Polycystic ovary syndrome (PCOS) is a common endocrine disorder which affects 5-22% of women of reproductive age. It is characterised by ovulatory dysfunction, polycystic ovaries and hyper-androgenism (i.e. high testosterone). Due to this, symptoms of PCOS include infertility, irregular periods, obesity/weight problems, hirsutism (increased hair growth), hair loss, acne and mood changes. None of which are very desirable!
Although the exact cause of PCOS is unknown, we do know there are many drivers. These include pre-existing hormonal imbalances (i.e. high cortisol/insulin levels), a diet high in refined carbohydrates, genetic predisposition (i.e. the “thrifty” gene), poor sleep, inflammation, and a sedentary lifestyle. Rather than addressing the many aspects of PCOS in this blog, I’m going to focus on one more complex aspect of this condition, insulin resistance (IR).
Insulin Resistance and Fat metabolism
Insulin resistance is extremely common in PCOS women, with studies showing that women with PCOS are at much higher risk of developing Type 2 diabetes due to impaired glucose tolerance. Here is a good little video explaining what this IR is. As a consequence of this impaired glucose tolerance, many women with PCOS battle with their weight, and often present with higher levels of visceral fat (abdominal fat), giving some PCOS women an “apple” shaped appearance.
Here is a handy article on the topic of sugar. The bottom line is that sugar/refined carbohydrate intake indirectly increases testosterone production and thus increases PCOS symptoms. Lessening sugar/refined carbs for those of you with PCOS is therefore key.
NOTE: A simple way to assess your risk of IR is to measure yourself around the smallest part of your waist (don’t hold your stomach in!) and the biggest part of your hips. Then, divide the waist measurement by the hip measurement. If you get a ratio bigger than 0.8, it’s an indication that you’re at risk of developing IR.
Thrifty Gene – Common in PCOS Women
From an evolutionary perspective, humans have actually benefited from an ability to store fat, and this has been identified as a key survival mechanism via so-called thrifty genes. The premise of this idea is that as humans we’re programmed to conserve energy, storing it up for a time when food is scarce. So clever! The problem is, that many of us don’t live in times of food scarcity. Over the last 2 generations, changes in the human diet and lifestyle have been so dramatic that our genome simply cannot adapt to our changing environment of sedentary jobs and plentiful energy-dense foods. Basically, the ‘thrifty gene’ is very good in times of famine, but disastrous in times of abundance.
What is the answer?
Both medical experts and alternative healthcare professionals agree that overcoming IR is the greatest priority when treating PCOS. Currently, diet and lifestyle changes appear to represent the first-line management for all overweight and obese patients with PCOS (Pandinis et al, Endocrine, 2013).
Thus, Naturopathic support for women with PCOS is extremely effective. A low glycaemic diet, which is low in refined sugars and high in fibre, is usually my first recommendation. Acupuncture, regular exercise, good quality sleep and stress management are also top priorities. Blood sugar regulating nutrients, herbs and foods (i.e. Cinnamon, Turmeric, Fenugreek, Gymnema, Ginseng, Zinc, Magnesium, Chromium, Lipoic Acid, etc) are beneficial; and often some other herbs which restore hormonal imbalances and help with stress are indicated (i.e. Chaste Tree, Shatavari, Passionflower, etc).
Some take home message…
- Eat to be nourished! Choose low glycaemic load (GL) foods, clean protein, and don’t be shy of the favourable fats (i.e. walnuts, avocado, olive oil, etc). Avoid refined, high sugars and starches.
- Choose the right exercise for your body, and do it consistently.
- Manage your stress levels however you feel works best for you – Yoga/bush walking/the beach/deep breathing/laughing/planning a holiday/getting enough sleep/camping/etc!
- Consider acupuncture
- Consider consulting with a qualified health professional regarding herbal and supplemental support.
- Again… eat to be nourished! Choose whole, natural foods. Remember… food speaks to our genes.
I recently discovered that I have the thrifty gene, I have insulin resistance, and I have PCOS. I understand however that I am NOT my genes, I am how those genes EXPRESS themselves. I understand the power of diet and lifestyle in the management of this condition; and thus eat, think and move to SUPPORT my biochemistry, rather than work against it. With the right knowledge and support, you can too.
Until next time, Stacey.
