Everyone’s weight and health issues are different and I am sure each case of PCOS is completely different depending upon the person we all have different combinations of symptoms. I am going to try explain my own issues and try to understand how I can better deal with my own weight management issues.
What is PCOS?
PCOS stands for Polly Cystic Ovary Syndrome. It’s a common endocrine disorder that typically begins in adolescence or early adulthood and is a leading cause of infertility.
In PCOS, a woman’s ovarian follicles fail to release an egg every 28 days as a result of hormonal imbalance: too much luteinizing hormone (LH) and not enough follicle-stimulating hormone (FSH). Instead of the egg maturing, it remains in the ovary and forms into a small cyst. This process is repeated on a monthly basis, alternating between the two ovaries, leading to the formation of dozens of cysts over time. When I was last scanned the doctor said I have lots and lots surrounding my ovaries. It’s hard not to get upset or feel I have the entire world against me as I struggle to keep my weight under control. If I don’t exercise and restrict my diet I gain weight very quickly and soon find I am struggling to lose weight. It’s all too easy to slip into the high carbohydrate low-fat diet that consumers want us to buy. It’s hard to maintain keto but I am going to stick with it for the sake of my health. Writing this only helps me reaffirm why I need to do this. This isn’t just about being slim it’s about my health.
The role of insulin is to allow cells of the body to take in glucose to be used as fuel or stored as body fat. It also means that glucose is more likely to build up in the blood and this can lead to too high blood sugar levels. When the body becomes resistant to insulin, it tries to cope by producing more insulin. People with insulin resistance are often producing too more insulin than healthy people.
What Are the Symptoms of PCOS?
signs and symptoms of PCOS include:
- Menstrual irregularities, including absent periods (amenorrhea) or infrequent periods (oligomenorrhea
- Overweight and obesity
- Acanthosis nigricans (skin tags and darkened pigment in the skin folds of the armpits, groin, thighs and neck)
- Masculinisation due to hyperandrogenism (high levels of testosterone). Symptoms include hirsutism (excessive facial and body hair), acne & pattern baldness.
However, not every woman with PCOS experiences all of these symptoms. In addition, some don’t even have the characteristic cysts on their ovaries. I understand and know I the following symptoms weight gain, Menstrual irregularities & Masculinization. Thankfully I don’t suffer from depression or Acanthosis nigricans.
In addition to infertility and other chronic symptoms, women with PCOS are at increased risk for a number of diseases and health conditions,
- Type 2 diabetes
- Coronary artery disease (CAD)
- Non-alcoholic fatty liver disease (NAFLD)
- Obstructive sleep apnea
What Causes PCOS?
Doctors are unsure of what causes PCOS, but information suggests there are several links including genes, possible abnormal fetal development, insulin resistance and inflammatory response contributing to the cause. We know that insulin resistance plays a key role in PCOS, but what leads to the development of this has not been pinned down. PCOS is also negatively affected by diet, lifestyle and exposure to certain environmental toxins. PCOS directly impacts fertility, but has serious health implications as well, especially if left untreated.
Genetic Predisposition and Abnormal Fetal Development
Women whose mothers, sisters or grandmothers had PCOS are at a higher risk for developing PCOS. Research suggests that exposure to excessive amounts of male hormones (androgens) by the developing fetus may alter proper gene expression. This means that the affected genes will not function correctly later in life, which may cause PCOS during the reproductive years of a woman’s life.
Insulin Resistance and Hyperinsulinemia Often Play a Major Role in PCOS
Insulin resistance affects about 64% of all women with the disorder, mainly those who are overweight or obese.
In women with PCOS, high levels of free testosterone and low levels of SHBG (Sex hormone-binding globulin) promote insulin resistance and the storage of visceral fat in the belly and around the liver and pancreas. Excess visceral fat drives insulin resistance, inflammation, and further stimulates androgen production, creating a vicious cycle that can seem impossible to break.
In women with PCOS may have metabolic syndrome, an insulin-resistant condition strongly linked to type 2 diabetes.
Metabolic syndrome is formally diagnosed by meeting at least 3 out of 5 criteria:
- Large waist circumference: 35 inches (89 cm) or higher for women
- Elevated triglycerides: 150 mg/dL (1.7 mmol/L) or higher
- Low HDL cholesterol: 50 mg/dL (1.3 mmol/L) or lower for women
- High blood pressure: 130/85 mm Hg or higher
- Elevated fasting blood sugar: 100 mg/dL (5.6 mmol/L) or higher
PCOS and Weight Loss
Insulin-resistant PCOS sufferers also tend to have an extremely difficult time achieving and maintaining a healthy weight.
Because obesity perpetuates insulin resistance and hormone imbalances, women with PCOS are frequently urged to lose weight in order to reduce disease risk and improve hormonal regulation. However, as anyone who has struggled with this disorder knows, losing weight and maintaining the loss is often easier said than done.
In studies, drastic calorie restriction has been shown to produce weight loss in most people, including those with PCOS. In a 4-week controlled study, when women with PCOS consumed a 1000-calorie diet with either higher or lower protein content, both groups lost weight and had decreases in blood sugar and insulin levels.
Although this shows that very-low-calorie diets can lead to weight loss, they aren’t sustainable or healthy long term. Cutting calories too low can lead to rebound hunger and overeating, low energy levels and mood issues. Additionally, severe calorie restriction causes loss of lean muscle and a reduction in metabolic rate, making weight loss and maintenance even more difficult in the future.
Low Carb and Ketogenic Diets for PCOS
By contrast, low-carb and ketogenic diets may be ideal for women with PCOS, especially those with insulin resistance.
carb restriction has been linked to loss of weight and visceral fat, reductions in insulin and blood sugar levels, and improvements in other cardiac disease risk factors in those with metabolic syndrome.
In one study, people with metabolic syndrome who consumed approximately 1500 calories on a low-carb diet lost 14% of their body fat and experienced a 50% or greater reduction in insulin levels, insulin resistance and triglycerides.
Anecdotal evidence about carb restriction’s effects on PCOS is pretty impressive.
Several women with PCOS have reported major weight loss, resumption of normal menstrual cycles and fertility, and other beneficial health changes as a result of switching to a low-carb or ketogenic lifestyle.
And although there are very few formal studies exploring carbohydrate restriction for PCOS, those that exist are encouraging.
In a small study lasting 6 months, 11 women with PCOS lost an average of 11% of their body weight while following a ketogenic diet restricted to 20 grams of carb daily. In addition, their fasting insulin levels dropped by 54%, and their LH:FSH ratio improved. Moreover, two of the women who had been struggling with infertility became pregnant during the course of the study.
In addition to reducing insulin levels, ketogenic and low-carb diets also help control appetite, resulting in a spontaneous reduction in calorie intake that can lead to weight loss without hunger.
Despite the limited formal research on low-carb and ketogenic diets in women with PCOS, it’s that decreases insulin resistance may be effective for managing the disorder.
I feel so frustrated and know this is going to be a lifestyle change this is no longer about me eating healthy this is about me changing my lifestyle to fix health issues. The NHS doesn’t treat PCOS unless you are trying for a baby. I have to fix this with my diet and with exercise. This isn’t going to be easy and I am not going to let PCOS consume me. I will fight this and I will come out on top. If you have PCOS let me know how you manage your symptoms with your diet. What issues affect you most? Is there anything you would recommend or say to avoid any help is welcome with this.
For further reading on research please take a look at the links below.