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Understanding PCOS

Understanding PCOS

By Maiya Ahluwalia

RD, MAN, BASc.

Did you know that 10% of all women get diagnosed with Polycystic ovarian syndrome (PCOS), but yet it is a condition that is often misunderstood and when not consulting with the right healthcare practitioner, can be challenging to manage. 

Not to worry-you have come to the right place. As a registered dietitian and founder of Nourishing Balance Integrative Health Team, I am very passionate about supporting women with PCOS in a non-restrictive, weight-inclusive manner. 

You may have heard of PCOS, been told you may have it because you have cysts on  your ovaries or you may be wondering, do I have it? My goal is to give you more insight into what PCOS is and its impact on the female body. 

What is PCOS?

  • An endocrine disorder characterized by an imbalance in women’s sex hormones including testosterone (androgens), estrogen, and progesterone
  • Not constricted to only having cysts on the ovaries
  • Has roots in metabolic health, inflammation, and adrenal function

Symptoms

  • Acne
  • Oily skin and hair
  • Excess hair growth on the face and body
  • Hair thinning or loss on the head
  • Darkened skin patches
  • Irregular periods or no periods
  • Pregnancy complications 
  • Some types of cancer

Diagnosis

  • Two of the three Rotterdam criteria listed below are needed to be met for a diagnosis:
    1. Polycystic ovaries: 12 or more follicles on one ovary or the size of one or both ovaries is high
    2. Hyperandrogenism: High levels of androgens (male hormones) 
    3. Irregular periods: You can have many issues occurring with your periods including spotting or no periods at all

Cause

It is still unclear of the exact cause of PCOS, although studies have shown it can be linked to genetic and environmental factors.

Genetics:

  • Very common for sisters or a mother and daughter to have PCOS

Environmental toxins:

  • Plasticizers such as BPA or bisphenol belong to the category of endocrine-disrupting chemicals (EDC’s)
  • Studies have shown that fetuses, infants, and young children are the most susceptible groups in the early developmental periods
  • EDC’s can mimic endogenous hormones which may later fetal programming and lead to PCOS

Diabetes:

  • Women with PCOS can have insulin resistance, which means the body can’t use insulin very well
  • When insulin levels build in the body, it can cause higher androgen levels leading to PCOS

Types

PCOS is often misunderstood. It does not always cause infertility and can actually continue to occur post-menopause. Some women may see period irregularities and some may not. It’s important to remember it is unique to each individual and you may fall into one of these categories or all of them.

Types of PCOS

1. Insulin Resistant PCOS

  • Insulin is a vehicle to transport glucose into our cells allowing our bodies to use it for energy
  • When you are insulin-resistant, your body can become “numb” to the effects of insulin and will no longer use it efficiently
  • This can cause your pancreas to produce more insulin until the cells receive the message
  • This state is called hyperinsulinemia
  • High insulin can spike your luteinizing hormone levels and can lead to excess production of testosterone in your ovaries
  • High levels of testosterone can sometimes prevent ovulation
  • Can experience intense sugar cravings and hold more weight around your abdomen
  • The high levels of insulin drive androgen levels up, which can lead to symptoms of hair growth/loss, acne, fatigue, and brain fog

2. Pill-Induced PCOS

  • Hormonal birth control pills secrete synthetic hormones that suppress ovulation and our bodies natural hormones
  • For some women, it can take many months to rebalance their hormones after coming off birth control (usually anywhere from 3-6 months)
  • During this period, your ovaries can secrete high levels of androgens causing irregular periods
  • Can persist from months to years
  • May be reversed after hormonal rebalance

3. Inflammatory PCOS

  • When you are stressed ,your body releases a hormone called cortisol
  • High levels of this hormone can cause your ovaries to make excess testosterone, throwing your natural hormonal balances off
  • Some signs your body has inflammation include fatigue, skin issues such as eczema, and bowel issues like Irritable Bowel Syndrome (IBS)

4. Adrenal/Stress PCOS

  • Least common type of PCOS and generally affects 10% of those who are diagnosed
  • Occurs from having an abnormal stress response that causes elevated adrenal androgens such as DHEAS
  • These hormones can be converted to testosterone by peripheral tissues in the body
  • This process can occur independently from the ovaries and any involvement with insulin

How can this affect ovulation? 

  • Ovulation occurs when a follicle in your ovary gets stimulated by the follicle stimulating hormone (FSH)
    • This hormone helps the follicle to develop and produce estrogen
  • As the estrogen levels increase in your body, it will signal a hormone called luteinizing hormone (LH)
    • This hormone will help to release the mature egg from your ovaries
  • The egg will then be ready for fertilization
  • If the egg is not fertilized, then you will get your period and the egg will be released

Now let’s talk about how your body’s response can change during ovulation with PCOS 

  • If you have PCOS, your body may release higher levels of luteinizing hormone into your bloodstream, causing disruption to your natural ovulation cycle
  • High levels of LH do not allow your follicles to mature and release proper amounts of estrogen
  • The immature follicles don’t always dissolve and can remain as fluid-filled sacs or “cysts” on your ovaries
  • This may lead to irregular periods and/or lack of ovulation

Management of PCOS 

Although there is no cure for PCOS, there are many methods for managing the condition. And believe it or not, hormonal birth control is not your only answer. It is key to take a deeper look at lifestyle factors such as diet, type of exercise, supplementation, and environmental toxins to improve symptoms. 

 

Looking to learn how to manage your PCOS in a sustainable way?

Book a free discovery call with Maiya. She will work with you in creating sustainable changes that fit into your lifestyle.

Maiya Ahluwalia

References: 

Polycystic ovary syndrome and environmental toxins

Reproductive Hormones

Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome