September is National PCOS Awareness Month and an important time to highlight the top cause of infertility in the US. It’s estimated that Polycystic Ovarian Syndrome (PCOS) affects 10-20% of women, but it often doesn’t get diagnosed until later in life after symptoms (like irregular or non-existent periods) are treated with a Band-Aid approach like the birth control pill.
How do you diagnose PCOS?
There is no specific test to diagnose PCOS; however, it’s generally agreed upon that a woman has PCOS if she meets at least two of the following three criteria:
Absent or irregular periods
Physical signs of high androgens, such as excess body/facial hair and acne
Ovarian cysts (detected via ultrasound)
Types of PCOS
What causes PCOS is still unknown; however, finding the root cause of your PCOS will support the best plan for treatment. Although there is no cure for PCOS at this time, symptoms can be managed with the right diet and lifestyle.
Insulin Resistant: This is the most common type of PCOS (around 70% of women have this type). Symptoms include weight gain, acne, hirsutism, and mood swings. Women with this type of PCOS are also at a higher risk for diabetes due to blood sugar imbalances.
Post Pill: Triggered by coming off of hormonal birth control, this type of PCOS typically involves irregular or non-existent periods.
Inflammatory: Many women with this type of PCOS don’t present with classic symptoms, but may be experiencing inflammation due factors like a poor diet and environmental toxins. Symptoms can include fatigue, headaches, bowel issues, and joint pain.
Adrenal: This type of PCOS is stress-related and is marked by elevated levels of DHEA-S, but normal testosterone and androstenedione.
Supporting Your Body to Optimize Fertility
If you or a client have been diagnosed with PCOS, it might feel discouraging, but it is possible to conceive naturally or with medical treatment (including Clomid and Metformin). First, I recommend determining the type of PCOS you (or your client) has, then working to address the root cause. If you’re unsure of the type, I encourage speaking to a medical provider about running the following tests (though there are several others!):
Tests for PCOS
Dutch Test
FSH/LH Test
DHEA/Testosterone
Fasting blood glucose
Fasting insulin
DHEA/DHEA-S
Thyroid Panel
Vitamin D
Omega 3
Inflammatory markers
Lifestyle Changes for PCOS
All PCOS types benefit from healthy lifestyle upgrades. Though these changes cannot “cure” PCOS, they can lessen or even eliminate symptoms, including those that cause fertility issues.
Diet I recommend a low glycemic diet that’s packed with fiber, high quality protein, zinc, and omega 3s. I also recommend limiting or avoiding dairy, particularly if acne is a recurring symptom. Keeping blood sugar balanced is also key for healthy hormones, so I encourage my clients to include a protein and healthy fat with all of their meals and snack
Grab my free guide for a day of hormone friendly meals and snacks here!
Stress Management It’s impossible to avoid stress altogether - especially on a fertility journey - but learning how to manage stress is an important piece in the PCOS puzzle. Practices like journaling, meditation, affirmations, and acupuncture can support a healthy stress response.
Exercise Finding ways to move your body regularly is important for both physical and mental health. As far as the best types of exercises for PCOS, I recommend listening to your body and starting with low impact options (like walking, yoga, Pilates, swimming, and hiking). You can add in more high intensity workouts 2-3x/week, if your body responds well. Listening to your body and finding movement that works best for YOU is most important on your healing journey.
Supplements I have a whole blog post on supplements here, but there are some additional supplements that specifically support the symptoms brought on by PCOS. I recommend working with a medical provider to get up to date lab work done to determine what your body needs and supplementing accordingly. Generally, I find that these supplements are helpful to women with PCOS:
Vitamin C: for ovary function
Vitamin E: normalizing estrogen levels
Zinc: hormone balance
Inositol (D-Chiro and Myo): blood sugar regulation
Magnesium: improves insulin sensitivity
Chromium: reduces insulin resistance
As you can see, there are many factors to consider with a PCOS diagnosis, but there is also a lot of encouraging news regarding symptom management and fertility. If you or someone you know has been diagnosed with PCOS, just know that there are tools and resources available to support the journey to parenthood. Check out PCOS Awareness Month online and be sure to reach out if you need help navigating the next steps for you or a client.