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Polycystic Ovary Syndrome (PCOS)
How this page (and inCYST)
can help you
Our philosophy is that when hormones are out of balance, they can cause a lot of
problems. Some of those problems are medical, some emotional, some
behavioral--but all have a physiological basis. Even many eating disorders
we have seen got their start with hormone trouble! Rather than put
band-aids on individual symptoms, we are gathering information and doing
research to figure out where all this trouble starts. All of the resource
centers you see listed above discuss problems we have learned can be associated
with polycystic ovary syndrome. None of them are good or bad, right or
wrong--but if they are not acknowledged as part of the problem, your symptoms
may actually worsen.
We also believe there are
many things that can be done to help before adding expensive medications and
procedures. Many of those things are nutrition-related, many are stress-management related. Of course, we understand the importance of metformin
and other medical options for PCOS...but we believe with good nutrition and
stress management, the amount of invasive medical care you need with these
priorities may be less than if nutrition, exercise, and stress management are not priorities for
you.
This page gets over
12,000 visitors per year. As traffic has increased, I have done my best to
add and update information in a fashion that as much of it as possible can be provided
free of charge. However, the more detailed the information you want, the
greater the cost to After the Diet to provide it. Below is a list of the products
and services provided and their cost.
Consider the following questions:
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Do you have a family
history of infertility, irregular periods, or diabetes?
-
Are you of Hispanic
descent?
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Do you have a
history of early puberty (first period at 11 years or younger?)
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Did you ever take medication for
depression,
bipolar disorder,
seizure disorder, epilepsy, or migraine?*
-
Did you ever have
gestational diabetes in any of your pregnancies?
-
Do you have an android
("apple shaped") body type (measure your waist to hip ratio; greater
than .8 equals an android body type)?
-
Do you have irregular
periods (or none at all)
-
Do you have dark velvety
patches of skin on you neck, groin, or in your armpits?
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Do you have hair loss or
male balding spots?
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Difficulty losing weight?
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Intense cravings for
carbohydrates or sweets?
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Problems conceiving?
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Decreased sex drive?
-
Excess hair growth on
your face, like a mustache or beard?
-
Excess hair on your chest
or back?
-
Acne on your face, chest
or back?
If you answered yes to any of these questions, you are at a higher
risk for Polycystic Ovary Syndrome, which can place you at risk for
diabetes and certain types of cancer. Print out this list and take it
to your doctor.
*Not all medications for
all of these conditions cause PCOS. However, if you are on these
medications and have noticed an increase in other symptoms, please
consult with your physician.
Is PCOS affecting your eating?
Is your eating affecting your PCOS?
Click here to find help near you.
PCOS--Some
basic information
What is PCOS?
PCOS stands
for polycystic ovary syndrome, an imbalance affecting several hormone
systems. It affects 10% of all women of reproductive age. If not
treated, it can progress to metabolic syndrome (high cholesterol, high blood
pressure, diabetes)...and even reproductive cancers. The questionnaire
above is a quick survey of the many hormone systems PCOS can affect.
The syndrome has many different presentations; no two women are exactly
alike. However, two things do appear to be common in most
cases--insulin resistance and some kind of stressor that pushes the body
into "stress mode".
For endocrinologists, an
official diagnosis of PCOS requires two of the following three: (1)
oligo-ovulation or anovulation, (2) elevated levels of circulating
androgens, (3) polycystic ovaries as defined by ultrasound. This is
known as the Rotterdam Criteria. The symptoms in the checklist
above may also be present, but they differ from woman to woman, and they do
not always mean you have PCOS. If you have all of those symptoms, but
do not have 2 of these 3 criteria, according to the Rotterdam Criteria, you
do not have PCOS. However, this does not mean that changes in diet,
exercise, and stress management cannot help your symptoms!
I have met many women who
refuse to change their lifestyle choices until they get a definitive
diagnosis. My advice is not to allow the lack of a specific set of
words describing your symptoms prevent you from making healthy choices.
Decisions to take good care of yourself can NEVER hurt you and they might
even help you! Why wait until you're sick enough for a diagnosis to
take charge of your health? You can make choices today that help
improve your health and prolong/prevent the development of many problems the
doctor CAN diagnose.
What causes PCOS?
No one knows for sure.
There is a greater risk if you have a family history of diabetes, so there
seems to be a hereditary factor. PCOS seems to start in regions of the
brain where the stress (fight or flight) response originates, so stress may
be an important contributing factor. Sometimes that stress is
biological, such as going through puberty. Sometimes it is
environmental--what we consistently hear from the women writing us at
After the Diet is that they are juggling many responsibilities and have
very busy lives. Sometimes the stress is the result of a "high energy
personality"--the symptoms of PCOS seem to occur more often when there is
also a diagnosis of bipolar disorder, anxiety, and/or
depression.
