Polycystic Ovary Syndrome (PCOS) is a complex condition that affects millions of women worldwide. While the exact cause remains unclear, PCOS often impacts menstrual cycles and fertility, and can have broader health implications. In this blog, Genea Fertility Doctor Dr Simon Nothman breaks down the symptoms, complications, and how lifestyle changes can help manage this condition.
What is PCOS?
First up, the word “syndrome” often feels scary, but it really just means a combination of symptoms or features often seen together. The “cysts” in this case are ovarian follicles, which both affect and are affected by the abnormal hormonal mix typically seen in PCOS. Symptoms can vary from person to person, but common signs may include:
- Irregular periods: Some women with PCOS may have fewer than nine periods a year or experience missed periods altogether, due to irregular ovulation which decreases the chance of conception.
- Elevated male hormones (androgens): This can lead to excess facial and body hair, severe acne, and thinning hair on the scalp.
- Weight gain: Many women with PCOS tend to gain weight, particularly around the abdomen area.
- Skin changes: Dark patches of skin, especially around the neck, armpits, and groin, can appear, and skin tags may also develop.
What causes PCOS?
Although the exact cause of PCOS isn’t fully understood, several factors may contribute:
- Hormonal imbalance in the womb: Some research suggests that exposure to high levels of androgens before birth may increase the risk of developing PCOS later in life.
- Insulin resistance: PCOS and insulin resistance often go hand in hand. Elevated insulin levels can trigger the production of more androgens, which further disrupts the body’s ability to manage insulin.
- Genetics: PCOS often runs in families, meaning a family history may increase your risk.
- Weight: Being overweight or obese can increase your chances of developing PCOS and make symptoms worse.
What hormones are high in PCOS?
Women with PCOS often have elevated levels of androgens. Additionally, oestrogen levels are typically high, while progesterone, which balances oestrogen, may be low. This imbalance is responsible for some of the long-term complications, such as changes in the uterine lining.
How Is PCOS diagnosed?
PCOS is diagnosed based on the “Rotterdam criteria,” which require at least two of the following three indicators:
- Irregular or absent ovulation.
- Elevated levels of androgens.
- Polycystic ovaries visible on an ultrasound.
A healthcare provider will also consider your medical history and should rule out other similar conditions to confirm the diagnosis.
Complications and effects of PCOS on the body
PCOS impacts various aspects of a woman’s health and, if left untreated, can lead to several long-term health issues, including:
- Reproductive system and fertility: PCOS is one of the leading causes of infertility because it often disrupts ovulation. Irregular ovulation can lead to irregular periods and difficulties conceiving.
- Type 2 diabetes: Many women with PCOS develop insulin resistance, which can lead to type 2 diabetes.
- Endometrial cancer: Irregular periods can cause the uterine lining to grow too much, raising the risk of endometrial cancer.
- Metabolic syndrome: PCOS increases the risk of developing metabolic syndrome, a condition that includes high blood pressure, high blood sugar, and abnormal cholesterol levels. This syndrome increases the risk of heart disease, stroke, and diabetes.
- Skin and hair: Higher levels of androgens can cause acne and male-pattern hair growth.
- Pregnancy complications: Women with PCOS have a higher risk of pregnancy-related complications like gestational diabetes and high blood pressure.
How does PCOS affect fertility and menstrual cycles?
PCOS is one of the most common causes of infertility in women. It disrupts ovulation, making it harder to predict when, or if, you’re ovulating. This can reduce the chances of conception and make planning for pregnancy more difficult.
For a comprehensive overview of menstrual cycles and their impact on fertility, read Dr Simon Nothman’s blog on ‘Understanding Menstrual Cycles, Ovulation, and Fertility Implications’ here.
The role of lifestyle changes in PCOS management
Lifestyle changes play a key role in managing PCOS. Regular physical activity, maintaining a healthy weight, and eating a balanced diet can help control symptoms. Exercise improves insulin sensitivity, which lowers your risk of developing type 2 diabetes and heart disease.
Can PCOS be managed with weight loss?
While PCOS cannot be “cured,” losing just 5-10% of your body weight can help improve symptoms. Many women find that weight loss helps regulate their periods, improves insulin sensitivity, and lowers androgen levels, making it easier to manage PCOS.
What diet is recommended for PCOS?
While there’s no standard diet for PCOS, it’s recommended that women with PCOS eat a healthy, balanced diet, especially because of its link to insulin resistance. Here are some dietary tips that can help:
- Limit sugar: Reducing sugar helps control insulin levels and manage weight.
- Choose low glycemic index (GI) foods: These foods, like whole grains, absorb more slowly and help improve insulin sensitivity.
- Increase fiber intake: Fiber helps slow down sugar absorption, reducing insulin spikes.
- Eat anti-inflammatory foods: Leafy greens, tomatoes, and oily fish can help reduce inflammation in the body.
- Focus on fresh, whole foods: Aim for minimally processed foods to support overall health.
Conclusion
PCOS is a complex condition, but with the right approach, it can be managed effectively. By incorporating lifestyle changes such as regular exercise and a balance diet, women with PCOS can improve their symptoms and overall quality of life. If you think you may have PCOS or are experiencing its symptoms, consult a healthcare provider for a proper diagnosis and personalised treatment plan.
Written by Dr Simon Nothman, Fertility Physician at Genea Bondi Junction and Genea Sydney CBD.
