Been diagnosed with PCOS – Now What?

Perhaps you have been diagnosed with polycystic ovary syndrome (PCOS) and are now left feeling a bit clueless… Well, welcome to the cysterhood! If PCOS is something you’ve never heard of before, it can sound rather petrifying. Your brain may feel like a battlefield and your emotions are sure to be all over the place, but that’s completely normal. Our go-to has become Google for our own investigations, however, there are thousands of websites, articles, links and blogs all claiming to know how to manage PCOS. But how do you know who to trust? They’re all stating multiple things in which many are contradicting each other; everyone thinks they are an expert and their advice is right. During this overwhelming time, you need advice and guidance by people who have experienced the struggles of having PCOS and you need to be able to understand how to manage your newly diagnosed condition. 

Here are our top tips to help you manage your PCOS symptoms.

PCOS 101

The current treatment options for PCOS are symptomatic as there is no cure, so, unfortunately, it’s sticking around for a while. However, you, yourself can treat your condition such that it becomes unnoticeable and hence lead your life normally. By learning to manage and control the complications of PCOS with a few lifestyle changes and some medication you can improve your quality of life yourself, because let’s face it… you are your own best friend. 

Making healthy choices and bringing changes into your lifestyle has become pretty much common sense, almost every condition requires you to eat healthily and exercise. However, for PCOS sufferers, it is a little different, the minor tweaks in your diet and weight will make a major difference, it can induce ovulation and make you fertile from infertile, it can significantly reduce the spots and acne scars on your face and it can reduce the random strands of hair growing on your chin. 

The main symptoms of PCOS include;

• Insulin resistance
• Irregular periods
• Hyperandrogenism, mainly hirsutism- increase in facial hair
• Obesity
• Hair thinning/loss- alopecia
• Depression
• Poor mental health
• Infertility

 As with most conditions, the symptoms of PCOS vary among women, as does the severity of the symptoms. Some PCOS sufferers’ menstrual cycle may be right on time, whilst yours may pop-up every few months, this is completely normal and expected; your bodies are insanely unique!

A trip down to your GP?

You may decide to take a trip down to your GP where you will find that the treatment of PCOS follows patient-centred care. This means you have a say in your treatment and the doctors will provide you care which is respectful and responsive to your preference and needs. Yes, you can boss your GP around a little.

 However, the first line of treatment they will recommend will be to make changes to your lifestyle. These include changing your diet, exercising, losing weight and taking part in activities to maintain healthy mental health. The more overweight you are the more complications you will face as well as a higher risk of developing other long term health conditions. Hence, losing weight and maintaining a healthy weight is crucial in managing PCOS. 

The hormonal imbalance does not only affect your sex hormones, but other hormones secreted by the endocrine system as well, such as insulin. Insulin metabolises carbohydrates in your body and those with insulin resistance are unable to respond to glucose properly. This then leads to being overweight and in-turn obese because your body is not able to absorb the sugars from your chocolate cake, into your liver and convert it into energy and stores it as fat instead. Higher insulin levels also induce your ovaries to produce androgen such as testosterone, the male hormone. An increase in male hormones causes hirsutism, acne and alopecia; all of which can be managed with weight loss.

Check in with your diet and nutrition

Now, if only losing weight was as simple as we thought. Apple crumble and French fries are so tempting, of-course anyone would choose those over a bowl of salad. But following a healthy balanced diet is a significant way to manage your PCOS; it can regulate your period, decrease your acne and make you feel better overall. The worst thing to do is to Google different diets and try and follow the tons of advice people are giving on their websites. These diets may work temporarily but are not always healthy and are difficult to maintain in the long-run. However, following a low glycaemic index (G.I) diet and substituting high GI carbs with low GI carbs help PCOS sufferers lose weight efficiently and are a key technique that clinicians and dieticians advise. 

Now, don’t be fooled, low GI carbs are still carbs, they still contain sugars (glucose), however, they increase blood glucose levels very slowly by producing smaller fluctuations whereas high GI foods are rapidly digested and absorbed, increasing blood glucose and insulin levels vigorously. This means when you eat a piece of cake, your body digests it rapidly, extracts all the glucose and signals lots of insulin to be released whereas if you have a granola bar, your blood glucose levels fluctuate slowly delaying the entire process, in addition, low GI foods are incredibly filling so you won’t be craving snacks in between your meals as much. A great book that explains the G.I diet very well is ‘ The Low GL Diet Bible’ by Patrick Holford, it contains a list of foods that you can substitute your daily carbs with. 

Another super helpful technique that helps with losing weight is consuming lots and lots of water, and not just the recommended eight glasses. Instead having 3-4 litres a day makes a huge difference in aiding your diet to manage your PCOS.  As well as managing and decreasing your carbohydrate intake, you should also manage your fat and salt intake and make sure you’re taking in all the necessary vitamins and minerals. Also, increasing the intake of whole foods aids weight loss and helps maintain a healthy balanced diet. Although losing weight isn’t so easy for PCOS sufferers, it is totally worth it; just a 5% weight loss can significantly improve symptoms.

