Polycystic Ovary Syndrome (PCOS)
A little bit of background...
Polycystic ovary syndrome (PCOS) is the most common hormonal disorder in women. It affects approximately 10% of women of reproductive age worldwide.
Obesity is associated with PCOS and weight loss is beneficial in improving symptoms. Why? The exact cause is unknown. PCOS is most common in women who are overweight and demonstrate insulin resistance.
Insulin is a hormone found in the body that controls glucose (sugar) levels in the blood, and allows glucose to be brought into our body’s cells to be used as energy. Insulin resistance is when the body's tissues doesn’t respond to the normal level of insulin. The body therefore has to produce extra insulin to compensate. This excess insulin can increase the production and activity of male hormones. The main cause of insulin resistance is excess weight around your middle.
PCOS may be diagnosed if any two of the following three factors are present:
- A number of cysts have develop around the ovaries (polycystic ovaries)
- A failure in the release of eggs from the ovaries (ovulation)
- Slightly higher than normal levels of the male hormones in your blood
These can lead to symptoms which vary greatly from woman to woman. These include excessive body hair (hirsutism); irregular or infrequent menstruation; problems getting pregnant (infertility); weight gain; acne, oily skin and dandruff; and thinning hair on the head.
Long term health Risks
PCOS, in combination with having and being overweight can lead to an increased risk of diabetes, cardiovascular disease, high cholesterol, high blood pressure and fertility problems. Polycystic ovary syndrome is one of the most common causes of female infertility. However many women with PCOS can still conceive.
Treating polycystic ovary syndrome
Risks can be minimized with a combination of lifestyle changes and adherence to medicine. What can you do?
If you are overweight, even a small amount of weight loss can improve PCOS symptoms. 5-10% loss of total body weight can help normalise menstrual cycles, regulate blood sugar and increase a woman’s chances of conceiving a baby. A weight loss of between 1 - 2 lbs (1/2 – 1kg) a week is a safe and practical target. However a healthy diet is beneficial to all women with PCOS, even if not overweight.
Eat regular meals
This will help to keep your insulin levels stable
throughout the day. Eating often can also help to control your appetite. Try to be aware of recognising signs of hunger and fullness. Developing this consciousness can prevent binge eating or overeating. Pre-planning meals is also a key component of this.
Eat a Balanced Diet
This includes eating lots of fruit and vegetables, choosing low-fat dairy foods and lean meats and fish. It’s also critical to limit the amount of fatty, sugary and processed foods and drinks you consume. Use the food pyramid as a guide.
There have been a number of studies summarised in 2013, suggesting that a lack of vitamin D leads to insulin resistances. Supplementing with vitamin D may help to prevent this, however more research is needed before this can be confirmed.
These foods provide you with energy, fibre, vitamins and minerals and are recommended at each meal. Try to choose high fibre varieties as they are absorbed more slowly e.g. wholegrain/granary bread, brown rice/pasta, and potatoes with skins intact.
Limit Added Sugar
It’s critical to avoid high sugar foods with PCOS. Eating less sugar results in lower blood glucose levels. This decreases insulin levels, and reduces male hormone levels. Most women with PCOS crave sugary foods, even after eating meals. This is due to increases in insulin. To best manage insulin levels and cut down the amount of sugar in your diet:
- Opt for fruit instead of sugary foods during sugar cravings
- Avoiding sugar in your diet will result in fewer cravings for sugar over time
- Be sure to eat often, such as every 3 to 5 hours
- Have sufficient protein with meals and snacks – this will help with feeling full
- Avoid high sugar foods, especially soft drinks, sweets, cakes, sweetened yoghurts and ice cream, sweetened cereals. Avoid adding sugar to food and drink
Some fats are essential in your diet. However, eating too many foods which are high in fat will result in weight gain. This can increase your risk of heart disease. It is especially important to cut down on saturated fat e.g. processed meats, pastry, chocolate, cake, biscuits and full fat dairy products.
- Choose lean red meat, poultry without the skin and the fat cut off. Try to have at least 2-3 serving oily fish per week e.g. mackerel, sardines, salmon, pilchards
- Avoid frying. Use low fat cooking methods e.g. poach, grill, steam, bake or microwave
- Opt for unsaturated fats or use oils sparingly in cooking – these are more “heart-healthy” e.g. rapeseed or olive oil.
Stress can worsen your PCOS symptoms. The stress hormones make your body pump out more testosterone, which can increase insulin resistance. Managing your stress levels is an important part of getting to grips with your PCOS. Ensure you get enough sleep.
Exercise is also a great way of reducing your stress levels and simultaneously targeting your weight. There are many benefits to be gained from being physically active, including improving insulin resistance. Get moving with at least 30 minutes of moderate-intensity physical activity most days of the week. For weight loss, additional physical activity may be needed.
Trying to Conceive
If you are trying to conceive, it is especially important ensure you have a balanced diet. You will also need to take a folic acid supplement. Speak to your doctor or dietitian about this.
Updated by Ruth Quinn MINDI, December 2015. Review date: December 2018.
© 2015 Irish Nutrition and Dietetics Institute, INDI. All rights reserved. May be reproduced in its entirety provided the source is acknowledged. This information is not meant to replace advice from your medical doctor or individual counselling with a dietitian. It is intended for educational and informational purposes only.
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