Polycystic Ovarian Syndrome (PCOS): The Ultimate Guide to PCOS

Polycystic ovarian syndrome affects between 5 and 20% of women of childbearing age (depending on where you look for statistics). That is as high as 1 out of 5 women between the ages of 16-40. PCOS affects A LOT of ladies. It is a complex condition, which we will explore more deeply.

If you are one of us, please read on, we can beat this PCOS thing together!

Please read: This information is provided for educational purposes only and is not intended to treat, diagnose or prevent any disease. We encourage you to make your own health care decisions in partnership with a qualified health care professional.

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What is Polycystic Ovarian Syndrome?
What are the PCOS Symptoms
Why Are The Symptoms Of PCOS Different in Everyone?
What causes PCOS?
Is PCOS Genetic?
PCOS Treatment – Can you get rid of Polycystic Ovary Syndrome?
Can PCOS Be Cured With Medications?
How do I Lose Weight with PCOS?
What not to Eat with PCOS for Optimum Health
How can I Get Pregnant with PCOS?
Is It Possible To Get Pregnant With PCOS Without Treatment?
How does Polycystic Ovaries affect Pregnancy?
Can you get Pregnant with PCOS without a Period?
PCOS and Pregnancy – Success Naturally?

What is Polycystic Ovarian Syndrome?

PCOS is a hormonal condition, which affects many aspects of a womans body.

With PCOS, your reproductive hormones are all out of balance. This can lead to problems with your reproductive system, such as not having your period on time, or missing it entirely. As well as affecting the rest of your body.

Hormones are simply substances your body makes to help different processes happen, the ones that are specifically involved in PCOS include:

Androgens

Often called “male” hormones, or sometimes referred to as just testosterone. Women actually need to have them too.

Those with PCOS tend to have higher levels of androgens (testosterone being one of several androgens), which can cause symptoms like hair loss, hair in places you don’t want it, and trouble getting or staying pregnant.

Insulin

This hormone manages your blood sugar, fat use and fat storage. If you have PCOS, your body might not react to insulin the way that it should, you may be told that you have insulin resistance, or diabetes if it is more severe.

Progesterone

With PCOS, your body may not have enough of this important hormone. Poor progesterone levels can make you to miss your periods for a long time, or to have periods that are really hard to predict.

Progesterone is also the hormone responsible for restful sleep, and it keeps estrogen (the fat building hormone) in balance.

What does PCOS Mean?

PCOS stands for Polycystic Ovarian Syndrome, it is also known as polycystic ovary disease, functional ovarian hyperandrogenism, ovarian hyperthecosis, sclerocystic ovary syndrome, and Stein–Leventhal syndrome.

PCOS got its most widely used name due to the most common sign on ultrasound – of numerous (poly) ovarian cysts.

These “cysts” are actually naturally occurring immature follicles, not true cysts. So reassuringly they are not filled with pus or cancer. They are annoying, but not deadly.

The follicles have developed as part of the normal ovulation process, but the development has stopped at an early stage due to the disturbed ovarian function.

These half matured follicles may be sitting along the ovary edge, appearing as a ‘string of pearls’ on ultrasound examination.

In a normal ovary, several follicles develop each month, but one ripens fully and goes on to release it’s egg, the other follicles get re-absorbed. But in PCOS they seldom fully ripen, which means often there is no egg released (no ovulation) so there is no trigger to re-absorb the unripened follicles.

HOWEVER, some women have perfect looking (and sometimes functioning) ovaries, but still have enough other symptoms to fit the PCOS diagnosis criteria.

What are the PCOS Symptoms

Polycystic Ovarian Syndrome can be a complex condition to diagnose. This is because it isn’t a disease as such, it is a syndrome.

Diseases have a specific cause, specific symptoms and specific treatments. A syndrome is simply a collection of symptoms that you may, or may not, have. This means that the list of PCOS symptoms is rather long.

