthens the effect of LH on the ovaries (see #1).
- Genetic causes: 40% of women with PCOS have a sister with PCOS and 35% have a mother with PCOS
What is Insulin Resistance Syndrome (IRS)
Insulin Resistance Syndrome is most commonly referred to as metabolic syndrome and syndrome X.
Insulin Resistance, weight, and PCOS
Overweight and obesity are closely intertwined with insulin resistance. Weight gain is frequently associated with worsening PCOS symptoms, insulin resistance, and insulin resistance syndrome (IRS). Many times it’s impossible to determine which came first – weight gain or insulin resistance. Losing 7-10% of body weight can reduce PCOS symptoms, such as insulin resistance. However, it is more difficult to lose weight if you are insulin resistant. When organs and tissues lose sensitivity to insulin (the hormone that lowers blood glucose in the body), a normal amount of insulin is no longer sufficient to regulate blood glucose levels in the body, and the pancreas must put out more insulin to properly regulate itself. As insulin levels rise, the ovaries secrete more male hormones and PCOS symptoms worsen.
A rise in blood sugar is answered by a secretion of insulin. During each cycle of increasing blood sugar and insulin secretion, the insulin is converting excess blood sugar to triglycerides and fat, and weight accumulates quickly. Thus, the more insulin resistant you become the more weight you gain and the more weight you gain, the more insulin resistant you become.
Insulin resistance can be hard to diagnose because it cannot readily be detected by any convenient lab testing.
What tests or information help diagnose PCOS?
A history of irregular menses, ovarian ultrasound (although this test is not sufficient for PCOS diagnosis), testosterone level, luteinizing hormone (LH), sex hormone binding globulin (SHBG), prolactin level, dehydroepiandrosterone sulfate (DHEAS), 17-alpha-Hydroxyprogesterone (17-OHP), lipid profile, glucose level, insulin level, 2-hour glucose tolerance test, TSH, T4, C-reactive protein, urine microalbumin, and/or adrenocrticotropic hormone (ACTH) .
Eating right with PCOS
Unfortunately, women with PCOS simply do not “burn” calories as quickly as those without PCOS. Yet, weight management may be one of the most powerful ways to reduce negative PCOS symptoms.
Tips to eat right:
– Include protein with most meals and snacks – protein helps slow the absorption of sugar into the blood.
– Balance meals – include complex carbohydrates, lean protein, and heart-healthy fats in each of your meals
– Avoid high-carbohydrate and high sugar meals and snacks – they cause big swings in blood sugar and insulin levels
– Reduce meal size and include small snacks throughout the day
– Eat regular meals – skipping meals can cause blood glucose to rise
– Utilize low glycemic index foods
– Reduce calories to produce weight loss, if necessary (8-9 calories per pound of body weight)
Is there a cure for PCOS?
No. But you can control the symptoms to the point of being symptom-free.
*While symptoms tend to run similarly in PCOS sufferers, the treatment and action plans are different based on individual needs. If you suspect you may be suffering from PCOS, seek medical attention.