The low-down on PCOS

WHAT IS IT?

Polycystic Ovaries Syndrome (PCOS) is the most common female disorder of the endocrine system. The symptoms can be varied but are connected by an underlying hormonal imbalance and almost always an excess of androgenic hormones. ‘Polycystic’ ovaries contain several small follicles which have not matured for ovulation, unlike regular ovarian follicles. These follicles are referred to as ‘cysts’ (though, confusingly, they are not actually cysts!) To add to the confusion, not everyone with PCOS has polycystic ovaries – and not everyone with polycystic ovaries has PCOS.

There are actually four different types of PCOS (I have an article dedicated to this):

  • Adrenal PCOS
  • Inflammatory PCOS
  • Post-pill PCOS
  • Insulin-resistant PCOS

HOW DO I KNOW IF I HAVE IT?

You need a doctor’s diagnosis to confirm PCOS. A doctor will usually run various blood tests (testosterone, Leuteinizing Hormone, Follicle-stimulating Hormone, prolactin, Thyroid-stimulating hormone, sex hormone-binging globulin) as well as pelvic ultrasounds to look for enlarged ovaries or ‘cysts’ on the follicles.

COMMON SYMPTOMS

  • Irregular, absent or long menstrual cycles
  • Anovulation (meaning ovulation doesn’t occur)
  • Hirsutism (excess facial or body hair) or hair loss
  • Difficulties managing weight
  • Low mood and low self-esteem
  • Acne

MISCONCEPTIONS

There are several common misconceptions with PCOS. The first is that it makes you infertile – or that you will struggle to get pregnant. Neither is necessarily true. Firstly, PCOS affects women differently, and secondly, it is usually the hormonal imbalance associated with PCOS that affects fertility – and the great news about that is that there is a lot that can be done through diet, lifestyle and supplements.

It is also often assumed that PCOS predominantly affects the ovaries but it actually affect the whole body, including the adrenals, digestion, insulin management and inflammation. This is why I take a holistic approach to PCOS clients – I look at the individual, their health history and their unique experience with the syndrome. We work together, step-by-step, to support the whole body using functional testing, diet and lifestyle changes and supplements.

NEXT UP: THE FOUR TYPES OF PCOS

by laura

The Game Changers

This is the Netflix documentary that everyone seems to be talking about. I have a lot of opinions on a lot of the documentary but I’ve narrowed them down to three key points:

 

  1. I’ve had several people tell me they’ve ‘gone vegan’ on account of the documentary – but this is where my first issue with it lies. The Game Changers consistently refers to a ‘plant-based’ diet without defining what that actually is. Newsflash – it’s not a vegan diet! A plant-based diet is one based predominantly on plants, but can also include all other food sources. We don’t actually know whether the athletes in the programme are strictly vegan, or if, for example, they’re also taking whey protein supplements which are based on dairy.

 

  1. The studies are ‘cherry-picked’ to display the desired results. Nothing in the documentary said anything positive about meat or fish consumption – yet there are a mountain of studies demonstrating the potential benefits, when consumed as part of a balanced diet.1, 2, 3, 4, 5   Let’s take the ‘cloudy blood’ study… it lasted 2 hours, was based on 3 people, didn’t account for what they’d eaten before the study, nor how long the effects lasted. Physiologically, fat in the blood is a normal effect of digestion.6Let’s also look at the wrestlers – I don’t think anyone would try to argue that eating steak twice a day is at all healthy or conducive to optimum performance! It’s an extreme example and not representative of the differences between a diet that includes meat versus a diet that does not. Another poor example is the athlete who eats KFC before a game – fried, poor quality chicken cannot be compared to high quality sources of animal products.

 

  1. The subjects are athletes who often have diets carefully constructed for them, like in the experiments shown on the documentary – those veggie burritos were a careful combination of plant protein, fat, carbohydrates and micronutrients. Many of the people now ‘going vegan’ do not have access to the same resources that professional athletes do and whilst a vegan diet can be healthy when carefully planned, it is likely to cause nutrient deficiencies if not done properly.7Despite what the documentary might lead you to believe, the scientific literature shows that vegans are at risk of deficiency of nutrients like vitamin B12, iron, vitamin D and omega 3 fatty acids, as well as protein – see my article on veganism for more details.7

 

The conclusion? In my opinion, the documentary is not based on accurate scientific evidence and I worry that it will inspire a lot of people to change their diets due to misleading information. I’m a great advocate for a plant-based diet, but if you are thinking of becoming a strict vegan I would encourage you to seek professional advice to ensure that you are getting adequate nutrition.

 

  1. Jacob, J., Peter, S. and Chopra, S. (2013). A fish a day, keeps the cardiologist away! - A review of the effect of omega-3 fatty acids in the cardiovascular system. Indian Journal of Endocrinology and Metabolism, 17(3), p.422.
  2. Tørris, C., Molin, M. and Småstuen, M. (2017). Lean Fish Consumption Is Associated with Beneficial Changes in the Metabolic Syndrome Components: A 13-Year Follow-Up Study from the Norwegian Tromsø Study. Nutrients, 9(3), p.247.
  3. Bowen, K., Harris, W. and Kris-Etherton, P. (2016). Omega-3 Fatty Acids and Cardiovascular Disease: Are There Benefits?. Current Treatment Options in Cardiovascular Medicine, 18(11).
  4. Li, D., Siriamornpun, S., Wahlqvist, M., Mann, N. and Sinclair, A. (2005). Lean meat and heart health. [ebook] Asia Pac J Clin Nutr, pp.113-119. Available at: http://apjcn.nhri.org.tw/server/APJCN/14/2/113.pdf [Accessed 11 Nov. 2019].
  5. Wyness, L. (2015). The role of red meat in the diet: nutrition and health benefits. Proceedings of the Nutrition Society, 75(3), pp.227-232.
  6. Iqbal, J. and Hussain, M. (2009). Intestinal lipid absorption. American Journal of Physiology-Endocrinology and Metabolism, 296(6), pp.E1183-E1194.
  7. Rogerson, D. (2017). Vegan diets: practical advice for athletes and exercisers. Journal of the International Society of Sports Nutrition, 14(1).

 

by laura