Polycystic Ovary Syndrome (PCOS) is a common endocrine condition and a frequent source of confusion for women of reproductive ages. Approximately 10-15% of women in this age category struggle with PCOS, and it very much impacts health and quality of life. It is intricately tied to Insulin Resistance (IR), weight management, and overall metabolism.
(Short on time? Click here for The Bottom Line)
How can you tell if you have PCOS?
While it can cause a variety of symptoms and disruptions to life for many, there are a few common presentations we should watch out for:
- Changes to periods (menstrual cycles that are irregular or absent)
- Signs of high androgens (such as acne or excess body hair)
- Ovaries with multiple cysts (‘Polycystic Ovaries’ as seen by Ultrasound)
Generally, at least two of the above criteria can point us in the direction of a PCOS diagnosis. It is also crucial to ensure other potential causes are excluded during the diagnostic process. We also try to understand your metabolic history: whether you struggle with obesity and weight, cholesterol, blood pressure, diabetes or pre-diabetes, and even fatty liver disease.
You might be starting to see the common thread now: underlying insulin resistance and direct relationship with major chronic diseases. This is what makes PCOS an important and relevant topic for Obesity and Lifestyle Medicine.
In up to 75% of cases, Insulin Resistance is the primary driver behind PCOS. When your cells are resistant to insulin, you continue to have high insulin levels in your bloodstream, which signals your ovaries to make more testosterone. This creates a frustrating cycle: IR leads to weight gain, particularly around the midsection… the extra adipose tissue then further worsens hormone imbalances. And the cycle repeats.
While there is no “cure” in the strictest sense, PCOS is highly manageable. Lifestyle Medicine is the first-line treatment, focusing on:
- Balanced Nutrition: Whole-food, plant-predominant eating pattern.
- Movement: Daily physical activity.
- Weight Management: Pursuing sustainable weight loss or weight maintenance.
- Substance Reduction: Reducing or eliminating tobacco and alcohol.
Sometimes, lifestyle changes need a teammate, and that is okay. Medication can also play a strong role for individuals with PCOS. Options can include the use of hormonal contraceptives, metformin, or progesterone therapy.
It is also important to treat the associated chronic diseases related to PCOS, which is again where doubling down on the lifestyle measures and the required behaviour changes can lead to positive outcomes.
Remember that eating whole, high-fibre foods and resistance training can significantly boost your insulin sensitivity. This not only makes weight management easier, but it also directly supports regular ovulation and helps manage PCOS.
The Bottom Line
PCOS is a metabolic condition intricately linked to insulin resistance. While it can drive weight gain, health risks, and impact quality of life, it does not have to be a life sentence. Leverage the power of Lifestyle Medicine (especially high-fibre foods and strength training), with medication as needed, to improve hormonal balance and live a better, healthier life!