If you have been diagnosed with Polycystic Ovary Syndrome (PCOS) and are feeling a bit clueless or overwhelmed, we’re here to help. In this article, we explain all of the possible treatments for PCOS and how to effectively manage your symptoms.

Quick facts:

• There is no cure for PCOS so treatments are focused on managing symptoms. 
• Specific diet changes can be very effective in reducing the severity of symptoms. 
• Exercise, stress management and some medications can also help.
• PCOS can also be misdiagnosed in some cases. 
• We can support you with getting a specialist care plan for PCOS.

What is PCOS?

PCOS is an extremely common reproductive health condition that affects up to 1 in 10 people assigned-female-at-birth. It can affect how the ovaries work and can cause an array of different symptoms, which can range in severity from person to person. 

The good news is, that even if you are feeling overwhelmed or anxious at the outcome of your recent diagnosis, PCOS symptoms can be treated and managed with lifestyle changes.

Symptoms of PCOS

As with most conditions, the symptoms of PCOS vary from person to person, as does the severity of the symptoms. Not everyone with PCOS will experience all of these symptoms, but you need to have at least two of the below to have been diagnosed.  

• Irregular periods—which means your ovaries do not regularly ovulate.
• Excess androgens—these are high levels of androgen hormones, which can present as physical symptoms like increased facial or excess body hair, also known as hirsutism, acne and oily skin.
• Polycystic ovaries—your ovaries have become enlarged and contain many fluid-filled sacs (follicles) that surround the eggs.

Other symptoms can include:

• Obesity or weight gain
• Hair thinning/loss (alopecia)
• Depression and poor mental health
• Infertility

What causes PCOS?

Currently, the exact cause of PCOS is unknown but it often runs in families and can be related to abnormal hormone levels in the body, including high insulin. 

Higher insulin levels also induce your ovaries to produce androgen hormones such as testosterone. An increase in androgen hormones can cause symptoms like excess hair growth (hirsutism) acne and alopecia. 

High levels of insulin can also eventually cause insulin resistance. Because insulin metabolises carbohydrates in your body, those with insulin resistance are therefore unable to respond to glucose properly. 

This can then lead to being overweight as your body is not able to absorb the sugars from your food into your liver and convert it into energy—so it is stored as fat instead.

How to manage your PCOS symptoms

The current treatment options for PCOS are symptomatic, as there is currently no cure. This means treatment is focused on treating and mitigating symptoms with lifestyle changes and certain medications. 

Your treatment will follow patient-centred care, meaning you will have a say in your treatment and your doctors should respond by providing you with care that is responsive to your preference and needs.

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. 

Don’t underestimate the power of lifestyle changes. Making healthy choices and bringing positive changes to your lifestyle can create a major difference in your symptoms, allowing you to control them and improve your quality of life. With the right, tailored care plan, many people find that their PCOS symptoms can be controlled and that they don’t present any further problems for them.

Let’s take a look at some of the lifestyle changes involved in PCOS symptom management.

PCOS diet and nutrition

Some research suggests that following a healthy balanced diet is a significant way to manage your PCOS—it can regulate your period and ovulation and reduce the presence of symptoms like acne and hirsutism.

High GI carbs Vs low GI and weight loss

If you are currently overweight, losing weight and maintaining a healthy weight is crucial for managing PCOS. 

The more overweight you are the more complications you will face with PCOS as well as having a higher risk of developing other long term health conditions. 
There are many different PCOS diets that people recommend, but a healthy and sustainable option is a low glycaemic index (G.I) diet. This involves substituting high GI carbs with low GI carbs which can help PCOS sufferers lose weight efficiently.

Low GI carbs increase blood glucose levels very slowly, whereas high GI foods are digested rapidly, which can cause spikes in your glucose and insulin levels. 

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.

Here are some great examples of Low GI carbs that you could incorporate into your diet:

• Quinoa
• Oats
• Barley
• Lentils
• Chickpeas
• Sweet potatoes
• Brown rice
• Whole grain bread
• Bulgur
• Buckwheat
• Wild rice
• Rye bread
• Whole wheat pasta
• Spaghetti squash
• Amaranth
• Pearl couscous
• Mung beans
• Black beans
• Kidney beans
• Pinto beans

Following a low GI carbs diet is generally the key piece of advice that clinicians and dieticians will advise in the case of any PCOS diagnosis and will likely form the basis of a PCOS specific nutritional care plan. 

However, there are other foods and simple switches that you can incorporate into your diet which may help to further reduce your symptoms too.

A PCOS friendly food list may contain:

• Replace meats with high-protein legumes like beans
• Eat Omega-3 rich foods (mackerel, salmon, sardines)
• Replace butter with olive oil
• Lots of Leafy greens – Spinach, Kale, Lettuce, Broccoli
• Non-starchy Veg – Mushrooms, peppers, cauliflower, celery, tomatoes
• Whole-grains – Brown rice, bread and pasta.
• Fruit for dessert

If you’d like help with anything regarding PCOS specific nutrition, you can book a consultation with one of our Fertility Nutritionists who will be able to help you with a nutritional care plan.

Reducing fat and salt

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. Try to keep your salt intake to a maximum of 2,300 mg per day.Also, increasing the intake of whole foods aids weight loss and helps to maintain a healthy balanced diet. 

Although losing weight isn’t so easy for PCOS sufferers, it is totally worth it—just a decrease in 5% of overall body weight can significantly improve symptoms.

PCOS and exercise benefits

Like losing weight, exercise increases metabolism and may help to improve many of your symptoms. When exercising, the main goal is to lose weight in the abdomen and reduce fat around the organs. 

