All about: PCOS
What is PCOS?
Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder in women. In PCOS, women produce more androgenic hormones such as testosterone, while the levels of oestrogen and progesterone are reduced. This creates a hormonal imbalance, resulting in various symptoms. Due to the increased presence of testosterone, the follicles in the ovaries do not fully mature and transform into cysts. As a result of the follicles not maturing, ovulation does not occur, leading to missed periods and fertility problems.
Key features of PCOS:
- Irregular cycle or no menstruation at all
- Painful heavy periods
- Cysts on the ovaries
- Increased testosterone
- Fertility problems
- Overweight (sometimes underweight)
- Insulin resistance
- Excessive hair growth
- Skin problems
What causes PCOS?
PCOS can be caused by insulin resistance, being overweight, stress, and (low-grade) inflammation, but it is also thought to be partly genetic. It is a combination of different factors that influence each other and can lead to the manifestation of PCOS. Particularly, insulin resistance is a significant factor that plays a major role in the progression of this hormonal disorder (being overweight, stress, and inflammation also contribute to insulin resistance). In insulin resistance, the elevated insulin levels (because the insulin receptors are no longer sensitive and insulin cannot bind sufficiently) lead to increased production of LH (luteinising hormone), which stimulates the production of testosterone. Additionally, insulin inhibits the production of an important substance (SHBG - Sex Hormone-Binding Globulin) that binds to male hormones, rendering them inactive. This results in an increase in active androgens in the body, such as testosterone.
What to do about PCOS symptoms?
Fortunately, insulin resistance can be well-managed or resolved with a healthy diet and daily exercise. It is important to keep blood sugar levels stable by:
- Adjusting the number of eating moments, for example, 3 meals a day without snacks
- Reducing carbohydrate intake: replace bread, pasta, and rice with seed crackers, broccoli or cauliflower rice, and pasta made from courgette
- Adding more proteins (quark, tempeh, fish, tofu) and healthy fats (nuts, seeds, avocado, oily fish) to the diet
- Exercising on an empty stomach: take a walk of at least 30 minutes after waking up before having breakfast
- Intermittent fasting: fasting for more than 18 hours helps to make body cells insulin sensitive. You can determine the eating window yourself, for example, between 12:00 and 18:00 or between 14:00 and 20:00.
By adjusting the diet and increasing exercise, weight will eventually decrease, which helps to tackle insulin resistance. With lifestyle adjustments alone, women with PCOS can often improve their health.
Supplements for PCOS
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Author: Noëlle van Seggelen
