PCOS is a syndrome – a condition characterised by a set of associated symptoms. It is a complex condition that presents differently depending on the individual. Each woman will have her own set of symptoms that vary in severity. Confused? I’ll take you through the contributing factors to PCOS to help make sense of it all.
High levels of androgens
PCOS is highly associated with high levels of male-type hormones (androgens). These androgens not only lead to the symptoms of PCOS (such as irregular periods, acne and male-pattern hair growth) but also disrupt the hormonal communication network between your brain and your ovaries, interrupting the ovulation process (monthly release of an egg from your ovaries). You don’t have to have high levels of androgens in your blood test to have PCOS. This is because some women are more sensitive to androgens, meaning a blood level of androgens in the normal range can still cause symptoms.
Insulin is the hormone that your pancreas produces to deal with glucose (sugar) in your blood after you eat. Insulin resistance is where your body becomes less responsive to insulin and so needs to over-produce insulin in order to balance blood sugar. The excess insulin caused by insulin resistance directly stimulates your ovaries to make androgen hormones.
Some women have a genetic predisposition to insulin resistance, while for others it may be a consequence of lifestyle and diet.
Eating lots of sugary food and refined carbohydrates causes blood sugar to spike rapidly and the overproduction of insulin ensues. If done repeatedly, this can lead to insulin resistance, weight gain and/or PCOS.
Weight plays a role
Women with PCOS are more likely to be overweight (especially around the waist) and this can contribute to PCOS because it worsens insulin resistance. But normal-weight women can have insulin resistance and PCOS too.
Conversely, women who are underweight often end up with PCOS symptoms also. When body weight drops too low, ovulation is disrupted as nature wisely chooses to halt reproduction.
Could it be genetic?
Researchers think that genetics may be at play with PCOS as you are more likely to have PCOS if one or more women in your family have it. Insulin resistance appears to run in families too and because of the relationship of insulin resistance to type-2 diabetes and cardiovascular disease, you are also more likely to have PCOS if these diseases run in your family.
But remember just because you may be predisposed doesn’t mean you’ll develop it, but it does mean it’s easier to acquire PCOS if your environmental factors are in favour of it. This is one of the reasons we see PCOS sufferers improve once lifestyle changes are introduced.
Inflammation plays a role
Women with PCOS have been shown to have higher levels of inflammatory markers in their blood. Inflammation worsens insulin resistance and PCOS. It is not known what is behind the excess inflammation but it may be related to gut health, inflammatory diets and genetic predispositions.
Stress is a normal part of life but when it becomes chronic it is bad news for PCOS. Chronic stress worsens insulin resistance and can even delay or halt ovulation. Wisely, nature delays reproductive processes in favour of dealing with the more urgent concerns that are causing the stress.
The contraceptive pill
Some women find themselves diagnosed with PCOS after coming off the pill. The pill itself can cause temporary hormonal dysregulation by interrupting the communication network between your brain and your ovaries, which may or may not reinstate its regular pattern after ceasing.
Some pills can also cause or worsen insulin resistance, leading to excess androgen production. Interestingly, the pill is the mainstream treatment for women with PCOS who are not trying to conceive. What is often not explained is that your PCOS will likely come back, sometimes even worse than before, when you come off the pill.
What to do now?
- avoid sugar and refined carbohydrates
- eat more veggies, especially non-starchy veg like green leaves, broccoli, asparagus, cabbage, capsicum, radish, beetroot, tomato, carrot, green beans, onions, leeks, cauliflower, celery, cucumber, tomato
- get moving more, particularly doing resistance exercises such as free weights, machine weights or resistance bands
Be gentle on yourself and aim to make sustainable, achievable changes that become a part of your lifestyle that you can feel good about and enjoy. Keep it simple to begin with and expand as you are used to your new exercise or food choice. Before you know it, you’ll begin to see positive changes in your body for all your hard work.
Natural Fertility Teacher (TTNFE)
Author of The PCOS Solution
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