We're nearing the end of PCOS Awareness month, and it's the perfect time to shed light on this complex condition that affects so many individuals. Polycystic Ovary Syndrome (PCOS) is not a one-size-fits-all diagnosis; it's a multifaceted condition with various subtypes and contributing factors. In this article, we'll delve into the world of PCOS, explore its types, drivers, and diagnostic criteria, and provide actionable self-care tips for patients, including the role of fertility acupuncture.
PCOS key facts
1. Approximately 8–13% of women of reproductive age are affected by Polycystic Ovary Syndrome (PCOS).
2. Globally, as many as 70% of women with PCOS go undiagnosed.
3. PCOS is the most common reason for anovulation and a primary contributor to infertility.
4. PCOS is linked to various long-term health issues that impact both physical and emotional well-being.
5. Familial ties often play a role in PCOS, yet its presentation and effects can vary among different ethnic groups.
Understanding PCOS:
PCOS stands for Polycystic Ovary Syndrome, a condition characterized by an excess of androgens, often referred to as male hormones. There are four main types of PCOS, each with its unique characteristics and challenges.
1. Insulin-Resistant PCOS:
- This is the most common type.
- Increased insulin levels can impair ovulation and lead to the production of testosterone instead of estrogen.
- Hormone imbalances, including elevated Lutilising hormone (LH)
and reduced Sex Hormone-Binding Gobulin (SHBG), contribute to higher testosterone levels.
2. Post-Pill PCOS:
- Occurs in individuals whose periods were normal before birth control pills but became irregular after discontinuation.
- Typically, insulin resistance is not a prominent factor in this type.
3. Inflammatory PCOS:
- Characterized by irregular cycles, elevated androgens, and signs of inflammation like digestive issues, fatigue, and skin conditions.
4. Adrenal PCOS:
- Unlike other types, it doesn't often involve inflammation or insulin resistance.
- Elevated adrenal androgens (DHEAS) drive this type, often due to abnormal stress responses.
Diagnostic Criteria:
The Rotterdam criteria is a set of criteria used to diagnose PCOS. A diagnosis is usually made if at least two out of the following three criteria are met:
1. Amenorrhea (lack of menstrual cycle) or oligomenorrhea (irregular menstruation).
2. Hyperandrogenism, indicated by elevated male sex hormones and physical signs like hair loss, acne, and excess facial or body hair.
3. Polycystic ovaries visible on a scan.
The Three Drivers of PCOS:
Understanding the drivers of PCOS is crucial for effective management. PCOS is influenced by three main factors:
1. Insulin Resistance
2. Inflammation
3. Stress
Tips for PCOS Patients:
Managing PCOS involves making lifestyle changes that address its underlying causes.
Here are some actionable tips that you could incorporate into your strategy to support all presentations of PCOS
1. Maintain a Balanced Diet:
- Include protein, good fats, whole foods, and a variety of colorful vegetables.
- Embrace a low-glycemic index (GI) diet to regulate blood sugar levels.
- When you do consume carbohydrates, do so with with proteins and fats — like having cream cheese on a bagel, eggs or avocado with sourdough bread — to avoid blood-sugar spikes and crashes. Jessie Inchauspé (The glucose goddess) refers to this as ‘putting clothes on your carbs’ and I find this helps to remember.
2. Apple Cider Vinegar:
- Consider incorporating apple cider vinegar into your routine to help manage blood sugar and PCOS symptoms. Vinegar slows the process of converting starches into glucose and signals our muscles to absorb glucose as it enters our bloodstream. This is how it lowers the rapid rise in blood sugar after we've eaten something.
A tablespoon in a glass of water before meals (just use a straw and watch your teeth otherwise your dentist will not be pleased!)
3. Reduce Trans-Fats:
- Eliminate or reduce trans-fats from your diet to improve fertility hormones and reduce PCOS-related issues.
4. Regular Exercise:
- Engage in regular physical activity, aiming for at least 150 minutes of moderate-intensity exercise per week.
5. Stress Management:
- Practice stress-reduction techniques such as meditation and deep breathing exercises to lower stress hormones. Try Qigong, yoga, mindfulness practice, acupuncture, walks in nature, what ever suits you and your lifestyle best.
6. Adequate Sleep:
- Prioritise quality sleep, aiming for around 8 hours per night to regulate hormones and inflammation. Quality sleep is crucial for hormone regulation and inflammation, it’s not surprising adequate sleep can have a huge impact on fertility and fertility hormones. For my top actionable sleep tips visit https://www.clairenortonacupuncture.co.uk/post/poor-sleep-and-fertility
7. Regular Cycle Monitoring:
- Keep track of menstrual cycles and symptoms to share with your healthcare provider.
8. Consider Supplements:
- Discuss potential supplements like Myo-inositol, omega-3 fatty acids, magnesium, and vitamin D with your nutritionist.
9. Regular Acupuncture:
Studies have demonstrated that regular acupuncture sessions can help regulate menstrual cycles and hormone levels, improve blood flow to the ovaries to improve number of cysts, reduce stress, and support reproductive health.
Acupuncture has been shown to promote the recovery of menstrual cycles as well as downregulate the levels of LH and testosterone in patients with PCOS. Wu et al (2020)
10. Weight management
It’s important to note that it’s possible to be a healthy weight or even underweight and be diagnosed with PCOS.
- it’s recommended to try maintain a healthy weight through diet and exercise, as gradual weight loss can improve PCOS symptoms and increase fertility. This can be especially challenging as PCOS has an insulin resistant (pre-diabetes) component. Speak with your GP to see if they can refer you to a dietitian or specialist for support.
11. Spearmint Tea and Coriander Water:
- Explore natural beverages like spearmint tea and coriander water, which may offer some benefits. Spearmint tea is said to have an anti androgen effect, coriander water is antioxidant packed and said to be an aphrodisiac.
Final thoughts:
PCOS is a complex condition, but with the right support, knowledge and self-care strategies, individuals can manage their symptoms and improve their chances of conceiving. Remember that each person's experience with PCOS is unique, so consulting with healthcare professional is crucial for tailored guidance. Acupuncturists, nutritionists, functional medicine practitioners and herbalists can be a great options to support you and your specific presentation. Let's raise awareness about PCOS and support those affected by it on their journey to better health and fertility.
Resources
Briden, L. (2018) Period Repair Manual: Natural Treatment for better hormones and better periods. United States: Createspace Independent Publishing Platform.
INCHAUSPE, J. (2023) Glucose revolution: The life-changing power of balancing your blood sugar. S.l.: SIMON & SCHUSTER.
Polycystic ovary syndrome (no date) World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome (Accessed: 27 September 2023).
The Ultimate Vingar Guide [2022] (no date) Glucose Goddess. Available at: https://www.glucosegoddess.com/vinegar-guide (Accessed: 27 September 2023).
Ye, Y. et al. (2022) Underlying mechanisms of acupuncture therapy on polycystic ovary syndrome: Evidences from Animal and clinical studies, Frontiers in endocrinology. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9637827/ (Accessed: 27 September 2023).
Polycystic ovary syndrome (no date) World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome (Accessed: 27 September 2023).
Wu, Jielei MDa; Chen, Di MDb; Liu, Nenghui MDa,∗. Effectiveness of acupuncture in polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. Medicine 99(22):p e20441, May 29, 2020. | DOI: 10.1097/MD.0000000000020441