PCOS- A Hormonal Condition on the Increase

PCOS or polycystic ovary syndrome is one of the commonest female hormonal conditions affecting up to 18% of reproductive women.

The classic diagnosis of PCOS depends on identifying 2 out of the following 3 features:

  1. Hyperandrogenism– clinical or biochemical evidence of raised male hormones
  2. Menstrual irregularities– usually infrequent or absent periods
  3. Polycystic ovaries present on ultrasound

Not all women will display a similar profile and the diagnosis will also be affected by the age and reproductive life stage of the woman.

So what do we know about the causes of PCOS?

1.Insulin Resistance

There appears to be a genetic predisposition which with the wrong lifestyle choices leads to insulin resistance. In about 70% of women with PCOS the cell is resistant to insulin and so glucose does not enter these cells. This can lead to hyperandrogenism which then aggravates the insulin resistance and so a vicious cycle developes.

Unfortunately this can lead to obesity, prediabetes, increased risk of cardiovascular disease, as well as the classic symptoms of PCOS.

But not all PCOS women are obese or have insulin resistance. In fact there is a sub type of PCOS in thin women. So what is going on here?

2.Inflammation

A new paradigm is emerging with recent research showing that PCOS is an inflammatory condition. So it is the chronic low grade inflammation which could be the driver of insulin resistance, hyperandrogenism and ovarian dysfunction.

Interestingly studies are showing the women with PCOS have higher circulating levels of inflammatory markers in the blood and that foods such as glucose and saturated fats can trigger their release in women with PCOS but not in healthy women.

3.PCOS and Gut Health

Recent studies are pointing to the important role of gut health in PCOS. It appears that women with PCOS are more likely to have a gut dysbiosis

(imbalance) that promotes inflammation and also are more likely to have leaky gut which once again promotes inflammation.

As we have seen, inflammation can then increase insulin resistance and consequently hyperandrogenism.

It appears that many factors are involved in PCOS and while we don’t understand completely what causes this common condition, there are strategies that can be very helpful.

Treatment for PCOS

  • Herbs

Liquorice and Peony have both been shown to decrease levels of testosterone in the ovary and increase the conversion of testosterone to oestrogen.

  • Inositol

This nutrient can help to improve insulin sensitivity and decrease testosterone levels.

  • Lifestyle

Dietary change is essential and one of the core approaches to decrease inflammation, improve insulin signalling and consequently lower androgens.

Obviously dietary changes will also impact the gut microbiome in a positive way.

If overweight, as little as 5 % weight loss can have significant beneficial actions on all the drivers of PCOS.

Aim to avoid processed or refined carbohydrates, increase fresh vegetables and in some cases decreasing carbohydrate intake overall may be beneficial.

Finally let’s not forget the role of exercise. Try to schedule some resistance or weight work along with regular movement and more structured exercise.

To effectively manage PCOS it does require a holistic approach. It may seem overwhelming, but the results are definitely worth it!