Irregular or absent periods
Ovarian cysts (on ultrasound scan)
Irregular or no ovulation
Moderate to severe acne
Difficulty in conceiving or taking a long time to conceive
Weight gain / obesity / OR inability to gain weight
Hirsutism – Unwanted hair growth on the chin, upper lip, stomach, or chest
Thinning of hair on the head
Headache / Migraines
Sleep problems / Insomnia
Dandruff
Darker pigmentation in the folds of the skin – most commonly seen in the back of the neck, under the arms, or creases of the thighs
Skin tags
Depression and anxiety
Sleep apnea
Fatty liver
Problems with breast milk production
Insulin resistance
Abnormally high LH:FSH ratios

Usually to meet the criteria for a diagnosis of PCOS, on a pelvic ultrasound scan there will be 12 or more follicles visible on one or both ovaries, measuring between 2 and 9mm.

Alongside these results, a blood test will be carried out to look for increased levels in testosterone and LH (luteinising hormone), whereas FSH (follicle stimulating hormone) and SBGH (sex hormone binding globulin) will be at normal or reduced levels.

Why Are The Symptoms Of PCOS Different in Everyone?

This is because we are all different. Our bodies react to the hormones differently and what is a high androgen level for you, might be normal for my body, and so on with the other hormones.

PCOS is a syndrome – a collection of symptoms, and you don’t have to have all the symptoms to qualify. In fact, you don’t even have to have multiple cysts on your ovaries to qualify!

What Causes PCOS?

To be honest, we don’t know yet. There is definitely a genetic component, if your mother had PCOS then the chances are much higher that you will also get it.

Doctors believe that high levels of male hormones (androgens, particularly testosterone) prevent the ovaries from producing hormones and making eggs normally.

Genes, insulin resistance, and inflammation have all been linked to excess androgen production.

Is PCOS Genetic?

Studies show that PCOS runs in families (1).

It’s likely that many genes — not just one — contribute to the condition (2).

Insulin resistance

Up to 70 percent of women with PCOS have insulin resistance, meaning that their cells can’t use insulin properly as they have become desensitized to it (3).

Extra insulin triggers the ovaries to produce more male hormones.

Obesity is a major cause of insulin resistance. Both obesity and insulin resistance can increase your risk for type 2 diabetes (4).

Inflammation

Women with PCOS often have increased levels of inflammation in their body. Being overweight can also contribute to inflammation, but then higher inflammation also causes weight gain. It is a horrible upward spiral. One that doctors just don’t understand.

Studies have linked excess inflammation to higher androgen levels (9). Underlying food intolerances, pollution and chronic stress are also major factors in modern day raised inflammation markers in the general population, especially women with PCOS.

PCOS Treatment – Can you get rid of Polycystic Ovary Syndrome?

Most doctors will say there is no cure for PCOS. But there are plenty of women who have totally cured their PCOS with dietary and lifestyle changes and some key supplements.

The aim of a diet for PCOS is to

1) Remove inflammation

2) Stabilize blood sugar levels

3) Replace the missing and depleted nutrients

A sick body cannot lose weight. A healthy body will heal itself and find it’s own center. By increasing the nutrition, and removing the toxic rubbish, we can cure PCOS naturally.

Ideally you would be getting at least 25% of your daily calories from protein, less than 40% of your calories from carbohydrates and make the rest up with healthy fats.

Because our bodies are so out of whack, many of us really benefit from some hormone balancing herbs and vitamins. Myo-inositol and Vitex are my two favorites, as well as a top quality cod liver oil.

Can PCOS Be Cured With Medications?

NO. No matter what your doctor tells you, no amount of going on the oral contraceptive pill is going to help or cure your PCOS. All it does is mask the problem.

You don’t have symptoms anymore, you stop seeing the doctor, all is presumed better. Your cycle is regular (due to the pills) so it seems like it worked.

It didn’t.

Try coming off of the pill for 6 months. If you managed to get a period in that time, then yay! But more commonly, people come off the pill to try and get pregnant, only to discover the underlying PCOS is still there.

They still do not ovulate, and the longer they are off the pill, the more of the classic symptoms start turning up again.

That is because the oral contraceptive pill does not cure PCOS! If anything, it makes it worse as it shuts down your body’s natural hormone feed-back loop, so now it has to start again, from scratch.

While people are on the pill, they tend to blame the pill for the weight gain, and the moodiness, and the cravings. We don’t learn to eat well to help our symptoms, cos we don’t know any better. We believe what the doctor said, this pill will fix your PCOS.

