How to Manage PCOS (Polycystic Ovarian Syndrome) by Dr Larisa Corda

It’s an honour to welcome back Dr. Larisa Corda, not only a Obstetrician and Gynaecologist but also one of the UK’s leading Fertility Experts. Here, she offers deep insight into PCOS (Polycystic Ovarian Syndrome), something I personal suffer from and was interviewed about in the Huffington Post recently.

For more details, please visit www.drlarisacorda.com.

 

PCOS/ Polycystic ovaries affect 1 in 5 women in the UK and are therefore very common.

The term is a bit of a misnomer in that the ovaries do not contain cysts but instead small follicles that contain multiple immature eggs. Not all women with polycystic ovaries have the syndrome and not all women with polycystic ovarian syndrome (PCOS) have all the symptoms, which can vary. Essentially, it involves a hormonal imbalance in the body that can lead to metabolic and fertility-related problems.

Common symptoms of PCOS include:

• irregular periods or no periods at all
• difficulty getting pregnant (because of irregular ovulation or failure to ovulate)
• excessive hair growth (hirsutism)– usually on the face, chest, back or buttocks
• weight gain
• thinning hair and hair loss from the head 
• oily skin or acne

 

Fertility problems

PCO accounts for one of the commonest reasons behind female infertility. This is due to a hormonal imbalance that can mean a woman may not ovulate each month. As a result, an egg is not released and available to fertilise.

 

Metabolic problems

Having PCOS can increase your chances of developing other health problems in later life related to disturbances in metabolism. For example, women with PCOS are at increased risk of developing:

• type 2 diabetes – due to insulin resistance, meaning that blood sugar levels become difficult to control
• high blood pressure and high cholesterol – which can lead to heart disease and stroke
• sleep apnea – overweight women may also develop sleep apnoea, a condition that causes interrupted breathing during sleep

In addition, women who have very irregular periods are at risk of developing endometrial or womb cancer, which can be minimized by being on the oral contraceptive pill or having a coil inserted in your womb.

 

How PCOS is diagnosed

If you have any of the symptoms discussed above, go and see your GP who will also order some blood tests and an ultrasound scan to assess the ovaries. A diagnosis is made using a combination of symptoms, blood tests and ultrasound findings.

 

How is PCOS treated?

 

Lifestyle changes

The good news is that there’s lots of things that you can first do naturally to help with this condition and to improve the chances of spontaneous ovulation, reduce insulin resistance, improve your fertility and also reduce the risk of miscarriage.

Diet: Eat lean, clean and organic food where possible in its most wholesome state.

These are foods that are free from artificial sugars, hormones, and preservatives. They are as close to their natural, unprocessed state as possible, and don’t involve a lot of preparation or cooking.

Eating a lot of good quality plant-based protein and fats from nuts, legumes and whole grains can also help improve insulin resistance and overall metabolism.

Also, focus on eating complex carbs instead of refined sugars to help improve blood sugar control, which is often a problem with PCO.

Plenty of fibre is also important to help reduce the speed at which sugar is released in your bloodstream.

Consider dairy alternatives: PCO is a chronic inflammatory condition and much of the dairy we now consume has hormones that when ingested can flare up any condition such as PCO.

Whilst dairy is important in terms of our calcium and Vitamin D intake, consider finding alternatives to cow’s milk and instead go for coconut, almond or oat milk, making sure that the version you buy is fortified with vitamins, as many are not.

Consider supplements: Supplements such as cinnamon, magnesium, turmeric, zinc and evening primrose oil could be of benefit to help to either improve blood sugar control or reduce chronic inflammation as well as alleviating the side effects of heavy periods that can be associated with PCO, especially in those women who only bleed irregularly.

Probiotics are also important as they can help to improve hormonal imbalances and reduce inflammation.

Reduce stress: Stress can be a major contributing factor to inflammation, as can anything that increases the body’s stress hormone, cortisol, such as coffee.

Learning to practice mindfulness and meditatation is important for this, as well as keeping caffeine to a minimum of one cup of tea or coffee a day.

Many women with PCO also suffer from depression and so these techniques are also important for that too. Make sure you see a counsellor or get external help if you are suffering.

Prioritise exercise: This is vital as not only will regular exercise help you to maintain a healthy body mass index, which in itself can improve ovulation, but it will lift your mood, reduce your risk of cardiovascular disease (which is higher in women with PCO) and also improve insulin sensitivity.

As a result, exercise will improve your overall metabolism and ability to process sugar.

Up to 150 minutes per week of mixed aerobic and anaerobic exercise is what’s been recommended for women looking to get pregnant. Weight loss of even 5% will significantly increase your chance of ovulation.

Sleep well and consider acupuncture.

Sleep is vital for us all as it’s the prime time when the body detoxes itself from excess hormones which if left, could start to have adverse effects on your health.

So, prioritising sleep and doing what you can to help you to do this, such as using essential oils, removing all disruptive equipment from the bedroom, going to bed earlier, is important.

In addition, acupuncture can help to improve sleep, as well as blood flow to the ovaries and womb, with also some potential benefits to lower insulin resistance.

Pay attention to products you use around the house and on yourself.

A lot of these are full of chemicals and synthetics which are recognised as endocrine disruptors or, in other words, interfere with your hormones.

With a condition like PCOS where hormone imbalances are already an issue, this can make the problem worse, so try and replace products with more natural eco-friendly alternatives where you can. Even avoiding tap water and instead getting a filter is of benefit as traces of hormones can be found in tap water too.

 

Medications

Certain medications can be used to help improve regularity of periods and reduce the risk of uterine cancer. Most typically, this is the oral contraceptive pill. However, for those women looking to conceive, other medication, such as clomiphene, can be used to improve the chance of ovulation and therefore pregnancy. Ultimately, IVF can be used to help.

In addition, metformin is often used to treat type 2 diabetes but it can also lower insulin and blood sugar levels in women with PCOS. As well as stimulating ovulation, encouraging regular monthly periods and lowering the risk of miscarriage, metformin can also have other long-term health benefits, such as lowering high cholesterol levels and reducing the risk of heart disease.

Your doctor will decide on the best medication to put you on by doing an overall assessment.

Other medications

Medications can also be used to treat some of the other problems associated with PCOS, including:

• weight-loss medication, such as orlistat, if you’re overweight
• cholesterol-lowering medication (statins) if you have high levels of cholesterol in your blood
• acne treatments
• excessive hair growth treatments

 

Surgery

If PCOS does not respond to medication, sometimes something called laparoscopic ovarian drilling is done which involves stimulating the ovaries with heat during keyhole surgery.

 

Pregnancy risks

If you have PCOS, you have a higher risk of pregnancy complications, such as high blood pressure (hypertension), pre-eclampsia, gestational diabetes and miscarriage. These risks are all greater if you’re overweight, so by reducing weight, you can lower the chances of all these potential problems and improve the chance of pregnancy in the first instance.

In fact, the more you can do to get yourself in the healthiest possible condition before pregnancy, the lower the chance of any problems in your pregnancy. 

For more tips on PCO, including recipe ideas you can use to help improve your diet, as well as fitness routines, please visit my website on www.drlarisacorda.com or follow me on Instagram @drlarisacorda.

Top photo by Amy Shamblen on Unsplash