A major part of my work as a PCOS dietitian is helping women understand their PCOS diagnosis, what ACTUALLY causes it, and helping them address their individual root causes to improve symptoms. At the same time, it’s important to me to advocate for ALL women, no matter their body size, and provide the care they deserve, beyond typical advice to “lose weight”. This advice and treatment is LAZY medicine and harmful, especially for women with PCOS. You CAN live peacefully with PCOS and enjoy food, NO DIETING NEEDED!
In this three-part blog series, you’ll learn what PCOS actually is, how dieting isn’t effective, and how to embrace intuitive eating with PCOS!
What is PCOS?
Polycystic Ovarian Syndrome (PCOS) is an hormonal (endocrine) disorder. Not enough is known about the condition, even though it affects about 1 in every 10 child-bearing women. Many mistakenly associate it with being a disorder of the reproductive system. This is because PCOS is often known to be a cause of irregular menstrual cycles and infertility. However, this is not the case. PCOS is affected by hormone imbalances within the endocrine system.
PCOS is NOT caused by being overweight. It is, instead, believed to be triggered by genetic and environmental factors. Currently, there is no cure for PCOS. However, there are many in which women can address their PCOS causes and symptoms, naturally, through nutrition and lifestyle changes, as well as conventional treatments like medication. We will talk more about this soon!
What causes PCOS?
The short answer: hormone imbalance.
Further, insulin resistance, multiple hormone imbalances, and chronic inflammation are thought to be major causes of the symptoms women with PCOS experience. Women with PCOS may have one or more of these root causes. Let’s explore these three briefly.
Insulin resistance: Insulin is a transporter for glucose (sugar/carbs) into cells so it can be used for energy. When a person is insulin resistant, this mechanism does not work efficiently, leaving your body with high insulin levels and glucose not able to get to the cells as needed. High insulin levels drives production of androgen hormones, like testosterone. Most women with PCOS have insulin resistance. In addition to symptoms of high androgens seen in PCOS, those with insulin resistance may experience dark patches of skin (acanthosis nigricans), skin tags, and strong cravings for sweets. It’s important to note that insulin resistance can be experienced at any weight.
Hormone imbalance: Levels of hormones produced by pituitary gland, ovaries, and adrenal glands are often abnormal in women with PCOS. This is commonly a cause of anovulation or irregular periods. Specifically, androgens, such as testosterone and DHEA are often culprits. Androgens are often called “male hormones”. Although all women have androgens in their body, women with PCOS often have higher levels. These high levels of androgens often cause frustrating symptoms, like unwanted hair growth and acne. High insulin, stress, and hormonal birth control can affect hormone balance, among other causes. Other hormones, like cortisol and thyroid hormones can play a role in PCOS as well.
Inflammation: It has been observed that women with PCOS have high markers for inflammation. Symptoms like fatigue, gut issues, skin conditions, or headaches are often observed with chronic inflammation. Chronic inflammation may stem from gut/digestive issues, environmental toxins, hormonal imbalance, stress, poor nutrition, or other health issues. Inflammation affects PCOS by disrupting hormone balance, which may suppress ovulation and increase androgens.
What are symptoms of PCOS?
Excessive cravings and hunger: Cue the sweets cravings! Insulin resistance leaves your body desperately wanting energy from glucose, and triggers your brain to ask for carbs. You may also feel extra hungry.
Hirsutism: Excess hair growth on the face, neck, chest/nipples, arms, or abdomen
Hair loss on your head: Exactly where you don’t want to lose hair!
Weight gain/difficulty losing weight: Excess insulin and high androgen levels are a perfect mix for growth, aka weight gain. It also makes it near impossible to lose weight. Add in lazy recommendations to just “lose weight” and start dieting, and you have a recipe for frustration, poor body image, and further weight gain. More on this in the next blog post.
Irregular periods: Hormone imbalance often results in irregular, heavy or painful periods.
Acne: Caused by hormone imbalance, excess acne on the face and neck may be present.
Depression/Anxiety: Mood disorders are commonly associated with PCOS
Fatigue: Your body wants energy, and insulin resistance makes it difficult to provide efficiently. Sleep disorders are also commonly associated with PCOS.
Infertility: Irregular periods and hormone imbalance can make it difficult to conceive. PCOS is the leading cause of infertility.
Disordered eating: Along with the above symptoms, poor body image and desire for weight loss often leads to dieting and disordered eating behaviors, and sometimes binge eating behaviors.
How is PCOS diagnosed?
There are three criteria for PCOS; you must meet 2 out of 3:
1) Presence of ovarian cysts: This characteristic is how PCOS gets it’s name. Often in women with PCOS, cysts can be found on the ovaries. However, not all women with PCOS actually have cysts present.
2) High androgen levels: Symptoms of high androgen levels are observed, including hirsutism, acne, thinning of hair.
3) Anovulation/Irregular Periods: If you regularly experience missed periods or irregular periods, this may be a sign of PCOS.
So what now?
Here’s what won’t fix your PCOS: restriction and dieting
Here’s what will help your PCOS: nutrition and lifestyle changes specific to YOU.
Learn more about how dieting is harmful for PCOS here.
Want help with your PCOS?
I help women with PCOS address their root causes and symptoms through nutrition and lifestyle changes. Learn more about 1:1 PCOS Nutrition Coaching here.