What is PCOS?

Polycystic Ovary Syndrome, or PCOS as it’s more commonly referred to, affects one in 10 women in the UK (1). Though the exact cause remains unknown, PCOS is associated with hormonal imbalances and high insulin levels.
 

PCOS meaning

 
The term polycystic ovaries refer to a number of small ‘cysts’ – around twice as many as in normal ovaries and generally no bigger than 8 millimetres – that sit just below the surface of the ovaries.
 
Technically speaking, the ‘cysts’ caused by PCOS are small egg follicles that haven’t matured to ovulation, which is thought to be the result of altered hormone levels.(2)    
 
Follicular cysts were once thought to cause the condition. But they’re now understood to be a symptom, and it’s worth nothing that not everyone will have them. So, despite its name, polycystic ovaries aren’t a defining feature of PCOS. In fact, there are ongoing discussions to change the term ‘PCOS’, as there’s still some confusion surrounding the name amongst the general public and healthcare providers.
 

What are PCOS symptoms?

 
PCOS is an endocrine disorder that affects how a woman’s ovaries function.
 
There are three main features of this condition (2). If you experience two or more of these symptoms, you’ll likely receive an official diagnosis.
 

• Irregular or skipped periods, which means the ovaries don’t release eggs regularly (ovulation)

• High levels of androgens (‘male’ hormones), which can lead to physical symptoms, like excess facial or body hair and acne

• Polycystic ovaries, in which the ovaries become enlarged and contain fluid-filled sacs (follicles) that surround the eggs

 
In addition to this, you may notice the following symptoms (3):
 

• Excess facial or body hair, otherwise known as hirsutism. Around 70 per cent of women with PCOS experience excessive hair growth on their face, back, belly, and chest (4).

• Weight gain. More than 80 per cent of women with PCOS are overweight or obese (5).

• Difficulties falling pregnant. Women with PCOS take longer to fall pregnant than other women.

• Oily skin or acne. High levels of male hormones can lead to breakouts on the face, chest, and upper back.

• Thinning hair or hair loss. Some women may even experience male pattern baldness where the hair on the scalp becomes thins and falls out.

• Mood changes. Due to the troubling nature of symptoms, PCOS can have a significant emotional toll, leading to anxiety and low mood.

 
You can read more about PCOS symptoms here.
 

What causes PCOS?

 
Experts are still largely unsure of what causes PCOS. However, they believe genetics, insulin resistance, and hormonal imbalances play a role in the condition. 
 

Genes

 
PCOS often runs in families. If your mother, sister, or aunt has PCOS, there’s an increased risk of developing it. Despite this genetic component, the specific genes associated with the condition are yet to be identified (6).
 

Insulin resistance

 
Around 70 per cent of women with PCOS have insulin resistance, which means their cells can’t use insulin correctly (7). Insulin resistance can also lead to weight gain, which can worsen PCOS symptoms, as it can cause the body to produce even more insulin.
 

Hormone imbalances

 
Women with PCOS often have hormone imbalances, although the exact reason why this occurs is unknown. They may start in the ovary itself, in other glands that produce the hormones, or in the part of the brain that oversees their production. These imbalances may also be the result of insulin resistance.
 
Some of the hormone imbalances include (8):
 

• Increased testosterone levels – often regarded as a ‘male’ hormone

• Increased levels of luteinising hormone (LH) – this hormone triggers ovulation but may have an unusual effect on the ovaries if too high

• Lower levels of sex hormone-binding globulin (SHBG) – a protein in the blood that binds to testosterone and reduces its impact

 

PCOS and health risks

 
If you have higher-than-average androgen levels, it can affect different areas of your health and wellbeing.
 

Fertility issues

 
Many women with PCOS find it difficult to fall pregnant because they aren’t ovulating regularly. That’s why PCOS is one of the leading causes of infertility in women (9).
 

Cardiovascular issues

 
PCOS weight gain can lead to high blood sugar, high blood pressure, and high cholesterol, all of which can increase the risk of heart disease and type-2 diabetes.
 

Sleep apnoea

 
Weight gain is also a risk factor for sleep apnoea, a condition that causes repeated pauses in breathing at night, which fragments sleep and can lead to daytime tiredness.
 

Mental health challenges

 
The hormonal fluctuations and physical symptoms associated with PCOS, such as unwanted body hair and weight gain, often result in mental health challenges. Many women with PCOS struggle with anxiety, depression, and low self-esteem, making the condition even more difficult to navigate. Read more about the suspected causes of PCOS here.
 

Treatments for PCOS

 
Unfortunately, there’s no cure for PCOS. However, there are interventions you can take to improve the condition – many of which can be used alongside traditional medication.
 

PCOS and lifestyle

 
Switching to a healthier lifestyle is the first line of defence for women with PCOS. Eating a balanced, wholefood diet and taking part in regular exercise is essential for women with PCOS, mostly because they support weight loss, weight management, insulin resistance, and mood regulation.
 
Weight loss can be especially challenging for women with PCOS. Losing even 5-10 per cent of total body weight can improve hormone profiles and menstrual regularity (10). Crash diets aren’t the answer here. Little tweaks to how, what, and when you eat can help you lose weight with PCOS in a healthy, manageable, and sustainable way. You can read more about supporting PCOS weight loss here. Or find more information about the best foods for PCOS here.
 
