Polycystic Ovarian Syndrome (PCOS) is not uncommon and affects 8-20% of women worldwide. It is a problem in which a woman’s hormones are out of balance. Hormones are chemical messengers that trigger many different processes, including growth and energy production. For reasons that are not well understood, in PCOS the hormones get out of balance. One hormone change can trigger another, which changes another. In the case of PCOS sex hormones, thyroid function and insulin resistance all correlate and impact each other.
For example, elevated levels of male sex hormones leads to increased insulin resistance, and higher TSH levels.
To explain in more detail, in individuals with PCOS the sex hormones get out of balance. Normally our ovaries produce just a small amount of male sex hormones (androgens). But with PCOS they start making slightly more and may result in symptoms such as the stopping of ovulation and increased likelihood of acne. The increased amount of male sex hormones reduces sensitivity to insulin. Insulin is a hormone produced by our pancreas and is necessary for regulating blood sugar levels. With a reduced sensitivity to insulin there is too much insulin in the blood. Long term exposure to elevated insulin levels increases the risk of developing diabetes as well as an increased risk of high blood pressure, high cholesterol, hardening of the arteries, coronary artery disease, heart attack and stroke. The elevated levels of male sex hormones also have a correlated impact on thyroid function which is important for how our body uses energy (metabolism). Many individuals with PCOS are diagnosed with Hypothyroidism and other related thyroid diseases such as Hashimoto’s. Women with lower levels of insulin resistance often have lower TSH levels and the higher the insulin resistance the higher the TSH levels.
As a result of the hormone imbalances present with PCOS many women also struggle with weight management.
So what CAN YOU do to live with PCOS?
A doctor may prescribe medication to help manage hormones and reduce symptoms present, but regular exercise and balanced nutrition can also help by balancing hormones and reducing insulin insensitivity, as well as improving your overall health and wellness.
Exercise has been shown to improve insulin sensitivity and metabolic function in all populations by increasing our bodies demand for using energy and reduce blood sugar levels so that the body does not need to release excess amounts of insulin to do so.
For individuals with PCOS the following is recommended:
- 30 minutes of activity daily, with 20 minutes of cardiovascular interval training
- 3 days a week of strength training
- Exercise before a meal will improve metabolism by increasing your bodies demand for energy
Nutrition is also an effective way to manage PCOS by regulating the body’s intake of energy. A diet similar to that of a diabetic is recommended.
- Restricted calorie intake, which may be approximately 400 calories less than populations without PCOS.
- Focus on a low carb and high fiber diet by including plenty of high fiber fruits and veggies and whole grain starches (in moderation), as well a lean protein and plant based fats.
Foods to Avoid:
- Foods high in refined carbs, such as white bread, and other baked goods that contain white flour and processed sugar
- Sugary snacks or drinks
- Foods high in saturated fat such as meat, cheese and fried foods
Some of the best high fiber foods include:
- Brussel Sprouts
- Whole wheat pasta
- Pearl barley
Other ways to increase fiber in your diet….try adding these foods:
- Flax seeds
- Chia seeds
- Spinach and carrots- these are not as high in fiber as previously listed foods but can easily be added into baked goods like banana bread, shakes/smoothies, and eggs
- Pureed vegetables, as well as bean and lentils can be added to soups, stews, and sauces for that extra fiber and as a thickener without adding any starch
Even though these are the recommendations for those with PCOS they are not unlike the basic recommendations for maintaining health and wellness in the general population. Stay active and make exercise a part of your daily routine and balance it with a diet of nutritious foods, and be patient to see results. They don’t happen overnight, but consistent healthy habits will produce the long term results and have an impact on your health long term.
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All the best
Becky Doherty, Registered Kinesiologists