But it doesn’t, sorry folks.

Metformin

Another medication that we are often prescribed is Metformin (Glucophage, Fortamet, others). Using Metformin for treating PCOS is, at best, an off-label use.

It does seem to help somewhat with insulin resistance, and in some women it reduces sugar cravings. Some women find they lose weight on metformin, but this seems to be more related to it’s common side effect – ongoing nausea and upset stomachs.

If you are finding Metformin is working for you, I am not suggesting that you stop it. But, what I am suggesting is that you should look into more long term, effective lifestyle changes. A healthy whole food diet, effective supplements and regular weight-bearing exercise.

How do I Lose Weight with PCOS?

This is the tough one. It is hard. I know it is hard, I have been there, and I am still struggling with it. And chances are your doctor, dietitian, family and friends just don’t ‘get’ it either. “Just lose some weight and your PCOS will get better” they say. Hahaha. If only it was that easy!

Why is it so hard to lose weight with PCOS??

It is a multi-faceted issue.

1) Hormones

PCOS gives you too much estrogen, and not enough progesterone. Estrogen is the hormone that makes you hungry AND helps you store fat. And on top of that, guess what? Fat cells produce more estrogen.

When you ovulate, your body starts making much more progesterone, this is a sleepy sluggish hormone, designed to slow you down and protect your body in case you are pregnant. It allows you to burn the fat, and slows down digestion, meaning you absorb more goodness from it, but you are also less hungry.

2) Insulin Resistance

If your body has developed insulin resistance, it means it cannot use the insulin in your blood properly, so it makes more and more of it. Insulin’s role is to move sugar from the blood into your cells. If this mechanism isn’t working, the excess sugar goes to the liver, where it is transformed in to fat.

The problem is, your cells are still hungry, crying out for that sugar, so they tell your body that you are hungry. So you eat more, even though there is actually plenty of energy being eaten and stored as fat.

In a properly functioning body, the fat can be changed back into sugars when the body is hungry and it gets used back up.

But because your insulin delivery system is broken, the energy (sugars) cannot get in to your cells, so you feel tired and lethargic, you crave sugar, AND your body slows its metabolism down because your cells are starving.

3) Chronic Inflammation

An inflamed body cannot function right. Chronic inflammation can be caused by stress, food allergies and pollutants.

All of these things put stress on your liver, and your liver is busy trying to metabolize and get rid of all that excess estrogen your body is making. But halfway through that process, your liver is being interrupted, to process these more urgent chemicals related to stress and toxins.

This means that the half processed, but still active estrogen is re-released back into your blood stream only increasing the estrogen effects further.

Chronic inflammation also seems to play a part in developing insulin resistance in the first place, and high insulin levels can trigger inflammation (5). Again it is that horrible ever-worsening spiral.

What does inflammation do in your body?

A body in this state of inflammation is on high alert at all times. You have excess fluid stored at inflamed sites to allow for extra passage of nutrients and white blood cells, who are marching around their territories on guard constantly.

Your immune system is making and using up your immune cells very quickly. You may well catch every illness going, as your immune system is stretched to full capacity already.

There is an emphasis on storing and keeping fat in case this high alert going full disaster and our food supply being cut off (think of what our bodies are wired to protect us from, a chronic high alert scenario was one of war, famine or natural disaster).

Cholesterol in the blood is high, cholesterol is what your body bases most of it’s hormones on, so in a stress situation you are burning through your hormones, so your need lots of cholesterol around on hand to quickly make more. It is also the soft fat used to patch holes and cracks in stressed and inflamed blood vessels.

High cholesterol doesn’t CAUSE heart disease. Inflammation causes it. The plaques we blame heart disease on, are formed to try and heal our inflamed and stressed veins and arteries.

The problem comes when we don’t address and stop the inflammation, and when we keep eating unnatural oils (soy, canola and corn) which our body cannot form into light, fluffy ‘good’ cholesterol, so it makes it into hard, horrible ‘bad’ cholesterol because when the dam has a hole, you use whatever you have on hand to plug the gap right?

Why the sudden big rant about heart disease??

