We spoke to registered nutritional therapist Jen Walpole about the challenges and management of polycystic ovary syndrome (PCOS) symptoms
Androgens are a group of sex hormones that contribute to the onset of puberty and play a crucial role in reproductive health and body development in both men and women. They also support bone density, muscle development, red blood cell production, sexual desire and function. Four types of androgen hormones include dihydrotestosterone, dehydroepiandrosterone, androstenedione, and the most common, testosterone. An imbalance in androgen levels can cause health issues, such as fatigue, osteoporosis, and low sex drive. In women, excess production of androgens can cause abnormal periods, excessive hair growth and fertility issues. The most common cause of excess production of androgens in women is polycystic ovary syndrome (PCOS).To discuss some of the challenges associated with PCOS and what can be done to support symptoms, we spoke to nutritional therapist Jen Walpole.
How common is PCOS? Are there certain risk factors?
PCOS is surprisingly common, affecting an estimated 8-13% of women of reproductive age globally, according to the World Health Organization (WHO). This translates to roughly eight million women in the UK and 256 million worldwide. Unfortunately, up to 70% of cases remain undiagnosed, especially in the early stages. While the exact cause remains unknown, several risk factors can make you more susceptible, including family history and genetics, insulin resistance and obesity.
What are the key challenges currently facing the management and treatment of PCOS?
There are several key challenges currently facing the management of PCOS. Firstly, it manifests differently in each woman, making diagnosis and treatment complex. For example, some women can be classed as a ‘leaner’ type of PCOS, whilst others may be overweight. A one-size-fits-all approach rarely works. Secondly, the exact cause of PCOS remains unknown, hindering the management of the condition. Current options like the oral contraceptive pill, metformin or letrozole often manage symptoms but don’t address the root cause and personalised approaches combining medical care, dietary adjustments, and lifestyle interventions are what’s needed. Finally, PCOS can significantly impact mental wellbeing due to fertility concerns, body image issues, and social stigma around some of the symptoms, such as hirsutism and obesity. The lack of comprehensive support systems addressing these challenges adds another layer of difficulty.
Can you outline the biological and psychological effects of PCOS?
PCOS has several biological and psychological effects. It most commonly presents with hormonal imbalances, including elevated androgens such as testosterone, which leads to irregular periods, excess hair growth, and acne. Altered oestrogen and progesterone levels can affect fertility due to anovulation. Women with PCOS are more likely to develop insulin resistance, which increases the risk of type 2 diabetes. Unhealthy cholesterol levels are also common. The psychological effects can include anxiety and depression. This can be due to difficulty conceiving, body image issues, and social stigma. Physical changes and societal expectations can impact self-worth and confidence. Finally, navigating PCOS within relationships can be challenging and require open communication and understanding, particularly when fertility issues arise.
How can diet and lifestyle impact PCOS symptoms?
As a nutritional therapist specialising in PCOS and fertility, diet and lifestyle play a crucial role in improving your wellbeing. Firstly, blood sugar balance is key. PCOS often involves insulin resistance, where your body struggles to use insulin effectively. This can lead to higher blood sugar levels and worsen PCOS symptoms. Following a low glycaemic index (GI) diet can be helpful. This involves opting for whole grains like brown rice, quinoa, and wholewheat bread over refined carbohydrates like white bread, pasta, and pastries. These release sugar slower, preventing blood sugar spikes and promoting better insulin sensitivity. Lean protein also helps regulate blood sugar, keeps you feeling fuller for longer, and supports muscle mass, which is crucial for overall health and metabolic function.
Aim for protein at every meal, including breakfast – think eggs, Greek yoghurt, chicken, fish, beans, lentils or tofu.
Finally, don’t fear fats! Include healthy fats from sources like oily fish (salmon, mackerel, sardines), nuts, seeds, and avocados. These provide essential nutrients, support hormone balance, and can improve insulin sensitivity. Consider fish oil supplements to boost omega-3 fatty acids, which have anti-inflammatory properties and may improve PCOS symptoms.
Regarding supplementation, myo-inositol, a naturally occurring sugar-like molecule, shows promising results in improving insulin sensitivity and ovulation in PCOS patients. While further research is needed, its potential benefits are worth considering.
Remember, diet is just one piece of the puzzle. Prioritise quality sleep, regular exercise (especially strength training to build lean muscle) and manage stress through activities like yoga or meditation. These lifestyle changes can significantly improve your overall health and well-being and, in turn, your PCOS symptoms.
References
- World Health Organization:
- PCOS Association UK:
- National Institute of Health:
