What is PCOS?
Polycystic Ovary Syndrome (PCOS) affects 8-13% of Australian women in their reproductive years. This is due to hormonal changes. This ‘syndrome’ is linked to a range of health issues for affected women. In the short term, women with PCOS may have reduced fertility and difficulty conceiving. In the longer term obesity, diabetes and cardiovascular disease are more likely for women with PCOS.
The hormonal changes in PCOS are mainly related to those produced in the ovaries. Normally the ovaries produce large amounts of the female hormone oestrogen, lesser amounts of the male hormone testosterone, and the hormone progesterone (which is only produced in greater amounts after ovulation and during pregnancy). In PCOS, testosterone levels are often mildly increased.
The causes of PCOS are unknown. In some cases, it seems to run in the family whereas for other women the condition only occurs when they are overweight. Women who have PCOS may have problems such as:
Irregular menstrual cycles – menstruation may be less frequent due to less frequent ovulation, and may be either heavier or lighter than average.
Amenorrhoea – some women with PCOS do not menstruate, in some cases for many years.
Obesity – the cause of this is unclear.
Excessive hair growth – may be due to increased testosterone.
Acne – may be due to increased testosterone.
Infertility – related to less frequent or absent ovulation.
There may also be long-term health risks. Research suggests that PCOS is related to insulin resistance and the development of diabetes. Some women with PCOS develop diabetes, especially if they are overweight.
What is the latest research on PCOS and lifestyle changes?
Evidence-based guidelines for the assessment and management of PCOS have been developed in Australia. This large body of work documented results from studies around the world and gives direction for the best treatment steps to take. A take home message from these guidelines is the important role of ‘lifestyle management’ as the first line of therapy for PCOS and outline the clear benefits that result from a very achievable weight loss and increase in physical activity.
Do I have to get back to my ‘healthy’ BMI range for me to see improvements in my health?
No, the good news is that research shows that achieving a loss of just five to ten percent of your body weight, whatever weight you are at now, has significant effects for fertility and symptom management in women with PCOS. What might this look like? For most women, it is a loss of only 4 to 5 kg. Further health benefits come from greater losses, and are enhanced by increasing physical activity.
How active do I have to be to get health benefits?
A good goal is at least half an hour of moderate-intensity physical activity on most, preferably, all days. You do not have to do it all at once. Your exercise can be spread over the day, in ten minute blocks. Try three ten minute walks, or two fifteen-minute periods of activity.
What does moderate-intensity activity mean? Moderate-intensity means you are exercising at a comfortable pace. A good guideline is the “talk test” - you should be able to maintain a conversation easily without being short of breath.
What happens if I am already in my healthy BMI range?
Maintaining your weight in the healthy range can help prevent symptoms and longer term health risks for women with PCOS. Being a healthy weight is a balancing act: having a good knowledge of nutrition is important, but we also need to understand the reasons for why we eat, how we eat, what we eat, who we eat with and where we choose to eat. Believe it or not, there is a lot more to reaching and maintaining a comfortable weight than counting up kilojoules!
Dietitians are trained to take a key role in assisting women with PCOS to manage their symptoms. Here at Lifestyle Metabolic, specialist women’s health dietitians and doctors are able to tailor a program to support you to adapt guideline recommendations to your lifestyle and preferences. We look forward to supporting you on your journey to better health and quality of life.
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