Blood, sweat & tears!

Coming onto exercise, everyone’s favourite. Who wouldn’t want to be dripping in sweat with a heart rate of more than 150 and cramps in almost every muscle in their body? However, again, like losing weight, exercise increases metabolism and improves many of your symptoms; the sweat and cramps are totally worth it. When exercising, the main goal for cysters is to lose weight in the abdomen and reduce fat around the organs in your endocrine system which secretes your hormones and in turn, manages your PCOS symptoms. 

Again, like dieting, it is tempting to google insane workouts, watch tons of videos, carry out all the intense workouts for a few days and then give up. Instead, it is best to start slow, steadily increasing your workouts as well as the time spent working out; this will be much easier to maintain. For some reason, there is a misconception that you will only lose weight with cardio, it’s a total myth! Weight training and mild weight-lifting is equally as effective in weight loss. Therefore, don’t be hesitant to introduce the fancy machines at your gym, into your workout, or if you work-out from home, don’t be afraid to purchase some dumbbells. 

Peace of mind

Hormonal imbalance not only messes with your body physically but mentally as well. The random mood swings, the emotional sensitivity, the sudden panic and anxiety attacks; all of these are driven by your hormones and neurotransmitters in your brain. You may feel like your quality of life has worsened due to the symptoms and complications you face which also may impact your mental wellbeing. The stress, the anxiety, the frustration, all of these are damaging your health. Incorporate stress reduction techniques into your lifestyle to improve your mental health and manage your PCOS.

Carrying out activities that make you happy, being around people you love, doing yoga, meditating, maintaining a healthy work-life balance and many more, help reduce stress levels. However, like managing weight, managing stress can be extremely challenging, if you feel things are getting out of hand, it might be a good idea to visit your GP surgery again to discuss therapy and counselling options.

Pharmacotherapy!

Surely there is a simple drug to fix everything? Because almost every health condition is treated with medication it is natural for us to expect there to be a drug to treat PCOS. Unfortunately, there are no medicines that have been specially designed to treat or manage PCOS. PCOS pharmacotherapy includes drugs that are manufactured to treat other conditions. These drugs can not cure, but instead manage PCOS symptoms and complications.

For example, for irregular periods, the contraceptive birth control pill is often prescribed to induce regular period cycle. Oral contraceptives mainly contain oestrogen and progestin, these are female hormones and help normalise the menstrual cycle. They also reduce male hormones and as a result reduces hirsutism and acne. On the other hand, for women that are having fertility problems, Clomifene is prescribed, it induces regular ovulation. An alternative to Clomifene is Letrozole, which is generally used for treating breast cancer. 

These medications may be used temporarily and again the decision of prescribing these are very patient and person-centred. However, a long-term and more common drug prescribed for PCOS is Metformin. Metformin is a type 2 diabetes drug; it is prescribed to manage blood glucose and insulin levels. It not only helps with losing and maintaining weight, but it also stimulates ovulation and has other long term benefits. In addition to Metformin, recently, a new line of treatment has been introduced which is another drug used for type-2 diabetes. These are called gonadotropins; the most recent FDA-approved gonadotropin is called Liraglutide (Victoza). Liraglutide has shown significant results in inducing weight loss and managing PCOS symptoms.  

Now some of the symptoms of PCOS are physically visual for example obesity, acne and hirsutism. Different medications can be used such as oral contraceptive pills that block your male hormones and suppress the production of these androgens by your ovaries. Additionally, a cream called Eflornithine can help reduce hair growth, but it may not always be as effective. For more permanent and effective treatment of hirsutism, Laser hair removal is recommended by your GP or gynaecologist, however, it is not funded by the NHS and can be a little expensive.

Whether or not these medications are prescribed depends on many other factors such as underlying health conditions, the severity of symptoms, other existing medications you take and many other factors.

If you don’t respond to the lifestyle changes and medication, your GP or gynaecologist may offer you in-vitro fertilisation (IVF) or ovarian drilling. IVF is when your egg is fertilised in a lab by your partner’s sperm cells and then implanted into your uterus to grow whereas ovarian drilling is where several thin holes are pierced into your ovary to induce ovulation. 

Don’t give up!

Treating and managing PCOS can be a difficult process but little steps make huge differences hence every step of your journey you are constantly motivated by the improvements you observe. Suffering from any condition is frustrating and then suffering from a condition with no cure is even more difficult, however, taking proactive steps in your life may hopefully make your PCOS journey much easier and almost non-existent. It may be a long and tedious journey so don’t give up and stay strong, you can do it!

If you suspect you might have PCOS, our at-home tests can give you a better insight into your hormones. But at Hertility, we don’t believe in giving you results without the rest, we give you the what’s up, and the what’s next. Our team of experts include PCOS specialists that can help you to manage your symptoms and create an actionable plan for the future.