By Amber Charles-Alexis, MSPH, RDN
June 7, 2021
Polycystic ovary syndrome (PCOS) is the most common cause of infertility in women of childbearing age. This blog describes the impact of PCOS on women’s health and the role of nutrition in PCOS management.
Picture: Canva, stock image
What is PCOS?
Hormones are chemical messengers that control bodily functions, including metabolism, blood sugar, blood pressure and reproduction (3).
PCOS can affect up to 20% of women, depending on the criteria used for diagnosis (5).
Signs and symptoms of PCOS
The symptoms of PCOS are mainly due to the presence of excess testosterone – aka male androgens – a condition also called hyperandrogenism.
However, not all women with excess testosterone levels have PCOS, but they may share similar symptoms (5).
Hirsutism or excessive body hair on the face, neck, back, chest and thighs
Acne occurs in 15-30% of women with PCOS
Increased abdominal fat/obesity
Weight gain or obesity
Irregular menstrual cycles or lack of a menstrual cycle
Insulin resistance and pre-diabetes
Chronic, low-grade inflammation and poor gut health
Hair loss (alopecia)
Non-alcoholic fatty liver disease (NAFLD)
How is it diagnosed?
PCOS is a diagnosis of exclusion.
You can expect a combination of lab work (blood) and ultrasounds of your ovaries to confirm the presence of PCOS.
While there are several diagnostic frameworks for PCOS, the Rotterdam criteria is quite common and PCOS can be diagnosed if any 2 of the following are present (8):
Symptoms caused by hyperandrogenism, such as androgenic baldness, hirsutism
Menstruation and ovulation disorders
Enlarged (ovary volume > 10 cm3) or polycystic ovaries (at least 12 follicles) visible in an ultrasound image.
As you can see, you do not actually need cysts to be present on your ovaries to be diagnosed with PCOS.
Risk factors for PCOS
You are more likely to develop PCOS if you have (5):
A family history of PCOS
A history of weight gain
Diabetes – type 1, type 2 or gestational
How does PCOS affect women’s health?
Excess testosterone is responsible for a myriad of negative health outcomes in women with PCOS.
The high levels of testosterone trigger inflammation which leads to the development of insulin resistance - a condition where your cells become less responsive to the action of insulin, the hormone that regulates blood sugar (1, 4, 8).
Approximately 50-70% of women with PCOS have insulin resistance (IR) (5).
Scientists believe that inflammation and IR play key roles in the development of metabolic syndrome and increases your risk for diabetes, high blood pressure, heart disease, high cholesterol, and some cancers, like breast and ovarian cancer (1, 2, 3, 4, 7, 8).
Furthermore, IR is also believed to cause increased visceral fat - the fat around the organs - and an expanding waistline.
Although there isn't a cure for PCOS, if left unmanaged it may lead to the development of many chronic, non-communicable diseases and a reduced quality of life.
Can I have PCOS if I am not overweight?
In short - yes.
Furthermore, up to 75% of lean women with PCOS have insulin resistance (2).
This simply means that you can have a BMI within the normal range and still develop PCOS and its many side effects. However, women with higher body fat have more aggravate forms of PCOS and insulin resistance (2).
What is the role of nutrition in PCOS management?
While there isn't a specific diet for PCOS, nutrition and lifestyle changes are the first-line treatment for PCOS (2).