Polycystic Ovary Syndrome (PCOS): Symptoms, Causes, and Treatment

Polycystic ovary syndrome (PCOS) is a term used to describe a confusing collection of symptoms. It’s a metabolic and hormone disorder that affects around 6 to 12% of women of childbearing age.

What most of these women don’t know is that diet and lifestyle changes can be used to keep this syndrome in check. As a Nutritionist with PCOS, I’ve done it myself. Using the latest evidence-based information and proven practical tools, my free PCOS food plans have now helped over 100,000 other women too.

My free 30-Day PCOS Diet Challenge and my free 3-Day PCOS meal plan are great first steps towards taking back control of your health and fertility.

What is PCOS and How to Get Diagnosed

For decades, experts have disagreed about how best to diagnose polycystic ovary syndrome. However, the most up-to-date recommendation is to use the modified Rotterdam Consensus [1, 2]. These require two of the following three criteria:

• Irregular or absent periods
• Elevated androgen levels
• The presence of polycystic ovaries (seen via ultrasound)

Because only two out of three criteria are needed, there are four sub-types of PCOS:

Women with Frank PCOS have the greatest metabolic health risks. By comparison, PCOS women with normal androgen levels have fewer health risks [3, 4]. The Ovulatory PCOS sub-type shows that you can still have PCOS even if you have a regular period. And despite the confusing name, the non-PCO subtype shows that you can still have PCOS and not have polycystic ovaries!

It’s worth noting also, that despite the common perception, your body weight is not part of the diagnostic criteria. Many doctors only suspect PCOS in the case of overweight patients. This means that lean women are more likely to have their diagnosis missed. This is what happened to me and many other women I meet through my free 30-Day PCOS Diet Challenge.

The other important thing to keep in mind is that the Rotterdam criteria are used by doctors and medical researchers. But they’re not that useful from a patient’s perspective. That’s why many people are drawn to the four types of PCOS used in naturopathic medicine. These alternative sub-types of PCOS tend to focus more on the underlying drivers of your symptoms.

Common PCOS Symptoms

PCOS adversely affects hormonal balance. This can result in a wide range of seemingly disparate symptoms. The most common signs of PCOS include:

• Irregular or absent periods
• Heavy or painful bleeds
• Difficulty losing weight (and keeping it off)
• Unwanted hair growth, especially on the face
• Thinning hair or hair loss (sometimes male-pattern baldness)
• Oily skin, acne, and eczema
• Dark skin patches in the neck, groin, or under the breast
• Insomnia
• Anxiety and depression

Associated Health Risks

Understandably, the symptoms of PCOS can cause low self-esteem and dissatisfaction. But it’s the associated health risks that often drive people to take action. A lot of the women who join my free 30-Day PCOS Diet Challenge do so for their families. They want to be healthy so they can take better care of their loved ones.

PCOS is a metabolic disorder. This means that women with PCOS have increased risks of type 2 diabetes, heart disease, and some forms of cancer [5].

But because it’s a metabolic disorder, this also means there’s a lot you can do about PCOS yourself. Even if they disagree on the details, almost all experts advise that diet and lifestyle interventions should be the first treatment prescribed for managing PCOS.

PCOS and Pregnancy

Between 70 and 80% of women with PCOS have trouble falling (or staying) pregnant [6, 7]. That’s because PCOS:

• Impairs ovulation and reduces egg quality [8-11].
• Makes the womb less receptive during implantation [12, 13].
• Increases the risk of miscarriage by 40-60% [14-16].

Being overweight is one of the main causes of these issues [10, 17-19]. Although infertility affects lean women with PCOS too. Somewhat ironically, this is good news. Because this is a problem that can be addressed through diet and lifestyle interventions. We’ve seen this in scientific studies [20]. It’s also something we witness daily within my PCOS community. Just take a look at these PCOS pregnancy success stories and learn more about getting pregnant with PCOS here.

PCOS and Body Weight

PCOS makes it hard to lose weight and easy to gain it [21, 22]. That’s why more than half of women with this syndrome are considered overweight [23].

Insulin resistance is the primary mechanism that causes PCOS weight gain. This is where your cells are less capable of processing glucose. Over time, insulin resistance causes higher rates of body fat accumulation [24-26].

