September is PCOS awareness month. Yes, we agree – there are more awareness days, weeks and months nowadays than you’ve probably had hot dinners, but there are several that we consider to be important. Given that PCOS affects between 5 and 10% of women, this is an important one.
So PCOS. Sounds a bit like a new cool-kids acronym, or perhaps even a Pokémon character, but it actually stands for Polycystic Ovary Syndrome. Small, fluid-filled sacs called follicles grow inside the ovaries; each containing an immature egg. The eggs never mature enough to trigger ovulation, and this lack of ovulation alters hormone levels: oestrogen and progesterone levels are lower than usual, while androgen levels (male hormones) are higher than usual.
Whilst many women have polycystic ovaries, to be diagnosed with the syndrome, you may have some or all of the following symptoms:
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
thinning hair and hair loss from the head
oily skin or acne
We chatted with Hayley Down, a registered Nutritionist and specialist in women’s hormonal health to get answers to Team HL's top PCOS-related questions.
What causes PCOS?
Whilst the exact cause is unknown, it’s thought that genetics, being on the oral contraceptive pill, environmental factors as well as insulin dysregulation, chronic stress and poor digestive function can all contribute to PCOS.
How exactly is the menstrual cycle affected by PCOS?
Women with PCOS often have missing or irregular periods because they have excess androgens. Although it’s completely normal for women to have androgen hormones, in women with PCOS, the ovaries secrete more androgens than in women who don’t have PCOS. PCOS also affects how ovaries work and can lead to the formation of small undeveloped cysts in the ovaries. This can affect the menstrual cycle as some of the sacs are unable to release an egg, inhibiting ovulation.
Some who have PCOS experience (sometimes debilitating) fatigue and some don’t. Why is this?
Women whose PCOS is driven by insulin resistance or issues with blood sugar regulation can experience fatigue. Other causes of debilitating fatigue in women with PCOS include thyroid conditions, low levels of vitamin B12 (a common side effect of the PCOS medication Metformin) and also low iron or vitamin D levels.
Why is it linked to infertility?
Because the cycle is altered: 40% of women with PCOS have chronic anovulation (where the ovary fails to mature or release eggs each month).
Is there a link between PCOS and gut health?
Optimal digestion is key for successfully managing PCOS. PCOS has been associated with excess oestrogen or poor oestrogen clearance via the liver and bowel so it’s really important to ensure that gut function is optimised for the successful management of PCOS.
The digestive system is key to hormone health, and PCOS is an endocrine and metabolic disorder that affects more than just the ovaries.
Are there any supplements that women with PCOS should take?
Always consult your GP/Health Practitioner before taking any supplements, especially if you are on any medication or have any pre-existing health issues.
That said, yes, there are a few supplements that have been shown to support those with PCOS. Magnesium can be really beneficial in supporting insulin levels, reducing inflammation and adrenal health. Chromium or Myo-Inositol can be helpful for blood sugar. Likewise, a good quality Omega-3 fish oil supplement can be helpful in reducing inflammation and improving fertility levels. Vitamin D has also shown to be helpful in supporting those with PCOS, though it’s always best to get tested to check your levels prior to supplementing.
Is there anything that perhaps is commonly overlooked that you consider to be important in treating PCOS?
It's possible to have PCOS without having ovarian cysts. They are a symptom rather than a cause. PCOS cysts are different than the kind of ovarian cysts that grow, rupture, and cause pain.