Managing stress and supporting sleep hygiene are equally important considerations for women with PCOS as they help balance hormones and support overall emotional health. Mind-body practices, like yoga and breathwork, as well as therapeutic support, can provide an additional buffer for the mental health challenges associated with PCOS.                                                                                                       
 

Natural support for PCOS

 
Alongside dietary changes, there are many  nutrients available to support your overall health and wellbeing.
 
Vitamin D3
 
Lower levels of vitamin D3 have been linked to higher androgen levels in women with PCOS, so increasing your intake is a worthy investment (12).
 
Aside from eating more food naturally rich in vitamin D3, such as oily fish, egg yolks, cheese, and liver, and getting 10-15 minutes of unprotected sunlight every day, you may also want to take a high-strength supplement.      
 

Evening primrose oil

 
Evening primrose is rich in an omega-6 fatty acid called GLA (gamma-linolenic acid). Many natural health practitioners believe GLA and other omega fatty acids support hormone balance, with some recommending it for PCOS.
 

Myo-inositol

 
A vitamin-like substance (also sometimes called a pseudovitamin) found in many natural sources, myo-inositol is a carbohydrate with a molecular structure similar to glucose.
 
Studies suggest taking myo-inositol and the B vitamin folic acid in therapeutic doses may help with menstrual regularity, ovulation and higher-quality eggs in women with PCOS (13).
 
Alongside supporting fertility, there’s also some evidence that myo-inositol may improve insulin sensitivity (14).
 
The recommended dose of myo-inositol for women with PCOS is 2 grams in the morning and 2 grams in the evening. For convenience, choose powdered myo-inositol and mix it with water or juice.
 

B vitamins

 
Vitamin B6, folate, and vitamin B12 support hormone balance in PCOS. These nutrients help break down homocysteine, which is commonly elevated in women with PCOS (15). Lowering homocysteine may improve reproductive symptoms and cardiovascular health, making it a great addition to manage PCOS.
    
Read more about the best supplements for PCOS here.
 

Medical treatments for PCOS

 
Even with the best intentions, some people won’t be able to manage their symptoms with lifestyle and dietary changes alone. Fortunately, certain medications can offer additional support.
 
These include a medicine called metformin, which may help lower your insulin and blood sugar levels; clomiphene to initiate ovulation; and medication known to block the effects of androgens, such as finasteride, spironolactone or cyproterone acetate. Have a chat with your GP to discuss the best treatment options.
 
You can learn more about PCOS treatments here.
 

Find out more

 
PCOS is a complex and challenging hormonal condition. While it can’t be cured, there are plenty of lifestyle and medical interventions that can improve your symptoms and quality of life.
 
If you enjoyed reading this, you can find similar guidance on our dedicated PCOS health hub. Alternatively, please get in touch with our team of expert Nutrition Advisors, who are on hand to provide free, confidential advice.

 

References:

1. What is PCOS (no date) Verity. Available online: http://www.verity-pcos.org.uk/what-is-pcos.html

2. (2022) NHS choices Available online: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/

3. (2022) NHS choices Available online: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/

4. Polycystic ovary syndrome (PCOS) (no date) ACOG. Available online: https://www.acog.org/womens-health/faqs/polycystic-ovary-syndrome-pcos?utm_source=redirect&utm_medium=web&utm_campaign=otn

5. Polycystic ovary syndrome (PCOS) (no date) ACOG. Available online: https://www.acog.org/womens-health/faqs/polycystic-ovary-syndrome-pcos?utm_source=redirect&utm_medium=web&utm_campaign=otn

6. Marshall JC, Dunaif A. (2012) Should all women with PCOS be treated for insulin resistance? Fertil Steril. 97(1):18-22.

7. Marshall JC, Dunaif A. (2012) Should all women with PCOS be treated for insulin resistance? Fertil Steril. 97(1):18-22.

8. (2022) NHS choices Available online: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/causes

9. Polycystic ovary syndrome (PCOS) (no date) ACOG. Available online: https://www.acog.org/womens-health/faqs/polycystic-ovary-syndrome-pcos?utm_source=redirect&utm_medium=web&utm_campaign=otn

10. Moran LJ, Brinkworth GD, Norman RJ. (2008) Dietary therapy in polycystic ovary syndrome. Semin Reprod Med. 26(1):85-92.

11. Ellison DL, Moran HR. (2021) Vitamin D: Vitamin or Hormone? Nurs Clin North Am. 56(1):47-57.

12. Gokosmanoglu F, Onmez A, Ergenç H. (2020) The relationship between Vitamin D deficiency and polycystic ovary syndrome. Afr Health Sci. 20(4):1880-1886.

13. Merviel P, James P, Bouée S, et al. (2021) Impact of myo-inositol treatment in women with polycystic ovary syndrome in assisted reproductive technologies. Reprod Health 18, 13.

14. Merviel P, James P, Bouée S, et al. (2021) Impact of myo-inositol treatment in women with polycystic ovary syndrome in assisted reproductive technologies. Reprod Health 18, 13.

15. Günalan E, Yaba A, Y?lmaz B. (2018) The effect of nutrient supplementation in the management of polycystic ovary syndrome-associated metabolic dysfunctions: A critical review. J Turk Ger Gynecol Assoc 15;19(4):220-232.

16. (2023) NHS. Available online: https://www.nhs.uk/conditions/ovarian-cyst/causes/#:~:text=Polycystic%20ovary%20syndrome%20(PCOS)%20is,caused%20by%20altered%20hormone%20levels.

Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.

 

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