By Jarrod Agosta - Dietitian and Nutritionist

What is PCOS?

PCOS is a condition that affects the hormones that regulate the menstrual cycle. It is characterised by an abnormal number of follicles (sacs that contain an egg) on the ovaries. The name polycystic -meaning “many cysts”- is a little misleading as, although these follicles look like cysts to the naked eye, in reality they are not cysts (1). In addition to this high number of follicles, the ovaries are also enlarged.  

How prevalent is PCOS?

PCOS is the most common endocrine disorder among women of reproductive age and current data suggests that it could affect anywhere from 6-18% of this population (2).

How is PCOS diagnosed?

A syndrome is a group of symptoms. The most commonly accepted diagnosis criteria are that the patient must present with at least two of the following:

  1. Irregular or absent periods
  2. Clinical signs or blood test markers of hypoandrogenism (elevated circulating androgen levels such as the hormone testosterone)
  3. Polycystic ovaries, and the exclusion of other potential causes

What are the other signs and/or symptoms of PCOS?

  • Infertility (or reduced fertility) – PCOS is one of the most common causes of female infertility (6)
  • Increased risk of miscarriage
  • Excess hair growth, particularly on the chest, face and stomach (known as hirsutism)
  • Hair loss on the head (known as alopecia)
  • Obesity and/or difficulty losing weight
  • Insulin resistance
  • Hypoglycemia (low blood sugar levels)
  • Acne (on the face and/or body)
  • Fatigue
  • Poor memory and concentration
  • Mood changes (depression, anxiety, low self-esteem, poor body image)

Symptoms often present initially in the teenage years but may then vary in severity or frequency depending on factors such as age and weight.

Insulin resistance means that the muscles and liver resist the action of insulin. To compensate, the pancreas produces more insulin to manage blood glucose levels, however, additional insulin triggers the ovaries to produce more male hormones. Insulin resistance is more common in people who are overweight (particularly around the stomach area) and increases the risk of developing Type II diabetes and heart disease (8).

 

 

What causes PCOS?

Unfortunately we don’t yet know exactly what causes PCOS, however there may be a genetic or family link. Women with PCOS are 50% more likely to have an immediate female relative – mother, aunt, sister or daughter – with PCOS (3).

Will I have PCOS for life?

Currently there is no cure for PCOS so the treatment plan focuses on managing the associated signs and symptoms. 

PCOS and associated conditions (co-morbidities)

Women with PCOS are at an increased risk of developing the following health conditions: 

  • Type 2 Diabetes
  • Cardiovascular Disease
  • Impaired Glucose Tolerance (IGT)
  • Gestational Diabetes (GDM)
  • Hypertension
  • Sleep Apnoea
  • Endometrial carcinoma (cancer)

How can a Dietitian like myself, help if you have PCOS?

The primary therapy for overweight women with PCOS is weight loss (5). If overweight, losing just 5% to 10% of your initial body weight has been demonstrated to improve many of the features of PCOS (7) and this is where a dietitian can assist. As a Dietitian, I am an expert in the field of nutrition and healthy eating and will be able to help you develop a lifestyle program that can assist with weight loss.  Additionally, if you struggle with being unsure about the correct nutrition plan to follow for any of the above conditions, then a dietitian like myself is qualified in providing appropriate guidance to suit your individual needs. 

When should I see a Dietitian? 

It is beneficial to seek the help of an Accredited Practising Dietitian if you have:

  • been diagnosed with PCOS
  • are struggling to keep your weight properly managed
  • any of the above co-morbidities or are at risk of developing them

If you are ready to help improve your health, reduce the symptoms of PCOS or need any other assistance with your dietary and nutritional needs, scroll down to book an appointment and start feeling better today!

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References

(1)  Dewailly D, Lujan ME, Carmina E, Cedars MI, Laven J, Norman RJ, et al. Definition and significance of polycystic ovarian morphology: a task force report from the Androgen Excess and Polycystic Ovary Syndrome Society. Hum Reprod Update. 2014 May-Jun Feb;20(3):334-52. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/24345633

(2) Catherine Saxelby’s Complete Food and Nutrition Companion. Hardie Grant Books. 2012.

(3) Monash University. International evidence-based guideline for the assessment and management of polycystic ovary syndrome. 2018. Melbourne, Australia.

(4) https://www.jeanhailes.org.au/health-a-z/pcos/symptoms-causes

(5) Australian PCOS Alliance. Evidence-based guideline for the assessment and management of polycystic ovary syndrome. 2011 [cited 2014 Nov 27]. Available from: https://jeanhailes.org.au/contents/documents/Resources/Tools/PCOS_evidence-based_guideline_for_assessment_and_management_pcos.pdf

(6) https://www.acog.org/womens-health/faqs/polycystic-ovary-syndrome-pcos?utm_source=redirect&utm_medium=web&utm_campaign=otn

(7) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2909929/

(8) https://dietitiansaustralia.org.au/smart-eating-for-you/smart-eating-fast-facts/medical/what-is-insulin-resistance/