PCOS is one of the most common reproductive health conditions in the world, affecting at least 1 in 10 people with periods - although this number could be much higher! Some research actually indicates that around 70% of people living with PCOS are yet to be diagnosed.
Despite PCOS being so common, it is routinely misunderstood and misdiagnosed. Here we’ll explain the signs and symptoms of this condition and share advice on managing symptoms naturally.
- PCOS can lead to a wide variety of symptoms - including acne, hair loss, hair growth in particular areas of the body and in some cases, issues with conceiving
- Whilst ovarian cysts are a common symptom of PCOS, you can have the condition without any cysts at all
- There are actually 4 different types of PCOS and each one can have different symptoms and solutions
- PCOS is very sensitive to our blood sugar levels and inflammation - so looking at your nutrition can make a huge difference to symptoms
PCOS vs Polycystic Ovaries
PCOS - or Polycystic Ovarian Syndrome - is a reproductive health condition, which as the name would suggest, is often linked to having polycystic ovaries. But what does that mean?
During our menstrual cycle, our ovarian follicles mature and eventually one will usually grow to the point that it is released - this is the process of ovulation. If you have polycystic ovaries, it can mean you don’t produce enough of the hormones needed to mature a follicle fully or trigger ovulation, and this can lead to your follicles developing cysts.
Getting diagnosed with PCOS
To diagnose PCOS, doctors use something called the Rotterdam Criteria. The Rotterdam Criteria states that you must have two out of these three symptoms to be diagnosed with PCOS.
- Oligomenorrhoea anovulation - aka irregular periods
- Clinical signs of hyperandrogenism - aka acne, hair growth on face or body, hair thinning
- Polycystic ovaries - which will usually be found during a scan
That means technically you can have PCOS without having Polycystic Ovaries!
Symptoms of PCOS
As PCOS is a collection of symptoms, different people may experience it differently. Some of the most common symptoms of the condition include:
- Ovarian cysts
- Irregular menstrual cycles
- Missing periods - usually caused by anovulation; meaning a complete lack of ovulation
- Thinning hair
- Hair growth in places like your back, stomach, chest or face
- Weight gain or difficulty losing weight
- Sugar cravings
- Low mood
- Energy drops and fatigue
- Oily skin or acne
- Some people with PCOS also find it difficult to conceive - usually due to the lack or irregularity of ovulation.
4 Types of PCOS
As we start to understand PCOS better, experts are recognising that there are actually different variations of the condition.
High Androgen PCOS
Androgens are a group of hormones that include the main male sex hormone testosterone. If people are living with High Androgen PCOS, they may be more prone to symptoms driven by testosterone, such as acne, weight gain, hair growth or male pattern baldness (aka hair thinning on your head).
Insulin Resistant PCOS
High insulin levels and insulin resistance are found in the majority of PCOS cases, but what does it actually mean? If you are insulin resistant it means your cells don’t respond well to insulin being produced by the pancreas - which makes it harder for them to turn glucose into energy.
This can lead to a bunch of health issues including high blood sugar levels and a risk of diabetes. High insulin levels can also cause or exacerbate high androgen levels and vice versa, so there is often a lot of overlap between symptoms. Some of the signs of insulin-resistant PCOS are sugar cravings and dramatic drops in energy.
If you don’t see insulin resistance as a factor of your PCOS, it could be that your symptoms are being driven by chronic inflammation. With chronic inflammation, our immune system constantly thinks our body is under attack and it starts to damage the cells in our body. This can have an impact on our hormonal health - in fact, chronic inflammation is one of the root causes of endometriosis. In PCOS the inflammation can increase our androgen levels - triggering symptoms like anovulation.
Post Pill PCOS
There is still a lack of scientific research to support the idea that the contraceptive pill can trigger PCOS symptoms - but many health practitioners believe this to be the case based on anecdotal evidence. The theory goes that when we take the pill it shuts off communication between our ovaries and our brain. It’s also believed that certain birth control pills can lead to higher androgen levels once coming off. The disruption birth control can cause to our menstrual cycle can certainly mean that it takes a while for our natural rhythm and hormonal balance to come back.
