Your Polycystic Ovary Syndrome action plan
Around 1 in 10 UK women have polycystic ovary syndrome and to support PCOS Awareness Week 2012, Colette Harris, patron of PCOS charity Verity has put together a self-help action plan
Polycystic ovary syndrome (PCOS) is a common disorder that affects an estimated 10% of UK women – including Emma Thompson, Kym Marsh, and Jules Oliver.
What are the symptoms of PCOS?
Symptoms can include irregular or absent periods, excess facial and body hair, weight problems, thinning hair, acne, and fertility issues (if women have irregular periods it can mean irregular ovulation), but they will appear in different combinations and degrees of severity in each individual and may change over time. The symptom that gave the condition its name is the many small ‘cysts’ below the ovary surface, seen on an ultrasound scan. These ‘cysts’ are egg follicles that have not developed properly due to the hormonal imbalances that also cause the other symptoms.
What causes PCOS?
Women with PCOS often have elevated levels of testosterone (which causes symptoms such as acne, unwanted hair and is associated with failure to ovulate), whether they are slim or overweight. The factors that cause the development of PCOS are still not fully understood but include...
PCOS is an inherited condition – many women have close female relatives with PCOS. Some research has suggested that men in PCOS families may have a higher risk of obesity and cardiovascular disease too.
This is pre-diabetic state when the body's tissues are resistant to the effects of the blood sugar controlling hormone insulin, so the body has to produce extra. High levels of insulin cause the ovaries to produce more testosterone, which interferes with the development of egg follicles and causes symptoms such as acne and excess hair. This is more common in overweight women with PCOS but may also be present in slim women with PCOS.
This is the catch 22 for many women with PCOS. Insulin resistance often makes it more difficult to lose weight, but being overweight makes the symptoms of PCOS more pronounced because excess fat causes the body to produce more insulin. It is more common that insulin resistant women with PCOS burn fewer calories than women without PCOS.
What about long-term health?
The latest research has revealed that treating day to day symptoms is only part of the story – women with PCOS also need to be thinking about maintaining a healthy lifestyle in order to reduce their increased risks of diabetes and cardiovascular disease – women with PCOS are at a sevenfold increased risk of developing type 2 diabetes after the age of 40, and there is a link with heart disease, high blood pressure, and high blood cholesterol levels. Women with PCOS who have fewer than four periods a year can be at a slight increased risk of endometrial cancer – which is why doctors will treat you to ensure four bleeds a year if this is the case for you.
Getting a diagnosis
There is much greater awareness of PCOS now and it is increasingly better understood. Most GPs would order blood tests to detect hormone imbalances and blood sugar levels. If PCOS is suspected you may be referred to a gynaecologist and the diagnosis confirmed by ultrasound scan.
How can your doctor help?
Your doctor can prescribe medications and treatments for all sorts of PCOS symptoms, from acne to excess hair, and refer women with fertility issues or very challenging weight loss issues to further sources of help such as consultants and dietitians.
What can you do for yourself?
While there is no cure for PCOS, you can influence your symptoms and protect your future health with some basic steps.
● Eat to beat sugar cravings
Insulin resistance causes higher levels of insulin to circulate, pushing sugar out of your bloodstream, and causing a blood sugar low which can lead to sugar cravings. Beat the sugar highs and lows by eating quality protein and fibre with each meal – they help you feel fuller for longer and release their energy slowly. Try porridge with soya milk, flaked almonds, a hefty teaspoon of cinnamon (it’s been shown to improve insulin resistance) and blueberries for breakfast; a wholegrain lean chicken or egg salad sandwich for lunch, wholegrain basmati rice with a fish or Quorn and vegetable curry in the evening. Snack on small quantities of dried fruits and nuts, low fat Greek yoghurt with chopped banana, wholegrain rice cakes with nut butter.
'Beware of "low-fat" and "fat-free" treats,' says Sam Bailey, a nutritionist and registered dietitian who is a member of the Executive Council of PCOS UK, which promotes learning and insights into PCOS management for medical professionals. 'They may contain lots of gooey glucose syrup to replace the texture you lose from biscuits, cakes or cereal bars when you remove fat. Check the labels!'
● Take regular aerobic exercise
'If you exercise your body’s metabolism will improve and reset insulin levels and ovarian function,' says Adam Balen, Professor of Reproductive Medicine and Surgery at Leeds Teaching Hospitals, a leading expert in the field of PCOS, and medical advisor to national charity Verity. Try to do some aerobic exercise every day, such as brisk walking, cycling, swimming, jogging, dance classes, energetic housework and gardening, or an exercise DVD at home.
Insider tip: 150 minutes of moderate intensity exercise that gets you warm and a bit breathless is recommended for cardiovascular health. Anything more than usual is a great start. Discuss your options with your doctor if you have concerns - there may be a GP exercise on prescription scheme in your area.
● Detox your life. 'Some simple steps can have a surprising impact on your PCOS symptoms and long term health,' says Colette Harris, author of 'The Ultimate PCOS Handbook' (Thorsons, £15.99) and patron of PCOS charity Verity. 'For example, getting good sleep can actually help reduce insulin resistance and lower the likelihood of gaining weight, according to the latest research. So wind down for an hour before bed, avoid heavy evening meals, and go caffeine-free after lunch – try decaf coffee, rooibosch tea or soothing herbal teas such as camomile. Giving up smoking can slash your increased risk of diabetes – it is now proven to be an independent risk factor for diabetes as it raises blood glucose levels. Get support from your GP and at www. smokefree.nhs.uk.'
Insider tip: Two recent studies have shown women with PCOS are more affected by the hormone-disrupting chemical bisphenol A (BPA), a chemical found in a wide range of plastic containers from baby bottles to water bottles and food containers. 'Drink water from glass bottles where possible, and store your food out of plastic wrappers and containers once you get it home,' says Colette.
● Lose weight if you need to: Some women with polycystic ovaries only develop symptoms if they put on weight. 'Losing between five to 10 per cent of your body weight is sufficient to make a significant difference to symptoms,' says Professor Balen. 'It also reduces the risk of developing diabetes, high blood pressure and heart disease and can sometimes regulate periods and improve fertility without medical treatment.'
'You will be more successful if you combine diet with exercise, make a realistic plan that fits your life, and lose weight gradually, at the safe level of 1-2lb or 1kg per week,' says Sam Bailey. “For weight loss, you need 60 minutes per day of moderate intensity physical activity, such as brisk walking, swimming, cycling or dancing. Build up to this and get your GP’s support. It’s also important to notice if you eat more sugary, fatty foods or carbohydrates such as pasta and potatoes when you’re stressed, down, tired, or even happy. Try and focus on eating to satisfy hunger rather than your emotions.”
Insider tip: 'Healthy fats are still fats,' says Sam. 'Don’t overdo nuts and seeds and oily fish. Grill, bake and casserole instead of frying your food, and use a spray pump dispenser to coat a pan with less oil if you do fry.'
Find out more
Get more information about PCOS, and access to discussion boards and local support groups at www.verity-pcos.org.uk