In our health-obsessed, hyperconnected world, it’s become OK to talk about cancer, bowel trouble and even depression – yet polycystic ovary syndrome, a condition affecting up to one in five women, has remained something of a taboo.
Polycystic ovary syndrome, or PCOS, is a condition affecting the function of the ovaries. It’s typically characterised by irregular periods, excess levels of testosterone in the body (which can cause acne or unwanted hair), and abnormal follicles in the ovaries (which can affect ovulation and thus fertility). These symptoms usually arrive when a woman is in her teens or twenties, but they vary dramatically between individuals. The causes of PCOS remain unclear, though it’s highly likely that genetics play a role, as it can run in families, says Stephen Franks, professor of reproductive endocrinology at Imperial College London, and a world expert on PCOS.
“It’s a wide spectrum of presentations – some women have infrequent periods, but no problems with unwanted hair, some have the hair but no problems with periods,” says Professor Franks.
Kate Martin, a researcher from Hampshire, aged 37, only discovered she had it at the age of 25, after she overheard a colleague making a joke about some hair she had on her chest.
“She was an idiot, but ultimately it was quite helpful,” says Kate. “I suddenly thought, ‘Oh – maybe that’s not normal’. My periods were also all over the place – I’d have one every four months – so I went to the doctor and they did a scan of my ovaries and a blood test. I had some cysts, not loads, but more than average, and high levels of testosterone, so they told me I had PCOS.”
But around half of women with PCOS don’t report any symptoms at all. Sarah Malcolm, 27, said being diagnosed with PCOS was a shock because she had none of the classic symptoms she knew about. “I hadn’t had a period for five years, but couldn’t tell if that was to do with the pill I was on or not. When I came off it, I went to my doctor and had a scan and he told me I had PCOS.
“I went home and wallowed in self-pity for a while, but then decided to do a load of research and saw a specialist privately.”
Longer term symptoms and solutions
PCOS is the most common cause of female infertility – often because it’s left undiagnosed. One study of 4,000 women found almost three quarters of those with the syndrome had had problems conceiving, compared with 16% of women without. But fertility drugs which stimulate ovulation can help women struggling to get pregnant or, if these don’t work, a surgical procedure to reduce the tissue in the ovaries producing the abnormal hormones.
The condition is also associated with insulin resistance – where the hormone insulin doesn’t break down sugars from food as effectively as it should – and so sufferers are also at raised risk of type 2 diabetes, especially if they are overweight. Support managing diet and weight can help.
Another common but poorly recognised complication is anxiety and depression, especially for those who suffer with acne or unwanted hair (as if that wasn’t enough, the condition can also cause alopecia – hair loss). For problems such as unwanted hair, oral contraceptives and anti-androgens can reduce the symptoms. “There’s some evidence that if you can intervene early, especially with unwanted hair, you stop it progressing,” says Professor Franks.
Future hope
There’s currently no cure for PCOS, but science is making advances: researchers at Imperial College are studying whether a device used in type 2 diabetes which burns off insulin-resistant cells in the gut could also help those with polycystic ovary syndrome. And earlier this year, in a major breakthrough, French researchers discovered that polycystic ovary syndrome may be caused by exposure to excess levels of anti-Müllerian hormone in the womb. A common IVF drug called cetrorelix reversed the symptoms in mice, offering hope that the same effect might be seen in humans.
Lifestyle changes
But while we wait for science to catch up, there are lifestyle changes that many women report helping them through their diagnosis. Though Kate wasn’t overweight, she started to eat more healthily, gave up smoking, and started hitting the gym three times a week – and her periods started to become more regular.
Then, when she was in her early 30s, she and her husband began trying for a baby, expecting a long journey ahead of them, but happily, Kate became pregnant within seven months, and she is now mother to two daughters, aged four and one.
Qualified nutritionist Lola Ross agrees that diet can play its part: “Supporting liver detoxification processes are a key component in the management plan of PCOS as it is thought to be an oestrogen dominant-linked condition. Plant foods containing sulphur (onions and leeks) and glutathione (most vegetables and fruits) are important to include as they are compounds that support the efficient removal of oestrogen from the body.”
Similarly, Sarah decided to cut out refined sugar and reduce dairy, and increased her exercise levels, training as a yoga teacher. “Exercise has shown to increase sex hormone binding globulin which is what testosterone requires to bind and avoid free circulating testosterone in the body which is a marker of PCOS,” Lola explains.
She now feels her periods – and hormones – are in a more balanced state. Describing herself as a PCOS ‘ass-kicker’, she is one of millions of women using social media to open up the conversation about this common, debilitating but treatable condition.
“I get so many messages from women saying they’ve been diagnosed with PCOS and don’t know where to start,” she says. “I always say: you’re not alone, and you shouldn’t feel scared or isolated – because there are so many things you can do.”
Food and Supplement recommendations
Supplementation
Chromium picolinate: may support insulin response as high insulin can reduce SHBG. CP may also help reduce cravings, manage weight and reduce risk factors for cardiovascular disease.
Sulforaphane: supports phase II liver detoxification to support hormone balance.
EPA/DHA omega fats: hormone support.
B vitamins: helps with anxiety mood shifts.
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