PCOS

Introduction to PCOS

 Although Polycystic Ovary Syndrome (PCOS) now affects around 7% of women in the UK of reproductive age, this syndrome still remains a mystery to many, including health professionals. There is still much controversy surrounding its cause and around which interventions work best.

Obesity, especially central adiposity (proportionally more weight being carried around the tummy), is present in around 40% of women with PCOS and a greater degree of obesity is associated with a more severe form of PCOS. There is also a higher incidence of metabolic syndrome (high blood pressure, high cholsterol and a tendancy towards diabetes) amongst women with PCOS than in non-PCOS overweight and obese women. Weight loss in the overweight/obese woman is therefore fundamental to treating the condition.

As nearly 90% of infertility cases attending infertility units are due to PCOS, women with this syndrome can improve their chances of falling pregnant and having a healthy baby if they address certin diet and lifestyle factors. There is no cure for PCOS, but adopting healthy lifestyle practices can control the symptoms caused by the syndrome and so much of the treatment for PCOS is in the sufferers own hands.

 

Background

Polycystic Ovary Syndrome (PCOS) is the most common ovarian function disorder in pre-menopausal women.  Around 1/3 of women in the UK have polycystic ovaries (PCO), but despite having small cysts on their ovaries, they don’t have any symptoms of PCOS. For actual PCOS, where definite symptoms are present, the incidence in women is between 5-10%  and the rate appears to be increasing.

The differing array of symptoms which can present themselves in PCOS often makes an initial diagnosis of PCOS quite difficult. PCOS is often described as being a condition of hormone imbalances and it is believed to have a genetic basis. The development of PCOS may also be affected by the gestational environment and there may be foetal programming involved. It is thought that the rise in obesity may be acting as a trigger to PCOS in women with a genetic pre-disposition

Getting a diagnosis

Defining PCOS According to the American Society for Reproductive Medicine , PCOS is defined by having of any two of the following signs and symptoms:

• Lack of ovulation for an extended period of time

• High levels of androgens

• Many small cysts on the ovaries (normal ovaries have 5-6 follicles, whereas in polycystic ovaries there are ten or more). These cysts are immature follicles, the egg-containing structures in the ovary, one of which should grow monthly to release an egg, but this tends not to happen routinely, if at all in PCOS, resulting in impaired fertility.

To diagnose PCOS in teenagers, all 3 of the symptoms need to be present

Symptoms

The symptoms of PCOS tend to be different from woman to woman and can be present in any combination; the symptoms can also change over time and 20% of women with polycystic ovaries are symptomless.

Symptoms are more severe with weight gain and tend to diminish with weight loss.

The most common symptoms are:

• Weight gain, especially central adiposity; 40-50% of women with PCOS are overweight

• Central adiposity (waist circumference of over 80cms)

  • Metabolic syndrome (11x increase risk in PCOS).  Metabolic syndrome is characterised by symptoms such as high blood pressure, increase in inflammatory and clotting factors as well as insulin resistance

• Hirsutism which can occur in various places on the body, including the face

• Male pattern baldness or thinning hair,

• Oily skin with acne

• Absent or irregular menstrual cycles, leading to infertility. PCOS women with long intervals between periods have a greater degree of insulin resistance

• Depression, anxiety, irritability and mood swings. It is thought that these emotional symptoms are due to a combination of the hormone disturbances that occur, coupled with the fact that PCOS causes a host of upsetting symptoms resulting in stress involved in living with a long term medical condition

•Insulin resistance: 40% of women with PCOS go on to develop insulin resistance and it can lead to conditions such as diabetes and heart disease as a result of other effects in the body such as a rise in LDL and triglycerides and a lowering of protective HDL. Insulin resistance can also result in tiredness, lethargy and sudden drops in blood sugar levels in PCOS sufferers.

Hormonal disturbance

The hormones involved in controlling periods, and ultimately reproduction, are produced in the pituitary gland. In PCOS two of these: luteinising hormone (LH) and follicle stimulating hormone (FSH) are produced disproportionately and this is believed to cause the follicles in the ovary to not develop properly: they tend to remain small and do not mature enough to release an egg. This results in a string of small follicles forming on the ovary, which gives rise to the characteristic ‘string of pearls’ seen by ultra-sound of polycystic ovary. A high circulating level of insulin is common in PCOS and can be detected even in sufferers of normal weight.

Insulin resistance is seen in 10-15% of slim women with PCOS and 20-40% obese women with it. As well as contributing to weight gain, high levels of insulin drive the ovary to produce high levels of androgens; this causes many of the outward symptoms of PCOS such as the acne, thinning hair and hirsutism. However high androgen levels tend to be driven by LH in slim women with PCOS and not and insulin in overweight women.

