Polycystic Ovary Syndrome (PCOS); an Overview
- georgiaspencenutri
- Jul 17, 2024
- 6 min read
Written by Megan Nippers (Registered Dietitian).
On Behalf of Georgia Spence Nutrition.
(Image courtesy of UnSplash)
What is PCOS?
Polycystic ovarian syndrome or PCOS, is present when a person has two or more of the
following symptoms:
● Irregular periods.
● Excess testosterone
● Multiple ovarian cysts
The name polycystic ovarian syndrome is somewhat misleading as ovarian cysts do not always need to be present for diagnosis (1).
How common is PCOS?
Although it is difficult to give exact numbers, PCOS is thought to be very common. Affecting around 1 in every 10 women in the UK (1). Throughout the world it is estimated around 70% of all women with PCOS remain undiagnosed (2). This is compelling as PCOS is one of the most common, but treatable, causes of infertility in women (3)
How do I know if I have PCOS?
The only way to truly know if you have PCOS is to visit your GP to be referred for relevant tests.
However, the symptoms commonly associated with PCOS are as follows:
● irregular or absent periods
● difficulty getting pregnant as a result of irregular or no ovulation
● excessive hair growth usually on the face, chest, back or buttocks
● weight gain
● thinning hair and hair loss
● oily or acne prone skin (1)
Symptom and Period Tracking
If you suspect you may be suffering from PCOS, it is worth taking note of any symptoms that you are suffering with, including tracking the regularity of your periods.
In the age of technology multiple apps exist to support this. Even better, the basic tracking apps are often free. Explore your App Store to see what apps are available to you. Prefer paper? Here at Georgia Spence Nutrition we have created a free printable period tracker.
When tracking, it is important to consider that periods can be complex. What’s normal for one person may be different for another. Multiple factors including stress, undernutrition and excessive exercise can all impact on your period, not just PCOS.
PCOS myths:
There are many myths surround PCOS. One of the greatest myths surrounding PCOS is that it is caused by excessive body fat. This myth is entirely incorrect. PCOS is not caused by excessive body fat. Can weight gain occur with PCOS? Yes. Can PCOS make it harder to maintain a lower weight? Yes. Is PCOS caused by excessive body fat? No. It is important to understand that PCOS is not caused by excessive weight, but that PCOS can make it more difficult to manage your weight. This understanding can help you take control of your condition.
Although PCOS is not caused by excessive weight. Reducing your weight, may support with symptom management. However, it is vital that this weight loss is done in a positive way. Gentle note if you or a loved one are struggling with your relationship with food please seek support. BEAT is the UKs leading Eating Disorders charity and can help guide you on where to find support with your or a loved ones relationship with food.
As mentioned, PCOS can be associated with difficulties in weight management. It is however important to understand that you don’t need to be overweight or struggling with your weight to have PCOS. Many people who fall within the healthy weight’ BMI also have PCOS. Your weight should never be a deciding factor when you consider seeking help.
What can I do to support my symptoms?
People with PCOS often suffer with insulin resistance. Insulin is a hormone that is released when we eat carbohydrate-based foods. Insulin works by unlocking the door to the cells in our body. The Insulin unlocks, so that our cells can take in and process the energy from carbohydrates.
When someone is ‘insulin resistant’ this process becomes more difficult. A person with insulin resistance can’t process carbohydrates as well as the average person, which can lead to higher levels of sugar in the blood. This can then result in weight gain, fatigue and brain fog.
You may be thinking, so if I am insulin resistant and carbohydrates are the issue, shouldn’t I just cut carbohydrates out? The answer to this is no. Cutting out carbohydrates isn’t needed and can in fact be detrimental to your health. Our bodies thrive on carbohydrates. Many carbohydrate-based foods also contain vitamins and minerals. Not to mention these items can be described as ‘nourishing to the soul’. Consider pasta, bread, rice and potatoes. Now
think of how unfulfilling a meal would be without these.
Although cutting out carbohydrates isn’t needed; to manage symptoms, you may wish to look at making some swaps on the types of carbohydrates you consume. Low Glycemic Index (GI) and high fibre carbohydrates for example can help support symptom management.
