Most women have been frustrated with their weight at some point in their lives; it’s common to want to lose a few pounds here and there. But for some women, weight gain is a side effect of a serious condition known as polycystic ovarian syndrome (PCOS). This condition affects 1 in 10 women between the ages of 15 and 45 and, if untreated, can lead to an increased risk for serious health conditions.
PCOS and Hormones
Women with PCOS produce higher-than-normal levels of male hormones, called androgens, from their ovaries.
Testosterone is an example of a male hormone. Elevated insulin is the trigger that leads to the production of androgens, and although the exact cause for this is unknown, research suggests family history could be a factor.
Insulin is a hormone that regulates the body’s ability to metabolize, or “burn off,” fat and carbohydrates. (Insulin is actually quite complex and not easily summed up in one sentence, but for purposes of this blog post I’ll just leave it at that.) Simply put, this hormonal imbalance can cause a variety of frustrating and very serious side effects.
PCOS Symptoms and Diagnosis
Ashleigh Sellman, a registered dietitian with UVA’s Nutrition Counseling Center, says that because symptoms are so varied and sometimes characteristic of other health conditions, many women don’t even know they have PCOS. For example, one woman with PCOS might have irregular periods but not be overweight, while another woman finds it nearly impossible to lose weight but still gets a period every month.
Here is what some PCOS symptoms may look like:
• Irregular, absent and/or heavy periods
• Difficulty becoming pregnant and increased risk of miscarriage
• Weight gain and difficulty losing weight despite diet and exercise
• Insulin resistance, which can lead to type 2 diabetes and other health complications
• Fatigue, feeling run-down or just feeling “off”
• Intense cravings for carbohydrates
• Tiny cysts that grow on the ovaries
• Male pattern hair growth on the chest, face, back, lower abdomen, fingers and toes
• Hair loss, often from the top of the head
Nutrition and PCOS
Although there is no “cure” for PCOS, Sellman says nutrition plays a key role in restoring the body’s hormonal balance and regulating insulin production.
Sellman offers small group workshops where women with PCOS can share their experiences and struggles with each other. Held at the Nutrition Counseling Center at Northridge, these workshops include in-depth discussions about the biology behind PCOS and insulin, why it causes weight gain and other side effects and how patients can adjust their eating habits to help decrease insulin levels. Sellman explains why women with PCOS crave carbohydrates so intensely and why they feel so tired and run down. Each participant leaves with a booklet of information tailored to her own unique needs. Workshops are open to anyone who has been diagnosed with PCOS, or the parent of a child with the condition.
“In patients with PCOS, moderate weight loss has been shown to significantly improve symptoms and regulate menstrual function, ovulation and insulin production,” she says. “Getting symptoms under control also increases a woman’s chances of becoming pregnant, which can be a huge source of relief for women who’ve been struggling for years to start a family.”
Sellman adds it’s important to remember that not all women with PCOS are overweight. The same nutrition guidelines apply to all women with PCOS, not just those who are overweight. She also stresses that there is not a “right diet” for PCOS because everyone’s body, history and genetics are different. But, there are a few key concepts that seem to be important for everyone.
The PCOS Diet
In general, a diet similar to that for patients with type 2 diabetes is usually recommended for PCOS patients. This includes:
• Eating breakfast within one hour of waking
• Having small frequent meals and snacks every 3-5 hours
• Limiting (or eliminating) refined, processed carbohydrates like white bread and packaged or processed foods
• Replacing refined carbohydrates with complex carbohydrates such as whole grains
• Increasing fiber intake
• Avoiding sweetened beverages
• Eating protein with complex carbohydrates at every meal or snack
• Incorporating omega 3 fatty acids (the healthy fat) from sources like fish and flaxseed oil, or supplements if you’re not eating these foods
• Eating more non-starchy vegetables like broccoli, carrots and greens
This is just a snapshot of the recommended diet and, as always, it’s important to talk with a doctor and work with a dietitian before dramatically changing your diet or lifestyle.
If you think you may have PCOS, ask your doctor to refer you to an endocrinologist. If you want to learn more about dietary and activity recommendations for women with PCOS, please call the UVA Nutrition Counseling Center at 434.243.4749 where you can meet individually with Ashleigh Sellman or attend one of her nutrition workshops.