Treatment

Unfortunately there is no cure for PCOS  but it can be controlled so that its effect on a woman is minimal. Treatment involves:

  • Improving insulin sensitivity to prevent the whole cascade of later problems such as developing Type 2 diabetes and heart disease.
  • Restoring normal ovulation and hence also fertility. (Reproductive outcome is best if BMI is reduced to less than 30 before drugs for ovarian stimulation are given)
  • Preventing androgen levels from rising.

Treatment of PCOS therefore involves the three pronged attack of:

  1. Diet: using a weight control diet if necessary with low GI advice
  2. Exercise: encouraging more physically active on a day to day basis and throughout the day
  3. Ensuring emotional well-being and motivation to change lifestyle

 

If you suffer from PCOS , we can help you with some diet an dlifestyle counselling

 

 

Wednesday, August 22nd, 2012

New App Developed for PCOS

The hardest part about making changes to your diet and lifestyle is keeping the motivation going; even when you know that the changes are going to help you reduce your PCOS symptoms.  That’s why Gaynor Bussell, author of ‘Managing PCOS for Dummies‘ has used her experience in treating PCOS to bring you a tip each day to help you understand and control your symptoms.

Research has shown that mobile technology helps keep people motivated and on the right track for making beneficial changes. Because we know you’re a busy person, we’ve produced an Android application that will deliver the tip directly to you everyday. There is one tip for every day of the year.

Download your PCOS Daily Tip application here

Our PCOS Daily Tips Android application

 

 

 

 

 

 

 

We hope it works for you!

Tags: , ,

Friday, April 6th, 2012

#PCOS: top 10 tips

1                       Lose weight if you are overweight; cut your intake to around 1500 calories or slightly higher if you have a lot of weight to lose or you are very active

2                              Eat regular meals (especially breakfast), with a couple of small snacks during the day.  Don’t let yourself get too hungry.  As you will be eating quite regularly watch your portion sizes; you could try eating from a smaller plate.

3                              Follow a low GI diet by subsdituting low GI carbs for the high GI ones See the Table below for some tips

4                              Keep the fat level in your diet down; cutting down particularly on saturated and trans fats (e.g. fatty meat, butter, cakes, pastry and biscuits (cookies))

5                              Use as little salt as possible and look at labels of processed food to try and keep within 6g a day total

6                              Eat al least five helpings of fruit and veg every day

7                              Have a fibre rich diet by eating wholefrain rather than refined cereals and plenty of fruit , veg beans, peas and lentils wih some nuts and seeds

8                              Try and get some physical activity every day; half an hour is great but an hour is fantastic if possible as it will help keep your weight in control.

9                              Enjoy a variety of food, eating mostly healthy stuff but don’t feel guilty ifyou have the odd treat now such as a dessert, cake or chocolate.

10                           Just because you are trying to eat healthily does not mean you can’t enjoy eating with your friends and family; your healthy habits may even rub off on them!

Table

Substituting not so good carbs for good carbs

Meal occasion

Instead of:

Have:

Breakfast Cornflakes Muesli
Instant porridge oats Whole oats made into porridge
White toast Granary toast/seeded toast
Lunch Jacket potato with filling Sweet potato (baked) with filling
White filled baguette Pitta bread filled with hummus
Brown bread sandwiches Wholegrain bread sandwiches
Dinner Curry with white rice Curry with basmati rice
Shepherds pie Spaghetti Bolognase
Stir fry with quick cook rice Stir fry with noodles
Desserts Bread and butter pudding made with white bread Bread and butter pudding made with fruit loaf
Fruit Crumble made with white flour Fruit crumble made with oat topping
Snacks Muffins/cakes/biscuits Cakes, biscuits or muffins made with fruit, oats and wholegrains
White bread and jam Fruit loaf with ricotta

White crackers and cheese

Oatcakes with avocado or hummus dip

Tags: ,

Wednesday, April 4th, 2012

Our dietitians book on PCOS

Product Details

 

Managing PCOS for Dummies by Gaynor Bussell Published by John Wiley & Sons Inc ISBN-10: 0470057947-ISBN-13: 978-0470057940 This book is aimed at helping women with PCOS deal with the symptoms of PCOS through following a suitable low GI diet and taking on board some physical activity. There are four chapters of healthy but easy to make recipes, general advice on medication and alternatives for PCOS and what treatments should be avoided! Included is also a chapter on how to maximise the chances of getting pregnant when you have PCOS and having a healthy pregnancy and baby. It is currently the third best selling book on PCOS in the UK It can be ordered from Amazon by clicking here

Tags: , ,

Categories