This will help to support your endocrine system, which secretes and regulates your hormones, including your insulin and testosterone levels. 

If you’re new to regularly exercising, it’s best to start slowly, steadily increasing your workouts as well as the time spent working out. In the long run, this will be much easier to maintain. 

Cardio is great for heart health, with things like swimming, hiking and running great for getting a sweat on. But there is a misconception that you will only lose weight with cardio, it’s a total myth! 

Weight training and resistance training is equally, if not more effective, in generating weight loss around the organs. Weight training can also help you to build muscle and strength, boosting your metabolism helping to keep weight off.

Yoga and pilates can be great forms of gentle resistance training. Why not give a few of these moves a go, there is a wealth of Youtube video which can help you with your form.

Yoga:

• Child’s Pose: reduces stress and promotes relaxation.
• Cat-Cow Pose: improves hormonal balance and alleviates back pain
• Reclining Bound Angle Pose: stimulates the ovaries and enhances pelvic blood circulation
• Warrior II Pose: strengthens legs, improves digestion, and promotes stability
• Bridge Pose: strengthens gluteal muscles, and reduces anxiety and fatigue
• Legs Up the Wall Pose: improves circulation and regulates the menstrual cycle

Pilates:

• Hundred: engages core muscles, improves circulation, and enhances energy levels
• Leg Circles: strengthens abdominal muscles, improves hip mobility, and aids digestion
• Pilates Bridge: activates gluteal muscles, strengthens the back, and improves posture
• Roll-Up: strengthens abdominal muscles, improves spinal mobility, and enhances body awareness.
• Relaxation Pose: promotes relaxation, reduces stress, and supports overall well-being.

PCOS and mental health

Hormonal imbalance, like those present in PCOS, don’t just mess with your body physically, but they can also present as mental health symptoms too. Things like random mood swings, emotional sensitivity, sudden panic and anxiety attacks can all be driven by hormones and neurotransmitters in your brain. 

Mental health concerns such as depression and poor mental health can therefore also be symptoms of PCOS. Even if this isn’t caused by hormonal imbalances, feelings of low mood or depression may arise if you feel like your quality of life has worsened due to any symptoms or complications from PCOS.

Stress, anxiety and frustration are all damaging to your health and it is therefore important to incorporate some stress reduction techniques or things to support your mental wellbeing into your lifestyle as part of your treatment plan. 

Carrying out activities that make you happy, being around people you love, doing yoga, meditating, maintaining a healthy work-life balance and many more, can all help to reduce stress levels and improve mental wellbeing. However, like managing weight, managing stress can be extremely challenging.

If you are struggling mentally and need support, our Fertility Counsellors are here to support you. You can book a 1-1 consultation with one of our professional mental health counsellors anytime. All of our counsellors are specifically trained in reproductive health concerns, helping to support those struggling with recent diagnoses.

Medication and PCOS

Unfortunately, there are no medicines that have been specially designed to treat or manage PCOS. Therefore, PCOS pharmacotherapy includes drugs that are manufactured to treat other conditions. These drugs can not cure, but instead manage PCOS symptoms and complications.

Medication that can be prescribed to help with PCOS symptoms includes:

• The contraceptive birth control pill—this can help normalise your menstrual cycle and reduce the level of androgen hormones in your body, reducing symptoms like hirsutism and acne
• Clomifene—this can be prescribed if you are having fertility problems, to induce regular ovulation
• Letrozole—this is sometimes prescribed as an alternative to Clomifene, but is usually used for treating breast cancer
• Liraglutide (Victoza)—this is what’s known as a gonadotropin drug and has shown significant results in inducing weight loss and managing PCOS symptoms as well as being used predominantly for type-2 diabetes

All of the above medications can be prescribed, but a longer-term and often more common drug that is prescribed for PCOS is Metformin. 

Metformin is a type 2 diabetes drug, 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. 

Other topical medications, like a cream called Eflornithine, can help with excess hair growth—as well as treatments such as laser hair removal.

Whether or not any form of medication is prescribed for your PCOS will depend on a range of factors that your doctor will be able to talk you through. This can include your medical history, any other underlying health conditions, the severity of your symptoms, other existing 

medications you take and your lifestyle. 

If you don’t respond to any lifestyle changes or medication, your GP or gynaecologist may offer you in-vitro fertilisation (IVF) if you’re trying to conceive or ovarian drilling, to induce ovulation. 

IVF is when your eggs are retrieved and fertilised in a lab by either your partner or donor sperm, and then implanted into your uterus to grow. Ovarian drilling is where several thin holes are pierced into your ovary to induce ovulation.

Can PCOS be misdiagnosed?

Yes, PCOS can be misdiagnosed in some cases because of how diverse symptoms can be and their cross-over with other conditions. 

With symptoms that can be caused by other non-related conditions or lifestyle factors such as irregular periods, acne, weight gain, and hormonal imbalances, PCOS can be mistaken for other conditions or overlooked altogether. 

Additionally, there is no single definitive test for PCOS, and diagnosis often involves a combination of physical exams, medical history assessments, and lab tests. 

It is crucial to consult with healthcare professionals that are experienced in PCOS to ensure accurate diagnosis and effective management of the condition.

Remember our team is here to support you with your recent diagnosis. You can book a call with one of our Fertility Advisors to discuss the potential for any fertility treatments you may wish to explore.

Or, if you have done a Hertility Hormone & Fertility Test, you can book a consultation with one of our Private Gynaecologists to discuss a personalised care and symptom treatment plan. 

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!