top of page

Understanding PCOS

Jul 31, 2024

Updated: Aug 1, 2024

Organization: Root Health, Nutrition and Wellness

Publish Date: 7/31/24



Do you constantly crave sugar or find yourself staring into the fridge or snack cabinet ready to grab anything you can get your hands on? Are you experiencing unintentional weight gain, mood swings or irregular periods? These are symptoms associated with a condition known as Polycystic Ovarian Syndrome (PCOS)



What is PCOS?


PCOS is the most common endocrine disorder in women. It is caused by an imbalance in reproductive hormones.This imbalance often results in issues with the ovaries, which are the small, oval shaped glands located in the lower abdomen, at the end of each fallopian tube. The ovaries help to regulate egg growth and release, along with hormones like estrogen and progesterone. 


There are many different types of hormones within the body that help to regulate development and function, including androgens and estrogens. Androgens are produced in greater amounts in males, and estrogens are produced in higher amounts in females. Both of these hormones are responsible for physical characteristics, sexual development and reproduction, and in females, regulation of the menstrual cycle. In those with PCOS, estrogen is not adequately produced and utilized within the body, leading to an imbalance of hormones. 



What are symptoms of PCOS and how is it diagnosed?


PCOS is characterized by high levels of androgens and insulin resistance. It is estimated that 65-70% of women with PCOS have high insulin indicating insulin resistance, and 70-80% are overweight or obese. High insulin can lead to weight gain, as excess levels promote increased fat storage. 


In order to diagnose PCOS, the Rotterdam Criteria is used, requiring 2 out of 3 symptoms:

  1. Polycystic ovaries, or the development of multiple cysts on the ovaries. On an ultrasound, they often look like a “string of pearls”

  2. Hyperandrogenism, or an excess amount of androgens. This can lead to physical changes like male-pattern balding, acne, increased hair growth or hair growth in unusual places (ex: facial hair). 

  3. Oligo-anovulation, or ovulatory dysfunction leading to irregular menstrual cycles.


Other symptoms seen in those with PCOS include increased abdominal obesity, fertility issues, and patches of dark skin on the neck and/or back (commonly associated with increased insulin). Those with PCOS may also have sudden, intense cravings for sugar due to insulin dysregulation. 


What does a functional medicine approach to managing PCOS look like?


Managing PCOS using a functional medicine approach often includes dietary and lifestyle changes to help balance blood sugar and hormones, as well as to support gut health. Those with PCOS often experience systemic inflammation, obesity and/or metabolic disorder. These conditions increase the likelihood of developing other health issues such as diabetes, hypertension, and dyslipidemia.


Dietary changes


Dietary approaches to managing PCOS can help to balance blood sugar by stabilizing insulin levels to reduce the risk of developing diabetes and reduce inflammation, among other benefits. Focusing on whole foods such as vegetables, fruits, legumes, lean meats and omega-3 rich fish can promote reduced insulin and androgen levels. These changes can be beneficial for encouraging regular ovulation leading to increased fertility. Whole grains are rich in fiber, which slows digestion helping to reduce spikes in blood sugar. Regulation of blood sugar can result in decreased conversion of carbohydrates to fat, lowering the risk for diabetes and metabolic syndrome.


Certain foods are rich in phytoestrogens, or plant compounds that mimic estrogen and can aid in hormonal balance. These foods are beneficial for those with PCOS, as the condition often results in estrogen imbalance. Foods rich in phytoestrogens include:

  • Soy (tofu, tempeh, soy milk, edamame)

  • Flax seeds

  • Cruciferous vegetables

  • Legumes 


PCOS is closely linked with impaired gut function and lower microbial diversity, leading to inadequate production of short chain fatty acids (SCFA). These SCFA are produced when the microbiome ferments undigested dietary fiber, and plays an important role in digestion, nutrient absorption and the health of the immune system. When there is a disruption to the gut microbiota, it is known as gut dysbiosis. Gut dysbiosis can lead to increased intestinal permeability (or leaky gut), resulting in inflammation. To help support the gut microbiome, it is important to consume a variety of fiber rich foods such as seeds, beans, grains, fruits and vegetables. 


Limiting consumption of fried foods, sugary beverages and snacks, and alcohol can help to minimize symptoms by reducing inflammation and blood sugar spikes. Reducing intake of these foods can also help to lower the risk of developing other conditions like diabetes, hypertension and obesity, which are often seen in conjunction with those with PCOS. 


Stress reduction


Managing and reducing stress levels is an important aspect of PCOS management, as increased stress leads to elevated cortisol (stress hormone) levels. Higher levels of cortisol may raise testosterone levels, exacerbating PCOS symptoms. Some ways to help lower stress include: 

  • Exercise

  • Meditation

  • Breathing exercises

  • Adequate sleep

  • Finding hobbies or activities that you enjoy and making time for them


Supplements


There are a variety of supplements that may be helpful in the management of PCOS. Supplementation can help to reduce symptoms, improve fertility, balance hormones, reduce inflammation and heal the gut. Some common ones are:

  • DIM

  • Probiotic

  • Curcumin

  • Magnesium

  • Myoinositol

  • Omega-3

  • Zinc 


Before starting any supplements, it is important to speak with a registered dietitian to determine if supplementation will work for you. 


If you have symptoms or have been diagnosed with PCOS, visit us at roothealthnj.com to learn how a registered dietitian can help you. 

 

Citations


Polycystic ovary syndrome | Office on Women’s Health. (n.d.). https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome


PCOS diet. (2023, February 1). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/wellness-and-prevention/pcos-diet


Xenou, M., & Gourounti, K. (2021). Dietary Patterns and Polycystic Ovary Syndrome: a Systematic Review. Mædica, 16(3). https://doi.org/10.26574/maedica.2020.16.3.516


Smet, M., & McLennan, A. (2018). Rotterdam criteria, the end. Australasian Journal of Ultrasound in Medicine, 21(2), 59–60. https://doi.org/10.1002/ajum.12096covery call to become a patient.

 

Comments

bottom of page