It would not be surprising to learn that your friend, sister or colleague is suffering with polycystic ovary syndrome (pcos). After all, the condition is actually very common.
How common is PCOS?
PCOS is the most common hormonal disorder occurring in women during their reproductive years. Approximately 1 in 5 women have PCOS. Yet despite this large number, many women do not know a lot about the condition.
What is PCOS?
PCOS is the result of a hormonal imbalance that prevents ovulation. For many women the underlying cause of the imbalance is insulin resistance. Insulin resistance is a condition in which the body fails to respond to the hormone insulin. High insulin levels can cause the ovaries to make androgens such as testosterone. This can cause increased body hair, acne and irregular or few periods. High levels of insulin in the blood may lead to many health problems such as PCOS, diabetes type 2, gestational diabetes, cardiovascular disease.
Could I have PCOS?
There is a lot more to the condition than you probably realise. PCOS presents with a complex array of symptoms. Unfortunately there is no one single test to diagnose PCOS. Diagnosis requires a collaboration of blood test results, ultrasound and signs and symptoms. Each woman with pcos will present with a combination of the following:
• Irregular or absent ovulation
• Multiple small ovarian follicles
• Hirsutism (excessive facial and body hair)
• Acne
• Androgenic alopecia (scalp hair loss)
• Acanthosis nigrans (velvety hyperpigmented skin folds)
• Insulin resistance
• Obesity or difficulty losing weight
• Infertility or reduced fertility
• Multiple hormone imbalances, including
o Androgens (testosterone)
o Cortisol
o Oestrogens
o Progesterone
o FSH (follicle stimulating hormone)
o LH (luteinizing hormone)
o Insulin
o Prolactin
o Thyroid hormones
Conventional treatment
Diet and exercise are important parts for managing PCOS. Medications such as metformin improve insulin resistance, and may even promote the return of ovulation.
Other medical therapies include:
• Clomiphene-citrate (to induce ovulation)
• Spironolactone (anti-androgen)
• Oral contraceptives (to treat menstrual irregularities and hirsutism)
These medications have mixed results; and the potential side effects of medications may reduce tolerance and compliance.
Nutrient therapy for PCOS
If you are eating well, specific nutrients can help manage PCOS. These nutrients have been studied in clinical trials and proved effective for PCOS.
1. Vitamin D
There are two ways to obtain vitamin D:
1. Diet
2. Sunlight – through the conversion of cholesterol in the skin and activation in the liver and kidneys
The research shows that vitamin d deficiency correlates with:
• Insulin resistance
• Ovulatory and menstrual irregularities
• Lower pregnancy success
• Hirsutism
• Obesity
• Cardiovascular risk factors
Vitamin D is important in pregnancy. Deficiency has been linked with gestational diabetes and preeclampsia, in addition to low birth weight for the baby.
Top dietary sources of vitamin D:
• Fish – salmon, sardines, tuna
• Milk
• Eggs
2. N-acetyl-cysteine
NAC is the stable derivative of the amino acid cysteine. NAC is an antioxidant needed for the production of glutathione. Glutathione is one of the body’s most important natural antioxidants and detoxifiers.
How does NAC restore fertility in PCOS?
1. Improving insulin sensitivity
2. Reducing androgens.
NAC improves pregnancy outcomes in combination with clomid (an ovulation inducing medication). NAC is also helpful for supporting implantation of the embryo. Which makes it perfect for use during IVF.
While cysteine exits in high protein foods (pork, chicken, eggs, dairy), NAC does not.
3. Inositol
Inositol is a vitamin like substance. Inositol is effective for improving egg and embryo quality through its role in cell growth. Egg development is often impaired in pcos due to raised insulin and androgens, and hormone imbalance. Inositol is critical for proper insulin signaling. Proper insulin signaling leads to improved ovulatory function, and reduced serum androgens and triglycerides.
4. Chromium
Chromium is an essential trace mineral that enhances insulin activity. This means that chromium improves the metabolism of carbohydrates, fats and protein. Chromium has shown to reduce insulin resistance and restore normal ovulation.
Dietary sources of chromium are often poorly absorbed. Supplementation at a therapeutic dose is recommended.
Top dietary sources of chromium:
• Barley and oats
• Fruits – apples, bananas
• Vegetables – broccoli, green beans
• Protein – chicken and eggs
5. Magnesium
Magnesium deficiency is common in PCOS. Deficiency fuels the progression of insulin resistance to diabetes type 2 and cardiovascular disease. Magnesium improves insulin-mediated glucose uptake and insulin secretion in diabetes type 2 individuals. Insulin resistance is central to the development of PCOS. Thus magnesium is a critical mineral for women with PCOS.
Top dietary sources of magnesium:
• Seeds – pumpkin, sunflower and sesame seeds
• Vegetables – spinach, swiss chard
• Nuts – cashews, almonds
• Cocao
• Quinoa
PCOS friendly smoothie: serves 1
1 cup coconut water
1 tsp cocao powder
1 tsp cinnamon powder
2 tablespoons LSA (ground linseeds, sunflower seeds, almonds)
1 handful of spinach leaves
1 banana
½ cup mixed berries
*blitz and serve