PCOS | Symptoms, Causes, Diagnosis, Treatment

Nutrition Specialist, Esra Kozan
November 16, 2023 12 minutes
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What is PCOS (Polycystic Ovary Syndrome)?

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects many women worldwide. It’s characterized by a range of symptoms, and can have a significant impact on a woman's reproductive health and overall well-being. In this blog, let’s delve into what PCOS is and learn about its symptoms, diagnosis, causes, effects on fertility, treatment options, the role of diet and exercise, triggers, and the possibility of at-home testing.

What are the Symptoms of PCOS?

PCOS is a hormonal disorder that leads to the development of small cysts on the ovaries. PCOS comes with a number of symptoms, including:

  • Irregular menstrual cycles
  • Hirsutism
  • Acne
  • Weight gain
  • Difficulty in losing weight

Other symptoms may include mood swings, fatigue, and sleep apnea.

What Causes PCOS?

Polycystic Ovary Syndrome (PCOS) is a complex and multifaceted condition that affects many women worldwide. The exact causes of PCOS remain a subject of ongoing research, but several factors are believed to contribute to its development. One key element is hormonal imbalance, specifically an excess of androgens (male hormones) in the body, which can disrupt the normal functioning of the ovaries. 

Insulin resistance is another significant factor, as it can lead to elevated insulin levels, prompting the ovaries to produce more androgens. Genetics also play a role, with PCOS often running in families. Lifestyle factors, such as poor diet and lack of physical activity, can exacerbate PCOS symptoms. While the precise causes may vary from person to person, these factors collectively contribute to the manifestation of PCOS, resulting in irregular periods, fertility issues, and a range of other symptoms. 

How Does PCOS Progress? 

Polycystic Ovary Syndrome (PCOS) is a condition that manifests with a variety of symptoms rather than progressing through distinct stages. Typically, it begins with symptoms such as irregular menstrual periods and elevated androgen levels, which can lead to manifestations of facial acne and excessive facial hair. 

As PCOS advances, small cysts may sometimes develop on the ovaries, and symptoms become more noticeable, including weight gain and insulin resistance. In more advanced stages, hormonal imbalances can be associated with fertility challenges, difficulty conceiving, and an increased risk of metabolic disorders. The advanced stages of PCOS may lead to long-term complications, including cardiovascular problems, type 2 diabetes, and other chronic health issues. 

How is PCOS Diagnosed?

Diagnosing PCOS involves being assessed by a healthcare provider who will perform a physical examination and conduct other tests to determine whether you have PCOS. These tests may include blood tests to measure hormone levels, a pelvic ultrasound to examine the ovaries, and sometimes a glucose and insulin test to assess your insulin resistance.

How is PCOS Treated?

If you have Polycystic Ovary Syndrome (PCOS), there are several ways to manage your symptoms and improve your overall health. Treatment plans are tailored to each individual's needs, taking into consideration factors like the severity of symptoms, age, and reproductive goals. 

Lifestyle changes are the foundation of PCOS management, including maintaining a healthy weight, eating a balanced diet, and engaging in regular exercise. Medications are also commonly prescribed to address specific symptoms and hormonal imbalances. For instance, birth control pills can help regulate menstrual period and reduce high levels of androgens, while insulin-sensitizing drugs can manage insulin resistance. If you're trying to conceive, ovulation-inducing medications may be recommended. 

In more complex cases, assisted reproductive technologies (ART) like in vitro fertilization (IVF) may be considered. Depending on your individual needs, managing PCOS-related complications, such as acne, excess hair growth on the face, and infertility, may require additional treatments. This comprehensive guide will provide you with all the information you need to make informed decisions about your PCOS treatment options, empowering you to effectively manage your condition and improve your health and well-being.

How Does PCOS Affect Fertility?

PCOS can significantly impact fertility because it can cause you to have irregular ovulation or result in a lack of ovulation altogether, which means that women with PCOS might experience difficulties in getting pregnant. However, various treatment options are available to improve fertility, such as ovulation induction medication, assisted reproductive technologies like in vitro fertilization (IVF), and lifestyle changes.

PCOS can greatly affect fertility by disrupting hormonal balance and ovarian function. Women with PCOS often have higher levels of male hormones (androgens) and insulin resistance, both of which can disrupt the normal ovulation process. This can cause irregular menstrual periods or even a lack of ovulation, making it challenging to conceive naturally.