Instead of depriving yourself a softer approach to your nutrition may help. Instead of restricting, think about what you can add or swap in your current diet. A few examples may be swapping to lower GI whole-grain based foods. Or adding/swapping to more lean proteins and ‘healthy’ unsaturated fats. Plus adding in more fruits and vegetables. These changes may sound trivial; however, this type of dietary modification is informed by research. Some studies for example have suggested that low GI dietary modification could help
increase insulin sensitivity as well as improving ovulation cycles (4). Lean proteins on the other hand can help with satiety and weight management, something many people with PCOS struggle with.
Finally, having a dose of healthy fats in each meal can help support
with the absorption of the fat-soluble vitamins A, D, E and K (5).
PCOS diet and supplementation.
When considering reproductive health your diet should always be the first port of call. Supplements can be useful however, as the name suggests they should supplement not replace dietary changes.
The British Dietetic Associated recommends, if you want to support your fertility you should focus on ensuring your diet has higher levels of monosaturated fats compared to saturated. As well as the recommended level of fibre, enough protein from lean or plant-based sources and finally supportive levels of Iron, zinc and folate (6).
Supplementation of vitamin D, omega-3’s and inositol may also be beneficial in some situations. Research looking at the supplementation of inositol in woman with PCOS that are undergoing IVF has suggested that these supplements may support in improving insulin sensitivity, menstrual regularity and frequency of ovulation (7). Whilst an observation study showed a higher probability of conceiving in those taking omega-3 supplements (8).
Although supplementation can be tempting, it is important to consider the amount you are already obtaining from your diet. Understanding this, will allow you to know if you truly do need to take supplements. This is important as when it comes to supplements more isn’t always necessary better. Taking too much vitamin D for example, over a long period of time, can cause too much calcium to build up in the body which can weaken bones and damage the kidneys and heart (9). It is therefore always important to think about your current diet
before supplementing, as well as consulting a registered clinician.
If you are now thinking so what am I lacking, what could I add or even where do I start? It may be worth consulting a Nutritional Professional for 1:1 support, who can guide you through the process and assess your individual needs; helping you get the right balance in your nutrition, to support your health and wellbeing.
References:
1. NHS. Polycystic Ovary Syndrome [Internet]. NHS. 2022. Available from:
https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/
2. World Health Organization. Polycystic ovary syndrome [Internet]. World Health
Organization. 2023. Available from: https://www.who.int/news-room/fact-
sheets/detail/polycystic-ovary-syndrome
3. Office on Women's Health. Polycystic Ovary Syndrome [Internet]. womenshealth.gov.
2021. Available from: https://www.womenshealth.gov/a-z-topics/polycystic-ovary-
syndrome
4. Che X, Chen Z, Liu M, Mo Z. Dietary Interventions: A Promising Treatment for
Polycystic Ovary Syndrome. Annals of Nutrition & Metabolism [Internet]. 2021 Oct
5;77(6):1–11. Available from: https://pubmed.ncbi.nlm.nih.gov/34610596/
5. Fletcher J. Fat-soluble vitamins: Types, function, and sources [Internet].
www.medicalnewstoday.com. 2020. Available from:
https://www.medicalnewstoday.com/articles/320310
6. BDA. A clinical update on diet and fertility [Internet]. www.bda.uk.com. 2021.
Available from: https://www.bda.uk.com/resource/a-clinical-update-on-diet-and-
fertility.html
7. Merviel P, James P, Bouée S, Le Guillou M, Rince C, Nachtergaele C, et al. Impact
of myo-inositol treatment in women with polycystic ovary syndrome in assisted
reproductive technologies. Reproductive Health. 2021 Jan 19;18(1).
8. Stanhiser J, Jukic AMZ, McConnaughey DR, Steiner AZ. Omega-3 fatty acid
supplementation and fecundability. Human Reproduction (Oxford, England)
[Internet]. 2022 May 3;37(5):1037–46. Available from:
https://pubmed.ncbi.nlm.nih.gov/35147198/#:~:text=After%20adjusting%20for%20ag
e%2C%20obesity
9. NHS. Vitamin D - Vitamins and Minerals [Internet]. NHS. NHS; 2020. Available from:
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