Women with PCOS are at much greater risk of developing heart disease (6).

Chronically inflamed bodies are tired, depleted and sick.

What not to Eat with PCOS for Optimum Health and to Reduce Inflammation

Inflammation is often caused by undiagnosed food allergies/intolerances – the usual suspects are gluten, dairy and soy; consumption of sugar and industrial oils (corn, soy and canola) and insufficient intake of good antioxidants.

People with PCOS should avoid:

Sugar
Gluten/wheat
Dairy
Soy
Oils – soy, canola and corn
Too much fruit especially dried fruit
Margarine
Baked goods – cookies, cake, candy
Soda
Anything made with white flours (even if it is gluten-free)

What SHOULD Women with PCOS eat?

Plenty of fresh vegetables, especially leafy greens
Walnuts, avocados and flax seeds for their beneficial oils
Berry fruit – full of anti-inflammatory antioxidants
Bone broth – very soothing and full of minerals
Meat – protein for growth, healing and energy
Eggs – a complete food full of amazing nutrients
Butter – vitamins A, D and K2
Cod liver oil – vitamins A, D and K2 PLUS omega 3’s
Fermented foods – probiotics and easy to absorb vitamins

How can I get pregnant with PCOS?

With great difficulty. Or by complete surprise.

There is no real consistency here.

All you need for a pregnancy is one egg and one measly sperm. Sometimes is takes over a decade for them to get together, sometimes just the once.

The big issue with PCOS is the lack of regular ovulation. It is difficult to time intercourse, if you have no idea when (or if) you will ovulate this cycle.

The best advice I can give, is what worked for me (and thousands of others).

Eat a high fertility diet – low carb and high nutrient
Remove toxins from your life – smokes, alcohol, caffeine, pesticides, sugar
Reduce your stress – take up yoga or meditation, change jobs if you have to
Use some herbal supplements – Myo-inosital, Vitex, Tribulus and Cod Liver oil are a great place to start
Exercise – gentle weight-bearing most days
Track your Fertility – take your temperature everyday and chart it

If after 6-12 months of following this perfectly and honestly, you are not pregnant. I suggest you talk with a fertility specialist.

They may suggest using an ovulation inducing medication called Clomid (clomiphene). This helps force you to ovulate. It also has some side effects and is not suitable for everyone.

Is It Possible To Get Pregnant With PCOS Without Treatment?

YES. Pregnancy can happen any time you ovulate and have well timed intercourse. HOWEVER it is less likely to happen if you do not ovulate regularly.

Try the natural options listed above first, and give them at least 3-6 months to have an effect. This isn’t a quick fix solution, but it is a permanent one (if you maintain the healthy lifestyle). It is the best chance you have for reversing the effects of PCOS on your body.

How does Polycystic Ovaries affect Pregnancy?

Women with PCOS are at 4 times higher risk of developing pre-eclampsia (7) and are at higher risk of developing gestational diabetes or experiencing an early miscarriage.

Women following a high protein, moderate salt, high nutrient, low sugar, low inflammatory diet both preconception and during pregnancy have much lower risk of all of these complications (8).

Can you get Pregnant with PCOS without a Period?

Technically, yes. Your period comes about 2 weeks (between 8 and 16 days) after you ovulate. So it is possible to ovulate and get pregnant, without having your period. Is it possible to get pregnant without ovulating? No, not at all.

PCOS and Pregnancy – Success Naturally?

Yes! Many many women are finding success with getting pregnant naturally with PCOS. I am one of them. You can be too!

Follow a fertility diet, exercise regularly, start some supplements and reduce your stress and toxins.

When to see a Doctor

See a doctor if:

You’ve missed periods and you’re not pregnant.
You have symptoms of PCOS, such as hair growth on your face and body.
You’ve been trying to get pregnant for more than 12 months but haven’t been successful.
You have symptoms of diabetes, such as excess thirst or hunger, blurred vision, or unexplained weight loss.

If you have PCOS, plan regular visits with your primary care doctor. You’ll need regular tests to check for diabetes, high blood pressure, and other possible complications.

Polycystic Ovarian Syndrome (PCOS): The Ultimate Guide