What are the Treatment Options for Infertility?

Thankfully, there are various treatment options accessible to enhance fertility in females who have PCOS. One such option is ovulation induction medication, which includes clomiphene citrate or letrozole, and can be prescribed to induce ovulation. These medications aid in regulating hormone levels and encouraging the release of mature eggs, thereby increasing the chances of conception.

Diet and exercise both can play a crucial role in helping manage PCOS symptoms. A balanced and nutritious diet, as well as focusing on eating whole foods and avoiding processed foods can help you regulate your hormone levels, improve insulin sensitivity, and help you manage your weight. Regular physical activity, such as aerobic exercises and strength training can also help reduce your PCOS symptoms.

For individuals who experience difficulties with fertility due to polycystic ovary syndrome (PCOS), assisted reproductive technologies (ART) such as in vitro fertilization (IVF) may be an option. IVF involves combining eggs and sperm in a laboratory and then transferring the resulting embryo into the uterus, bypassing the need for regular ovulation. Additionally, lifestyle changes such as maintaining a healthy weight through a balanced diet and regular exercise can improve insulin sensitivity and hormone balance, positively affecting ovulation and fertility.

If you're having difficulties conceiving and believe that PCOS could be a contributing factor, it's crucial to seek guidance from a healthcare professional or a fertility expert. They can conduct the required assessments and examinations to identify the most suitable approach and customized treatment plan to increase your chances of getting pregnant and having a safe pregnancy.

Can PCOS Patients Get Pregnant When They Lose Weight?

For women with Polycystic Ovary Syndrome (PCOS), weight loss can increase the likelihood of pregnancy. PCOS causes hormonal imbalances and insulin resistance, which are aggravated by excess weight. Adopting a healthy lifestyle that involves regular exercise and a balanced diet can improve insulin sensitivity and hormone levels, leading to more regular ovulation and increased fertility. 

Research shows that even a modest weight loss of 5-10% can positively impact menstrual regularity and fertility in women with PCOS. However, it's crucial to remember that each person's response to weight loss may vary, and age, overall health, and the severity of PCOS symptoms may also affect fertility. This guide delves into the relationship between weight loss and pregnancy in PCOS, providing evidence-based insights and practical advice to support women in their journey towards improved fertility and overall well-being.

What To Eat When You Have PCOS? 

There is no specific diet that can prevent or treat PCOS, but there are some general nutrition principles that can help improve PCOS symptoms. The general aim of these principles is to lose excess weight, improve cholesterol levels, correct insulin resistance, and reduce inflammation. These principles include: 

Eating regularly

It’s no mystery why it’s important to eat regularly. In summary, eating regularly helps you keep your blood sugar levels stable, which leads to reduced insulin resistance. Therefore, you should take steps to be conscious of the timing of your meals and how often you eat if you ARE trying to create a PCOS diet for yourself. Making sure that you have regular, varied, and balanced meals or snacks is a great way to start creating healthy habits if you have PCOS.

Having balanced meals

Balanced meals are important for managing high blood pressure. In fact, adding protein and fats to a meal with complex carbohydrates can reduce the impact of the whole meal on blood sugar levels. That’s why having a balanced plate that is made up of protein-rich foods, healthy fats, lots of fruits or vegetables, and high fiber can help reduce insulin resistance if you are trying to follow a PCOS-friendly diet. Balanced meals will also keep you feeling fuller for longer and reduce cravings.

Choose complex carbohydrates

When it comes to what to eat with PCOS in more detail, one of the most important rules to follow is to eat complex carbohydrates, such as whole grains. Eating foods containing complex carbohydrates can help improve insulin levels and reduce insulin resistance if you have PCOS. Whole grains contain lots of complex carbs, so it’s worth opting for whole-grain options of classic starchy foods like white bread or rice. 

Eat omega-3 fats

Besides whole grains and high-fiber foods like vegetables and fruits, how about oily fish? Oily fish are rich in  omega-3 fats, which can help lower inflammation that is common for those with PCOS. For this reason, try having one to two portions of oily fish a week. You can also include other plant-based sources of omega-3 fats such as seaweed, algae, chia and flax seeds, and walnuts if you’re trying to follow a PCOS diet.

