Polycystic ovary syndrome (PCOS), also known as polycystic ovarian syndrome, is a common health problem caused by an imbalance of reproductive hormones. The ovaries make the egg that is released each month as part of a healthy menstrual cycle and the hormonal imbalance creates problems in the ovaries. With PCOS, the egg may not develop as it should, or it may not be released during ovulation as it should be.

PCOS can cause missed or irregular menstrual periods which can lead to the development of cysts in the ovaries and infertility. In fact, PCOS is one of the most common causes of infertility in women.

We had a chat with Dr. Amal Badi, Specialist OBGYN at Koster Clinic, to find out more about PCOS. The Koster Clinic provides high quality private medical treatment within the fields of Obstetrics and Gynaecology, Dermatology, Family Medicine, Urology, Physiotherapy, Plastic Surgery, First Aid Training and Acupuncture.

Causes

  • Genetic. You can inherit the risk of PCOS and family members of women who have PCOS are also at higher risk for developing the same metabolic abnormalities.
  • Insulin resistance. This means that the glucose cannot enter the cells, and therefore your pancreas will produce more insulin, resulting in higher levels of insulin in the blood. This can have several negative effects including weight gain, difficulty losing weight and even affecting your ovaries, leading to lack of ovulation and higher levels of male hormones, called androgens.
  • Higher levels of androgens interfere with or even cause anovulation (lack of normal ovulation), which will cause irregular periods, absence of menstrual cycles, infertility and small cysts in the ovary.

Symptoms

  • Most women will have irregular or late and heavy periods.
  • You can have difficulty getting pregnant.
  • You can be prone to acne.
  • You can have increased hair growth mainly in the face (and other male distribution areas).
  • You might experience hair thinning with male pattern hair loss.
  • You can experience weight gain or difficulty losing weight, but there are also lean women who have PCOS.

Diagnosis

Unfortunately, there is no single test to diagnose PCOS. Diagnoses can only be made through investigating your medical history, your symptoms, a proper medical examination plus ultrasound and some hormone level blood tests.

Treatment and lifestyle management

Lifestyle modifications are the first line treatment and include making changes to your diet, exercise routine and losing weight. Various medications are available, including Oral Contraceptive agents, Antiandrogens (Spironolactone, finasteride), Hypoglycaemic agents (Metformin) and Clomiphene citrate if you are trying to conceive.

You and your doctor will work on a treatment plan based on your symptoms and needs. The treatment will depend on what the symptoms are, for example in the case of infertility, you need to stimulate ovulation. For irregular periods you can use contraceptive pills or other hormones to ensure a more regular cycle. If you want to lose weight, diet and exercise cannot be stressed enough but the addition of metformin and hormonal therapy may help. In all cases, a hypoglycaemic diet and being active are very important factors in controlling PCOS symptoms.

Long term effects of PCOS

  • Insulin resistance can lead to diabetes and weight gain.
  • Anovulation can cause your periods to stop and an increase in the thickness of the endometrium, which increases the risk of endometrial cancer.
  • Women with PCOS are at higher risk for high blood pressure, stiff and clogged arteries, high levels of heart-damaging LDL cholesterol and low levels of protective HDL.
  • Anxiety, distress, depression and eating disorders are more common in women with PCOS.

Jordana Smith, Clinical Dietician at Koster Clinic has some advice for women living with PCOS.

If you are a woman dealing with PCOS, the good news is there is hope. While there is no cure for PCOS, making a few lifestyle changes can help you manage the disease. It can also reduce your risk developing other health concerns.

PCOS and diet (what diets are best)

There is a lot of information available but not all of it accurate or based on science. Keto diets, paleo etc. may all work for a period of time, but the longevity of these diets does not lead to maintained weight loss. In terms of diet, the goal is to focus on meals that are centered around vegetables, whilst also providing a serving of protein and a small serving of carbohydrates. With your carbohydrates, focus on more unrefined options such as sweet potatoes, butternut squash and basmati rice. I set out to get women eating more frequently, but not necessarily snacking. I work with 4 meals per day, with 1 meal containing carbs and if exercising you can add a carbohydrate to another meal (normally to the meal following the training session).

Why PCOS causes weight gain and how to combat it?

PCOS makes it far more difficult for our bodies to utilise insulin, leading to a build-up of glucose (or sugar) within the bloodstream. These high insulin levels then increase the production of male hormones (androgens) which can lead to a number of symptoms such as hair growth, acne, and also the dreaded weight gain. And since the cause of weight gain is due to these male hormones, weight gain is most commonly distributed in the abdominal area. The aim to limit weight gain is to focus on maintaining glucose levels.

Do you have Polycystic ovary syndrome? We’d love to hear your story and how you manage your health.

Written by Dr. Amal Badi, Specialist OBGYN and Jordana Smith, Clinical Dietician at Koster Clinic. If you’d like more advice about PCOS or would like to speak a medical professional, please call 04 388 1887, email info@kosterclinic.com or visit the Koster Clinic website.

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