- +What is is?
PCOS or Polycystic Ovarian Syndrome is a relatively common condition, affecting up to 25% of women during their childbearing years. The name refers to the appearance of small cysts/follicles on the ovaries. The exact cause is largely unknown but is believed to have a genetic component, being commonly found in mothers, daughters and sisters.
The common presentation of PCOS includes
Polycystic ovaries (multiple ovarian cysts/follicles)
Menstrual irregularities or amenorrhoea
Anovulation or irregular ovulation
Heavy menstrual bleeding
High androgen levels (male hormone) low ovarian estrogen
Excess hair around the face, nipples, navel and pubic area
Insulin resistance/poor blood sugar regulation
Reduced fertility or infertility
Increased risk of miscarriage
However not all women diagnosed with PCOS will present with all of the above symptoms. You may even have polycystic ovaries (multiple cysts on your ovaries) yet not have any symptoms of PCOS.
PCOS can have a severe or mild presentation. Some women diagnosed with PCOS may be asymptomatic and unaware they even have the condition, whereas others will suffer all the above listed symptoms. The severity of symptoms does not necessarily correlate with the number of cysts on the ovaries, in fact there appears to be no diagnostic way of telling who will have severe symptoms and who will not.
- + How do I know if I have it?
If you have concerns as to whether you have PCOS, it’s important to consult with your Health Care Professional to obtain and official diagnosis.
There is no specific diagnostic test for PCOS. If your Health Care Professional suspects that you might have PCOS they may take the following steps to help reach a diagnosis
Menstrual history – you may be asked about your menstrual cycle, any irregularities, heavy bleeding or changes in weight
Take your blood pressure
Check your weight and BMI
Measure your waist circumference
Check for increased hair growth (if you use any form of hair removal for excess hair, this should be mentioned).
Palpate your pelvic region to asses any potential swelling in the area caused by cysts on your ovaries
A blood test may be recommended to asses for increased androgen levels and check your blood sugar levels
Ultrasound may be performed to visually assess the presentation or number of cysts on your ovaries and examine your endometrium, which may be thicker than normal.
- + Why does it impact fertility?
Polycystic Ovarian Syndrome is one of the leading causes of fertility issues and infertility. This is largely due to the hormonal imbalances it can create. Women with PCOS produce a larger amount of androgens, which are typically high in males. These excess androgens can cause ‘male’ characteristics such as increased body hair as well as interfering with the body’s ability to produce estrogen and progesterone required for regular menstruation and ovulation. This can cause irregular or absence of ovulation or menstrual cycles. Insulin resistance is also common, which can cause excess weight gain. Both of these factors can hinder chances of conception.
Fortunately for some women, the condition may be quite severe during their teens and twenties yet reduce or disappear completely in their thirties.
If conception does occur, sufferers of PCOS are at higher risk of miscarriage. So you should consult your Health Care Professional if you do fall pregnant with diagnosed PCOS.
- + What can I do to help me conceive?
There are two approaches to improving fertility in those with PCOS. The first is to balance the underlying hormonal imbalance, the second to help establish a healthy weight.
May be prescribed to help regulate the menstrual cycle, balance hormones and minimise symptoms.
Clomiphene Citrate (Clomid)
Is commonly prescribed, to stimulate ovulation in women with PCOS who may not be ovulating.
These medications may only be prescribed by your GP or fertility specialist.
Peony is beneficial in the treatment of PCOS for its ability to help reduce androgen (male hormone) levels and regulate estrogen and progesterone production. This herb works well when combined with liquorice.
Vitex helps stimulate ovulation which can help improve chances of conception in those with erratic or anovulation.
Hormone balancing herbs should not be self-prescribed. See your natural fertility specialist or other qualified health care professional for specific dose recommendations.
Supporting healthy blood sugar regulation
The insulin resistance component of PCOS is a significant contributing factor in infertility. It can hinder your ability to ovulate and increase the risk of miscarriage. For this reason, Gynaecologists may prescribe medications to help stabilise blood sugar. However much can be done to support insulin resistance and healthy blood sugar levels through diet either alone or in conjunction with prescribed medications.
