Sue Bedford MSc Nutritional Therapy
Many of us have heard of it, some of us have it and some of us are not sure – so we turned to Sue to find out a little more and here is what she had to say……
What exactly is PCOS?
Polycystic Ovary Syndrome (PCOS) is a condition in which the ovaries develop harmless cysts around the edges, containing eggs that have not developed properly and in which the ovaries do not regularly release eggs (ovulate). The exact cause of PCOS is considered unknown but the symptoms are thought to be due to abnormalities in some of the hormones which control the menstrual cycle, namely, a higher than normal amount of LH (Luteinizing Hormone) and of androgens (such as Testosterone), along with lower levels of FSH (Follicle Stimulating Hormone) and Progesterone. In those women with PCOS, higher than normal (average) amounts of testosterone is made by the ovaries. It is estimated that around 1 in 5 women in the UK has Poly Cystic Ovaries, but more than half of these have no symptoms. PCOS is confirmed using an ultrasound scan, monitoring regularity of periods and by also using blood tests.
What are the main symptoms of PCOS?
Some of the main symptoms of PCOS are: irregular or light periods, difficulty becoming pregnant, weight problems, skin problems, depression and mood changes and excessive hair growth. However, not all women develop symptoms and the causes of PCOS are not completely clear. What is known though is that if you have a resistance to insulin, you will be more susceptible.
What exactly is Insulin resistance?
Insulin is a hormone which is produced by the pancreas. Insulin’s role is to control the amount of sugar in the blood. It targets particularly muscle cells and the liver, causing them to absorb more glucose from the blood where it is either broken down to produce energy or converted into long term energy stores.
Many women with PCOS are often insulin resistant, whereby the tissues in the body become resistant to the effects of insulin and as a result the body attempts to compensate for this by producing more insulin. It is thought that this high level of insulin causes the ovaries to produce testosterone.
The raised levels of testosterone (along with high insulin levels) can lead to some of the symptoms associated with PCOS, such as problems with ovulation, period problems and excess hair growth.
Insulin resistance can also lead to weight gain. A vicious circle often begins, as excess fat in the body causes the body to make more insulin and further weight is then gained.
What can you do to help yourself?
It is important to try to maintain a healthy weight for those who suffer from PCOS as an increase in weight can lead to the symptoms becoming worse. This can sometimes be more difficult for those who suffer from PCOS due to hormone levels. A good diet and regular exercise is a priority in order to help to lower insulin levels.
There are 3 main areas that should be taken into consideration in relation to PCOS: symptom management, addressing any underlying causes, followed by wellness and prevention (ongoing support). These stages all involve balancing hormones, supporting blood sugar balance, reducing and managing weight (if applicable) and supporting the adrenal glands. It is important to note that although some general ‘tips’ and advice can be provided in this article, one size does not fit all when it comes to health, fertility, nutrition and lifestyle so it is a good idea to invest in a personalised plan from the start that is tailored to your own needs as this will help you to achieve the best outcome for you.
Some Top nutrition tips (general) to help in the management of PCOS
If you suffer with PCOS try to AVOID:
Alcohol as this puts stress on the liver- making it less efficient at processing/removing excess hormones
Carbohydrates with a high Glycaemic Load (GL) as this will help to keep your insulin levels down. Avoid white, refined carbohydrates, processed and packaged foods and sugar (eliminate cakes, biscuits, soft drinks etc).
Caffeine (may affect oestrogen levels)
Trans fatty acids and high levels of saturated fats as these can cause inflammation- which can worsen insulin resistance
But try to INCREASE:
Omega 3 foods such as oily fish, flaxseeds, as these help to reduce inflammation.
Fibre as this helps to prevent insulin spikes.
Chromium rich foods as these are thought to make insulin more efficient as it helps to promote the production of glucose tolerance factor (GTF), a substance released by the liver which helps to make insulin more efficient. Since the body does not produce it, chromium must be obtained through food. It’s main functions are to help maintain normal blood sugar and insulin levels and to support the maintenance of adequate cholesterol levels. This is important re weight management and balancing blood sugar levels. Good sources include: Onions, Tomatoes, Broccoli, Green Beans, Oysters, Whole grains, Bran cereal, Potatoes, Lean meat, Cheese, Black pepper, Thyme.
Vitamin B-rich foods to help control sugar and fat levels
Protein foods such as eggs, fish, chicken, meat, nuts, and pulses to help with the regulation of insulin levels
Foods with a low GL in order to keep blood sugar levels stable and prevent insulin spikes and may also aid in weight loss.
Balance protein and carbohydrate foods at each meal
And what about supplements?
Possible supplements (these need to be personalised to you)
A high- quality multivitamin and mineral – to balance and support. This will include key nutrients to help fill in any nutrient gap – including zinc, chromium, vitamins D and B. It will also provide key nutrients to help re blood sugar balance, carbohydrate metabolism and in the regulation of insulin.
Omega 3 – to help balance the ratio of omeg3: omega 6 and reduce inflammation.
Magnesium -to help increase insulin sensitivity.
Inositol (with folic acid) – Inositol is often referred to as being part of the B vitamin group, but it is not actually a vitamin. It is a type of sugar that influences the insulin response along with several hormones associated with mood and cognition and in studies has been found help improve insulin resistance. It’s also been found to help with fertility in some cases of PCOS. It is found naturally in fruit, grains, nuts, beans and organ meats (check with your GP/Consultant that this is suitable for you).
A probiotic -to help absorb nutrients more efficiently, reduce inflammation and help to regulate hormones.
Individual ‘bolt on’ supplements, such as co q10, iron, zinc, vitamin D, magnesium, chromium (if you are on medication and diabetic, speak with your GP before taking chromium), and others, may be required depending on the individual and if there are nutrient deficiencies identified.
Exercise
There is evidence to suggest that increasing the amount of exercise (around 3 hours of aerobic exercise per week) can improve insulin sensitivity, cholesterol levels and visceral fat. Researchers found that women with PCOS who did 3 hours of aerobic exercise per week for 12 weeks had improved insulin sensitivity, cholesterol and visceral fat even though they did not lose any weight (Hutchinson, S. et al., 2011). Researchers have also discovered that exercise can also reduce inflammation in those with PCOS (Danadona, P. et al., 2004).
Interesting reading:
Rocha AL, Oliveira FR, Azevedo RC, et al. Recent advances in the understanding and management of polycystic ovary syndrome. F1000Res. 2019;8:F1000 Faculty Rev-565. Published 2019 Apr 26. doi:10.12688/f1000research.15318.1
Hutchinson, S. et al., (2011) Effects of Exercise on Insulin Resistance and Body Composition in Overweight and Obese Women with and without Polycystic Ovary Syndrome. HYPERLINK “http://www.ncbi.nlm.nih.gov/pubmed/20926534” \o “The Journal of clinical endocrinology and metabolism.” J Clin Endocrinol Metab.;96 (1): E48-56.
Danadona, P. et al., (2004) Inflammation: the link between insulin resistance, obesity and diabetes. Trends in immunology 25(1) pp 4-7.
