Polycystic ovarian syndrome, or PCOS, is the most common hormonal condition affecting women of reproductive age; 1 in 5 women in the UK will be diagnosed with PCOS.
What is PCOS? It’s when small growths develop on a woman’s ovaries, (fluid-filled sacs that contain immature eggs); and this stops normal ovulation. Women with PCOS produce higher-than-normal amounts of male hormones, creating an imbalance in the body. This increases a risk of infertility and can act as a precursor for other conditions, such as diabetes, cardiovascular disease and endometrial cancer. Less serious but still annoying it can also cause weight gain, depression, adult acne, anxiety, stomach bloating, hair loss or excessive hair on the face, neck, chest and stomach. Its cause is unknown, though there’s a genetic link, and technically it’s incurable; although experts concur that lifestyle changes can make a huge difference.
Sana Khan is a registered Nutrition Consultant with a special interest in fertility and hormonal health. Founder of London’s Avicenna Wellbeing clinic, she was diagnosed herself with polycystic ovaries in her late teens.
She says, “I had all kinds of nasty symptoms and following an ultrasound they found several cysts on both ovaries. My GP put me on the pill straight away. But three months into this I realised that I was still battling many of the same things – sugary cravings, tiredness, and weight gain. But I began to notice that exercise and my diet had a real impact on how I felt. So I stopped the pill and started looking for my own answers and explanations.”
Following what she says was a lot of ‘confusing and controversial advice’ on the internet, Sana began to note the correlation of specific foods, and the timing of those foods – and the way in which they affected her hormones.
Sana admits, “Some of this was trial and error, and some through expert opinions. So I went on to study a degree in nutrition and learnt how to conduct research thoroughly – and I also further refined my lifestyle and dietary interventions for my PCOS – that’s when my symptoms started to diminish almost entirely.”
“At age 31 I underwent another scan and my sonographer was very confused about the time and how I was diagnosed with PCOS. She made it very clear that there were no cysts left on my ovaries. I am extremely thrilled and I know that through my dietary and lifestyle interventions I have managed my own hormonal health. My periods are regular now, my skin has completely settled, and cravings for sugar has normalised and my weight maintained.”
Here’s what Sana Says You Need to Know
Not Everyone is the Same: PCOS affects women in many different ways, and there is no one size fits all approach – therefore what works for someone might not work for you. Many of the symptoms are physical but we also know that this may have an impact on mental health. If someone suffers from PCOS they may have irregular periods as well as excess body hair, feel tired all the time, have thinning hair on the head and acne-prone skin due to a hormonal imbalance.
What You Can Do: Currently some doctors like to give drugs like the contraceptive pill, or Metformin, however these will require regular liver function tests. From a holistic perspective I would first suggest trying to normalise bodyweight and then to focus on reducing stresses as elevated stress hormones (i.e. cortisol), which can worsen the insulin resistance.
How You Should Eat
Complex is Best: I would also switch refined sugars and carbohydrates to complex carbohydrates, and combine with protein to keep blood sugar levels balanced. Instead of counting calories try to look for your source of protein combined with carbohydrate as that will help support your blood sugar and minimise symptoms of the insulin resistance. If you are counting calories you could be eating sugary and carb rich foods that can be low calories but still be causing your insulin resistance hormones to go haywire.
Omega is Mega: Seek out Omega 3 in supplements and diet—this is anti-inflammatory and will promote your body’s response to insulin.
Green Eating: Eat more vegetables, pulses and legumes as these may help to increase SHBG which then can help in reducing the excess androgenic and male hormones.
Put Down the Cocktail: Sorry to say it but you need to cut back on alcohol as alcohol is not ideal for a weight perspective and for the liver.
Cut the Coffee/Tea: Caffeinated drinks and stimulants keep the “stress hormones “ elevated and therefore caffeinated drinks should be limited.
Clean Eating: Avoid processed foods like cakes, biscuits, pastries as these may potentially promote inflammation in the body.
Say No to Sugar: Watch out for common culprits that have lots of sugar in them like fruit juice as this is considered a refined carbohydrate because of the fibre being removed, and also avoid sweeteners as these can disrupt your gut microbiome , And I would watch out for hidden sugars and things like sauces and condiments.
Small Meals are Best: I encourage small meals to be eaten but more often and I highly recommend keeping a gut in top shape through fibre rich foods and fermented foods to obtain probiotics and to allow optimal got motility. For smaller portions I recommend a top tip, if you’re preparing food at home use smaller plates and small spoons as this may encourage chewing your food more thoroughly which will aid digestive processes, and look into keeping a food diary as this may be a conscious reminder of all the potential sugars and other “ inflammatory” processed and preservative rich foods you maybe over -indulging in.
Exercise is key: This will help immensely with mental health as well as physical balance.
See a Specialist: Book in with a registered nutritionist to find out which supplements are ideal to take. Don’t self prescribe lots of supplements as these can be burdensome on the liver, and try not to be confused with controversial trends in the diet culture that may arise Instead learn how to look for evidence-based science and I would strongly urge to visit a registered nutritionist for advice on supplementation (Omega three supplements should definitely be considered.)
Remember It’s a Marathon Not a Sprint: It is important to remember that these dietary and lifestyle choices made are to be considered long term rather than short-term diets. Don’t become disheartened if results are not instant. Although you may start to notice improvement in skin health and hormones immediately it may take years for your menstrual cycle to settle into sync. But you will get there.
Do You Have Polycystic Ovaries? What are the Symptoms?
The main symptoms include irregular periods or no periods at all, and difficulty becoming pregnant. Also, because of the higher levels of testosterone in the body, PCOS can cause excessive hair growth on the face and body. Women may also notice weight gain, thinning hair or hair loss, and oily skin or acne on their face. Having polycystic ovaries can also increase a woman’s chance of developing other health conditions such as type 2 diabetes, depression, high blood pressure and high cholesterol. During ovulation, the uterine lining sheds, but if you don’t ovulate every month, the lining can build up, which can increase risk of developing womb cancer. It’s not known why PCOS happens but it may have a genetic link.
Sana Khan is the founder of Avicenna Wellbeing and a member of the British Association for Applied Nutrition and Nutritional Therapy (BANT), the CNHC and an Associate Member of the Royal Society of Medicine.