But like infertility, this is a problem that can be fixed with the right information and support. That’s what these PCOS weight loss success stories show. Switching to the right diet for PCOS can help you lose weight, even when all previous diets have failed you.

Learn how to lose weight with PCOS here.

What Causes PCOS?

The causes of PCOS are complex. Some experts argue that the high prevalence of this syndrome, along with many other chronic illnesses, is a consequence of our modern environments [27].

Estimates suggest that approximately 70% of PCOS has a genetic basis [28]. But we also know that it’s triggered during gestation by imbalances in the womb [29-32]. Chemical or biological toxicant exposure, for example, plays an important role in fetal programming of PCOS [33, 34].

Your diet, lifestyle, and environment also drive the development of PCOS [35, 36]. Especially during your teens. The negative impact of an unhealthy diet and lifestyle on PCOS has been well-established in the scientific literature [37]. More specifically, an unhealthy gut microbiome can account for all three PCOS diagnostic criteria [13, 38].

But this isn’t all bad news. The fact that PCOS is made worse by a poor diet and lifestyle, and an unhappy gut, speaks to the reversibility of this syndrome.

How to Treat PCOS

Medical treatment of PCOS is largely restricted to treating the presenting symptoms.

Birth control is the most common treatment given to women with PCOS. That’s because this treatment strategy is to override your hormonal imbalances. But using birth control for PCOS is not without its risks. I explain more here.

Metformin is another common treatment for PCOS. That’s because metformin improves insulin sensitivity, which in turn, can help restore hormone balance. Metformin is prescribed to help with weight management and to lower the risk of developing diabetes. It’s also used to improve menstruation and to help treat PCOS infertility.

Unfortunately, the weight of scientific evidence does not support the use of metformin for these purposes. As explained in more detail here, since 2018, experts have recommended against the use of metformin as a PCOS treatment for “any indication”.

In my view, you’re much better off taking myo-inositol and/or berberine which work just as well.

Spironolactone is another medicine that is commonly used off-label for the treatment of PCOS acne, hair loss, and hirsutism. Spironolactone lowers androgen levels, which can help relieve PCOS symptoms. However, the FDA has put a black box warning on this medicine due to concerns that it may cause tumors.

Diet & Lifestyle Changes

PCOS symptoms are predominantly caused by insulin resistance and chronic inflammation [37, 39-44]. This is great news for anyone wanting to treat PCOS naturally. That’s because both of these mechanisms can be dialed up or down by your diet and lifestyle.

The best diet for PCOS reduces inflammation and improves blood sugar regulation. Healing the gut is a core part of this process.

Download a free 3-Day PCOS meal plan here to see what this looks like in real life.

You can also take a bolder step forward by completing my free 30-Day PCOS Diet Challenge. During this event, you’ll join a supportive community of like-minded women. You’ll also receive meal plans, recipes, shopping lists, video lessons, and more.

There are also many dietary supplements and herbal medicines that can also relieve your symptoms. In many cases, these are just as effective as pharmaceutical solutions.

For example, I recommend that all of my clients consider supplementing with vitamin D and magnesium. That’s because the risk of inadequacy is high for these essential nutrients. But from a therapeutic perspective, myo-inositol is one of the most well-studied PCOS supplements. As explained here, myo-inositol is great for fertility and is an equally powerful substitute for metformin. Berberine also has pharmaceutical-level effects for the management of insulin resistance.

When to See a Doctor

If you suspect you may have PCOS, it’s best to see a doctor. Getting a formal diagnosis is helpful for managing your long-term health risks. Your doctor can also advise on your reproductive health. This is especially important if you intend to start a family in the future.

The Bottom Line

Common symptoms of PCOS include irregular periods, and challenges with your weight, skin, and hair. This syndrome has a significant impact on fertility. It also presents increased metabolic and cardiovascular health risks.

Medical treatments can relieve the symptoms of PCOS. But many women with this syndrome are able to manage their symptoms through diet and lifestyle interventions alone. Become one of these women today by joining my free 30-Day PCOS Diet Challenge here. Or download this free 3-Day meal plan to get started.

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References

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