Is commonly prescribed for people with type 2 diabetes as well as women with PCOS. Metformin helps control the amount of glucose in the bloodstream. Speak with your doctor about the benefits, risks and side effects of this medication.
- Low GI
Eating a low glycaemic index (GI) diet helps to reduce insulin demand and support healthy stable blood sugar levels. Low GI foods break down slowly in the body releasing sustained energy and don’t cause the dramatic spike and subsequent drop in blood sugar caused by high GI foods such as refined carbohydrates and sugars. A study in the Medical Journal of Metabolism concluded that a low carbohydrate, high protein diet improves insulin resistance whereas a high carbohydrate, low protein diet made insulin resistance worse. Although it’s not necessary to completely cut out carbohydrates, reducing the consumption of refined carbohydrates and replacing these with wholegrain alternatives such as wholemeal breads, quinoa, millet and brown rice as well as increasing your protein will help reduce the insulin load.
- High fibre
High fibre diets further support blood sugar balance by slowing the absorption of sugar into the blood stream, reducing the insulin spike. Fibre also supports healthy estrogen metabolism and reduction of androgens
- Small regular meals
A healthy PCOS diet should include 3 balanced meals and 2 healthy snacks eaten at regular intervals throughout the day. This helps to maintain healthy blood sugar levels and reduce sugar cravings.
- Oily fish, nuts, seeds and other sources of essential fatty acids
Essential fatty acids (EFA’s) help to lower the GI of foods and reduce cravings. These should be incorporated into the diet daily
Chromium is a trace mineral that supports insulin activity. Clinical studies have shown improved insulin sensitivity in women with PCOS using chromium. Chromium can also be safely taken throughout pregnancy and breastfeeding
Recommended dose – 500mcg per day, twice per day
Food sources – Broccoli, barley, oats, green beans, tomatoes, romaine lettuce
Vitamin D deficiency is commonly found in women presenting with insulin resistance or diabetes. Studies show that deficiency may play a role in blood sugar balance as well as increasing the risk of developing insulin resistance, diabetes and gestational diabetes. The exact mechanism by which vitamin D impacts blood sugar levels is largely unknown however studies have confirmed a link and further studies are being done to investigate the cause.
Recommended dose – 1000IU per day
Food sources – Milk, butter, salmon, tuna, cod liver oil, halibut liver oil, prawns, eggs yolk. The richest natural source of vitamin D is from sunlight
Gymnema has been used for centuries in the management of blood glucose. It supports healthy blood glucose levels by regulating the absorption of sugar. It achieves this by acting on the pancreatic cells, which produce insulin. Gymnema helps enable more efficient insulin production as well as stimulating the production of the enzymes that help uptake glucose from the blood stream into cells. Several studies have proved Gymnema to be as effective as medications in the treatment of diabetes and insulin resistance and it is commonly prescribed by medical practitioners in Europe. This traditional herb also helps reduce sugar cravings and supports healthy weight loss.
Gymnema should only be used to help reduce symptoms prior to pregnancy and should not be used during pregnancy or breastfeeding.
Recommended dose – 200 – 400mg 3 times per day
You probably recognise this herb from your favourite cake or muffin recipe. Now, clinical studies show that therapeutic doses of this aromatic spice have a strong balancing effect on blood sugar levels, greatly improving diabetic symptoms. Long before the blood sugar regulating properties of cinnamon were discovered, cinnamon was used traditionally for centuries to help reduce heavy menstrual bleeding and as a warming tonic for a ‘cold’ uterus. The term ‘cold’ uterus is a term used to describe a congested uterus with poor circulation and menstrual irregularities. It also acts as a warming, digestive tonic. You can freely use this spice for cooking during all phases of conception, pregnancy and breastfeeding.
Important note: Therapeutic doses of cinnamon should only be used to help reduce symptoms prior to pregnancy and should not be used during pregnancy or breastfeeding.
Recommended dose – 1000mg 3 times per day
Exercise is always beneficial for general health and fertility however it is particularly beneficial and important to help promote weight loss and maintenance of a healthy weight in women with PCOS. Exercise helps improve insulin sensitivity and boost metabolism. A combination of aerobic and resistance exercise has been found to work best.
- Low GI