Polycystic Ovarian Syndrome, or PCOS, is a complex condition. It is driven by a variety of factors including insulin resistance, androgen excess, estrogen and progesterone imbalance and inflammation. Because of this complexity, diagnosing PCOS can be drawn out and frustrating for women. PCOS can affect your cardiovascular health, your fertility and many other aspects of your life.
What Causes PCOS?
Because of the complexity of PCOS, we don't know the exact cause. There is also the indivudual factor. For different persons, there are different underlying drivers for this condition, but we do know that several components including genetics, in utero exposure, and external factors like exposure to endocrine disrupting chemicals (EDCs) are involved.
Causes of PCOS
While research has not yet discovered the exact cause of PCOS, research has illuminated several possible components that drive this condition. PCOS is generally driven by a combination of high androgen hormones, blood sugar dysregulation and genetic factors.
There are a lot of hormones at play to ensure our reproductive and overall health. PCOS is often driven by elevated hormone levels whether that be testosterone, estrogen or even inflammatory elevated cortisol. Hormonal disturbance is one of the prevalent drivers of PCOS and affects more than 80% of women with this condition. This often presents as a combination of elevated testosterone, estrogen, follicle stimulating hormone (FSH) or luteinizing hormone (LH). These hormone imbalances often lead to irregular or lack of ovulation posing a challenge for those trying to conceive for pregnancy. However, becoming pregnant with PCOS is not impossible but it does require some intentional work on nutrition and lifestyle and medication treatment.
Insulin resistance (IR) describes the body’s decreased ability to respond to insulin and effectively take up glucose for energy into your body’s cells. Insulin resistance is a complex condition in itself and is often affected by dietary habits and elevated blood sugar levels. While insulin is a key hormone in metabolism, blood sugar control and weight loss or gain, research has shown that insulin also plays a key role in the activities of sex hormones like LH, testosterone and estrogen. IR is thought to affect between 30-40% of women with PCOS regardless of body size. Effective treatments for improving insulin resistance include diet, movement, supplementation or medication.
To further complicate this complex condition, research shows that genetic factors also influence the occurrence of PCOS. This area of research is still limited so we don’t yet understand the full impact of genetics on this condition. Since we don’t have the ability to change our genes and reverse or cure this condition, it’s helpful to understand that you are not the cause or the blame for this experience. While not always the case, women with PCOS often suffer uncontrolled weight gain and carry excess weight. Because of the challenges around losing weight based on factors like hormone imbalance and insulin resistance, women often are given the blame of this condition when seeking support from their healthcare provider. Though weight loss can alleviate some of the symptoms of PCOS, addressing underlying factors like inflammation, dysregulated blood sugar, insulin resistance and hormone imbalances will offer a longer lasting beneficial effect to minimizing symptoms and also improving fertility for women with PCOS. So while you can’t change our genetics, you can make the best out of the hand you were dealt.
Symptoms of PCOS
To get to the root cause of PCOS, it is important to understand what symptoms can be a driving indication that you have this condition. Symptoms can vary from one individual to the next and the experience is different for each person.
One of the most common symptoms that relates to PCOS is irregular periods however, research shows that up to 30% of those with PCOS actually have regular cycles. Facial hair growth (hirsutism) is also a common symptom of high androgen hormones thought to occur in up to 70% of women with PCOS. Abnormal hair growth can also affect other areas of the body including chest, back, abdomen, arms and thighs. Due to the complex dysfunction of hormones, insulin and inflammation, one of the overarching challenging women with PCOS face is infertility and struggles with trying to conceive.
Symptoms of PCOS can include a combination of the following:
Severe premenstrual symptoms (PMS)
Painful or heavy periods
Getting a PCOS Diagnosis
If you are struggeling with these symptoms or suspect you might have PCOS, it is best to schedule an appointment with your physician or OB/Gyn specialist to have a thorough workup done. This process can include extensive blood testing and ultrasound exams. Once diagnosed, your provider will discuss treatment options that can include hormone contraceptive and other prescriptions. I’m here to also weigh in on the importance of diet and lifestyle in managing this chronic condition.
To learn more about using nutrition to improve your hormone health and fertility, contact Aida Sadeghi, MS, CNS owner of FeelGoodEats Nutrition. Schedule a free consultation call with FeelGoodEats Nutrition. Together we will design a meal guide that works for you and your unique lifestyle while providing everything you and your baby will need over the next several months.