It may be that PCOS is what happens when the body starts to have trouble
keeping up with the demands of a stress response that never has the
opportunity to turn off.
What kind of diet
should I follow for PCOS?
A really important stressor is
diet. Skipping meals, not eating enough, then eating too much in
response to not eating enough...chronic dieting...all of these things make
it difficult for the body to function the way it was designed to.
Emotional eating is also hard on the body. Our experience is that busy
people often don't prioritize eating well as part of their daily routine.
That can result in nutritional imbalances that make it difficult to manage
stress. It becomes a vicious cycle that is hard to break.
A low carbohydrate diet is
often recommended for PCOS. We do not disagree with this rationale at
all. However, if your carbohydrate intake is high because of binge
eating, emotional eating, and/or stress eating, we recommend that you
consider a "nondiet" approach, which works to reduce carbohydrate intake by
addressing the emotional aspect of food--in other words, you get more for
your money by addressing the problem where it starts.
Emerging
research is pointing to the importance of omega-3 fatty acids for
maintaining mood and hormone function among others. Flax is an example
of an omega-3 fatty acid; however, it is not the whole story. Fish
oils appear to be crucial. So does a low ratio of omega-6 to omega-3
fatty acids. Something very interesting my clients using fish oils are
reporting is that they help to reduce carbohydrate cravings, making it
easier to follow that low carbohydrate program.
Click here
for more information on omega-3 fatty acids.
Our experience
is that carbohydrate cravings make it challenging to follow a
low-carbohydrate diet. We have found that the right omega-3 balance
can help reduce cravings and allow you to naturally achieve a lower
carbohydrate intake. If you simply aim to limit carbohydrates...all
you are doing is transferring your obsession from eating carbohydrates to
not eating them. Omega-3's can help to reduce the obsession, allowing
you to focus on a lot of other things. Food doesn't have to get in the
way of your life!
"What is the biggest problem for most of the
women you see?"
The problem
most women identify is weight gain that does not respond to traditional diet
and exercise programs. In addition, many women are worried about their
inability to conceive. While these are the problems that are often the
most visible, and most important to the client, from a medical standpoint,
the hormone imbalances should not be ignored. PCOS can progress to
diabetes, heart disease, even cancer. The earlier the syndrome can be
identified and treated, the less damage the syndrome has the opportunity to
do in the long run.
The majority of
women with PCOS are also reporting to us that they struggle with depression
and fatigue. I have searched the literature many times and there are
few researchers who even acknowledge this aspect of the syndrome. If
they do, they have a tendency to say the depression is there because of
weight gain or because facial hair is growing. I personally believe
women with PCOS deserve a better explanation. Depression is a medical
diagnosis just as diabetes is. We would never tell anyone they are
diabetic because their appearance has changed! It can be dangerous to
blame your depression on exterior changes (though they may influence the
severity of the depression). If you believe you feel the way you feel
because you can't have a child or because you weigh too much--then you get
what you thought you wanted, and you still feel depressed--it can be the
straw that breaks the camel's back. Fortunately, the omega-3 fatty
acids I mentioned in the above paragraph are showing great promise for
resolving depression, anxiety, and other mood problems.
From a
professional standpoint, the biggest problem I see is that when it comes to
PCOS, everyone wants to be the expert. Most nutritional information
provided to women with PCOS has no basis in research. It is important,
whenever anyone tries to sell you a diet or a supplement, to ask to see the
peer-reviewed research that documents this is truly effective.
When looking at the research it is also important to look to see if the diet
was effective for 6 weeks, or if it worked for longer than a year. You
can make anyone lose weight over the short term; keeping it off is the
challenge.
I also often see
that most women jump from one potential solution to another without ever
giving anything they try a chance to take hold. It's consistency and
diligence that count most! Be sure that if you try anything, whether
recommended through this website or elsewhere, a fair shot. Don't
discount it because you didn't get instant results.
"Can women with PCOS have children?"
Most
definitely! PCOS is not a definite diagnosis of infertility. It
is an indication that the body is working harder than it has to.
Research is constantly finding new treatments and answers. Sometimes,
medications (most commonly, metformin hydrochloride/Glucophage®,
rosiglitazone/Avandia® and pioglitazone/Actos®) can help. Some
women have found help with Traditional Chinese Medicine.
As our own program
grows, we're seeing more and more women become pregnant (even ones who did
not succeed with IVF), using our nutrition and lifestyle management program.
Again, network providers are reporting that the women who are most
successful...are the ones who are willing to stick with the program.
Nutrition answers are going to be a little different than many other options
you have to choose from, because they require change and effort on your
part. It's not a passive process. But if you'd like to try us,
we'd love to help you. |