Have anti-inflammatory foods

Most people with PCOS have elevated levels of chronic inflammation. For this reason, adding foods that are rich in antioxidants can help you reduce inflammation if you’re following a PCOS diet. These foods include:

  • Berries
  • Green tea
  • Tomatoes
  • Kale
  • Spinach
  • Almonds and walnuts
  • Olive oil
  • Turmeric

Lose excess weight

If you are overweight, losing weight can help improve PCOS symptoms. At the same time, it’s important to note that it is easier said than done if you have PCOS considering the other symptoms, however, we know this can be challenging for many people with PCOS. Insulin resistance, food cravings, and binge eating can make weight loss with PCOS hard. 

If you are trying to lose weight and have PCOS, it’s important not to follow restrictive diets. Consult a dietitian instead who can help you tailor a diet specific to your needs and circumstances. But if working with a dietitian is not a possibility, it’s important to focus just on what foods you include in your diet. All the advice above about whole grain foods, omega 3s, and anti-inflammatory foods are a good place to start.  

The most important thing is developing a diet that suits your lifestyle without missing out on important foods or nutrients. If you are trying to get pregnant and have PCOS, it is particularly important that you get enough nutrients and that you take a folic acid supplement. Speak to your doctor or dietitian about this.

So here are a few steps that you can take to start developing your own version of a PCOS diet. At the end of the day though, the most important thing is that you follow a healthy diet that suits your lifestyle without missing out on any important foods and nutrients. With time, following a more PCOS-friendly diet will help you in managing the signs and symptoms of PCOS.

How to Lose Weight With PCOS?

Losing weight can be quite challenging for people with Polycystic Ovary Syndrome (PCOS) due to hormonal imbalances and insulin resistance. These factors often contribute to weight gain and make it difficult to shed excess pounds. However, there are ways to manage weight effectively with PCOS. A tailored approach that combines a balanced diet, regular exercise, and lifestyle modifications can help.

Adopting a low-glycemic index diet rich in whole grains, lean proteins, fruits, and vegetables can stabilize blood sugar levels and improve insulin sensitivity. Regular physical activity, including aerobic exercises, strength training, and flexibility exercises, can support weight loss efforts and help manage PCOS symptoms. 

Additionally, stress reduction techniques such as mindfulness and yoga may be beneficial. Stress can exacerbate hormonal imbalances, so it's important to find ways to manage it.

How can I test for PCOS at home?

While it is not possible to test for PCOS at home definitively, you can monitor your symptoms and track changes in your menstrual cycle, weight, and other associated symptoms. This information can be valuable when discussing your concerns with a healthcare professional, who can then perform the necessary tests so that they can properly diagnose you for PCOS.

In summary, PCOS is a common hormonal disorder that affects women and can have a significant impact on their reproductive health. While there is no cure for PCOS, its symptoms can be effectively managed through certain kinds of medication and treatment as well as by making modifications in your lifestyle. By understanding the symptoms, triggers, and available treatment options, you can take a proactive step towards improving your PCOS symptoms and your overall well-being and fertility.

Frequently Asked Question 

What does a “PCOS belly” look like?

A belly affected by PCOS often looks bloated and may have excess fat, particularly in the abdominal region. This is often because of insulin resistance, hormonal imbalances, and high levels of androgens. However, it's important to remember that the way a PCOS belly looks can differ from person to person.

What is the shape of the breasts with PCOS?

The shape of breasts is not linked to PCOS. It is mostly determined by genetics, body fat distribution, and hormonal factors. While PCOS can cause hormonal imbalances that affect breast tissue, it is not a defining feature of the condition.

What type of exercise is good for PCOS?

It is recommended that individuals with PCOS engage in a combination of aerobic exercises, strength training, and flexibility exercises. Aerobic exercises, such as walking, jogging, cycling, or dancing, can be particularly beneficial for improving insulin sensitivity and managing weight. Strength training can also play an important role in stabilizing blood sugar levels and boosting metabolism by building muscle. 

Flexibility exercises, like yoga or stretching, can reduce stress and improve overall well-being. It's important to find an exercise routine that you enjoy and can commit to consistently. However, before starting any exercise program, it's crucial to consult with a healthcare professional to tailor it to your specific needs.

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