PCOS
What is PCOS?
Polycystic Ovary Syndrome or PCOS affects about 10% of women in Ireland and is a leading cause of infertility. It is a condition that is caused by being resistant to insulin – the hormone that controls blood sugar levels. In PCOS, insulin levels can get too high which causes a number of problems. Insulin can trigger the ovaries to produce more male hormones, which leads to some of the signs of PCOS such as irregular (or absent) periods, excess hair on the face and legs, acne and, in some case, difficulty conceiving. Insulin also causes food cravings (especially for sugary or starchy foods like bread and chocolate) as well as increasing weight. Women with PCOS have a classic shape – putting weight on their tummies and having a round face – normally women put weight on their hips and thighs and put extra weight under their chin – creating a ‘long’ face. If you have irregular periods, excess hair and an apple rather than a pear shape, it may be PCOS and it is worth talking to your GP.
Extra weight is one of the main issues experienced by women with PCOS. Normal healthy eating doesn’t always work and women can struggle to lose weight – and can gain weight very easily. Working with a Dietitian can help you to find the foods that suit your body and help to you to manage your weight much more easily.
PCOS and fertility
Women with PCOS can also have some difficulty becoming pregnant. The excess male hormones can stop ovulation from happening fully or at all and, added to that, women with PCOS are more likely to have a miscarriage if they do become pregnant. In saying that, most women with PCOS do have babies, so you are not necessarily destined to be childless if you have PCOS but there is quite a lot you can do to boost your chances of becoming pregnant.
Dietitians can work with women who have PCOS to change how they eat to manage their condition. Some women want to lose weight others want to start a family – or both. They can guide you to the right foods and the right balance of nutrients that will help you to get to a healthy weight and help to manage the symptoms of PCOS.
Managing weight with PCOS
A big problem is that women with PCOS often find it much harder to lose weight than other women. Insulin resistance is probably at least partly to blame for this as insulin reduces fat burning, increases the amount of food we store after meals and can trigger intense food cravings. Any woman with PCOS will know all about the food cravings! This means that women with PCOS tend to struggle more with reducing calories and actually lose weight at a slower pace.
It’s not surprising, then, that eating disorders (such as bulimia) are much more common among women with PCOS. We see a lot of very frustrated women who have been fighting with weight for years and getting nowhere or even gaining weight on some plans. There are also plenty of women with PCOS who are not overweight but still show signs of insulin resistance. These women can also benefit from a diet that helps to manage insulin.
So what is the best diet for PCOS? Overall, reducing calories is the main aim if someone is overweight. However, diets that reduce (but not cut out) carbohydrate or which increase protein seem to be the most effective for women who are a healthy weight as well as those who are overweight. A low glycaemic index diet can be very helpful as it works to reduce insulin resistance. At the core, women with PCOS do need to look at the overall amount of carbs that they eat as well as the type. However, they also need to have a well-balanced plan that includes enough fibre and calcium and other micronutrients, especially if they are trying to become pregnant.
It is also important to remember that women with PCOS can still put on weight from all the usual places and we need to look at exercise, stress, sleep and emotional eating too.
The good news is that with the right support and the right advice, weight loss is possible for women PCOS. And even if you are not overweight, a good, balanced plan can bring a reduction in the PCOS symptoms that have such an impact in women with this condition.