Replay of Facebook/Instagram weekly live PCOS Month series.
Part 1: Welcome to PCOS Month! – Sept 2 2021
Welcome to the live stream or the replay, however you’re watching me right now…
It is PCOS Awareness Month, and as I posted yesterday this topic has a bit of personal significance to me, and I see a lot of clients with this condition, so I’m excited to bring more content on this topic throughout the month!
Tonight we’ve got an overview of PCOS, common signs and symptoms, comorbidities and risk factors, we’ll touch briefly on common treatment approaches, and some of the pervasive myths. Next week we’ll start talking about my nutritional approach to supporting people with PCOS and continue with that each week in September. This is first in our 5-part series!
So let’s jump in!
- 1 in 10 women, 1 in 4 trans men/masc people affected by PCOS. The statistics are still coming in on transgender people with PCOS, with transgender people being a very underrepresented group; but I’m still happy to see more of these numbers coming in as they also tend to be underserved in the medical community at large.
- As many as 70-95% of PCOS sufferers have some degree of insulin resistance.
- 25% have thyroid issues as well, usually underactive or hypothyroid – the thyroid isn’t producing enough of the hormones it should be producing to keep the metabolism up.
Signs & Symptoms
With insulin resistance, there may be strong sugar cravings and mood swings, weight gain or difficulty shifting body composition, particularly around the midsection, anxiety, low energy, missed/late periods, irregular periods, absent periods, difficulty with ovulation and trying to conceive – fertility tends to be a big struggle faced by PCOS sufferers. The ovary typically produces 1 cyst or follicle that matures throughout the menstrual cycle, whereas the polycystic ovary produces multiple of these per month. Because there are so many of them, they may not all get released, and that’s where the issue with menstrual irregularities due to missed or incomplete ovulation could arise.
This is of course not an exhaustive list of signs and symptoms, as no 2 presentations of PCOS are identical.
Comorbidities & Risks
People with PCOS tend to be at greater risk of developing type 2 diabetes – remember that 70-95% deal with insulin resistance, which is itself a risk factor for diabetes – as well as heart disease and increased risk of developing ovarian cancer.
There’s also a correlation between PCOS and ADHD symptoms, as many of them overlap! As noted in my own post yesterday, I was first informally diagnosed with both in university – presenting with acne, irregular periods, a little hirsutism, as well as anxiety and difficulty focusing. My doctor tested me for thyroid issues that had since been resolved, but she also sent me for ADHD testing, which is how I got an “informal” diagnosis. I never got a formal dx for ADHD as I… never finished the paperwork (and if that isn’t just the most ADHD thing ever I don’t know what is…)
But anyway, it’s because of these overlapping symptoms that I was tested for all of these issues at once.
Common Treatment Approaches
2 of the most common medications that may be prescribed: birth control pills and/or metformin (a blood sugar-lowering drug). Remember we talked about insulin resistance – lowered insulin resistance may improve ovarian function, so metformin is prescribed with that in mind. BCPs are prescribed for a variety of hormone-related conditions including PCOS. In my case, my testosterone was elevated so my doctor put me on an estrogen-progesterone combo pill for the first time to help me deal with my symptoms (mostly the acne). While many might experience improvements, it wasn’t great for me, in a nutshell, and a few years later I would be happy to learn additional ways to nutritionally support PCOS, which I in turn share with you.
There’s only one form of PCOS – false, there are multiple: insulin resistant, inflammatory, post-pill, adrenal, lean, and hidden cause. And even though there are symptoms that are designated to each type, you may find that your total symptom profile may actually align you with 2 or more types.
You’re overweight because you have PCOS or you have PCOS because you’re overweight – false! While there might be body composition struggles in those with PCOS, neither is necessarily causative of the other.
People with PCOS tend to be overweight – not true! There is a lean type, where the person who has PCOS can actually be thin or fit but still has PCOS. Really, any body type can have PCOS, and like the previous point, one is not necessarily causative of the other.
Losing weight will resolve your PCOS – false! First, as we’ve already mentioned “just losing weight” tends to be more difficult to do with PCOS – e.g. thyroid and insulin resistance issues mess up the metabolism and make it very hard to “just lose weight”. Second, as we’ve also said, being overweight and PCOS don’t necessarily cause each other. Weight loss may come with eating more whole foods and working on keeping blood sugar balanced, but “just losing weight” in and of itself usually isn’t the absolute fix because we need to get the hormones in check.
This one might be polarizing, but keto or paleo or low carb is the best thing to do for PCOS – and that’s also false. Similarly, vegan is the best diet – also false. I’m not here to attack any style of nutritional support, but I’m very much in favour of keeping nutrient density in play. An overall whole foods based diet that’s high in plant foods – rich in fiber and antioxidants, vitamins and minerals, carbohydrates… all those fantastic things we need to create and form and signal the hormones themselves – and lower in animal proteins tends to offer support across multiple presentations. That being said, no 2 presentations of PCOS are necessarily the same, so no 2 sufferers will respond to the same nutritional protocol in the same way either.
Polycystic ovaries are a clear sign that you have PCOS – false! PCOS is actually more of a metabolic disorder – we mentioned insulin resistance, thyroid disorders. One may have normal periods, lean body mass, regular ovulation, but due to the range of symptomatology can still be diagnosable with PCOS.
So there are a lot of things to consider, and we’ll get into it over the next 4 weeks!