The concept of post-pill PCOS might also be linked to the fact that many people with early symptoms of PCOS are simply put on birth control in their teenage years, to manage (but really mask) symptoms like irregular periods or acne. Many women who come off birth control to try or have a baby are then confronted with these symptoms once again!
These different types of PCOS can often overlap, but understanding where your symptoms most likely fall can help you discover the best ways to manage it.
Is there a cure for PCOS?
There is currently no complete cure for PCOS, but there are ways that you manage the symptoms and limit the impact they have on your quality of life.
As mentioned above, one of the most common ways doctors deal with a PCOS diagnosis is to prescribe birth control that can ‘regulate’ the menstrual cycle and reduce the long-term risk of developing cancer of the womb lining (endometrial cancer) associated with not having regular periods. This may be helpful in the short term, but ultimately your symptoms will likely return once you stop taking contraception.
There are also medications you can take to help with your PCOS, including Clomifene (which encourages ovulation) and Metformin (which can lower insulin and blood sugar levels and is often used to treat type 2 diabetes). These medications are usually used for women who are struggling to conceive.
Managing PCOS Naturally
There are also many ways that you can help to manage your PCOS symptoms. Once you understand more about your symptoms and the potential root cause of your PCOS, you can make impactful and sustainable lifestyle changes.
Tackling Androgens - If you are keen to reduce symptoms like acne and unwanted hair growth, whilst also working to balance your hormones and regulate your cycle, eating foods that are known to lower testosterone levels is a great place to start. Oily fish, nuts and soy products are all thought to help reduce androgens and spearmint tea has also been found to tackle symptoms of high-androgen PCOS.
Anti-Inflammatory Foods - Turmeric is a great natural anti-inflammatory and you can take it in so many ways - in a curry, in a latte or even as a supplement. Eating a Mediterranean diet is also a great way to ensure you’re getting plenty of anti-inflammatory foods. Olive oil, tomatoes, leafy greens, fatty fish like mackerel and tuna, and tree nuts all fight inflammation.
Balancing Blood Sugar - One of the easiest ways to balance your blood sugar levels is to eat more complex carbohydrates and eat plenty of protein - especially first thing in the morning. Also, try to eat whole foods which have had limited exposure to additives or preservatives - think fresh fruits and vegetables, legumes and lean meats over takeaways, ready meals and sugary snacks.
There are also supplements and herbal remedies you can take that may help with certain symptoms or triggers of PCOS.
Maca root - Maca root may help to balance hormones and lower cortisol levels. It may also help treat depression, which can be a symptom of PCOS.
Ashwagandha - Ashwagandha can help balance cortisol levels, which could reduce stress and symptoms of PCOS as well as balance hormones.
Holy basil - Holy basil is often referred to as the “queen of herbs” and addresses chemical and metabolic stress. It can also help reduce your blood sugar levels, prevent weight gain, and lower your cortisol levels.
Liquorice root - The root of the liquorice plant contains a compound called glycyrrhizin, which has several unique properties. It is a known anti-inflammatory and can also help to metabolise sugar and balance hormones.
Zinc - Zinc is great for reproductive health and can boost both your fertility and your immune system. Excessive or unwanted hair growth and hair loss may also be improved with zinc supplements.
Evening primrose oil - Evening primrose oil is often used to help with period pain and irregular menstruation. It may also improve cholesterol levels and oxidative stress, both of which are linked to PCOS.
Stress, sleep and lack of exercise can also all contribute to increased inflammation that can exacerbate PCOS symptoms. Making time for rest, movement and self-care will also help to support your emotional well-being - and various studies have indicated a link between PCOS and mental health issues.
Aim to get at least 7-8 hours of sleep a night, listen to your body when it needs time out and try to exercise throughout your cycle.