PCOS For Dummies Cheat Sheet

Polycystic ovary syndrome (PCOS) often seems like a collection of unrelated symptoms; it can affect your menstrual cycle, fertility, appearance, mental health, and metabolic health, including weight issues. But when you put the puzzle pieces together, you can see not only how the symptoms relate to one another, but also how simple lifestyle changes can have a positive impact on them. Unlike many disorders, PCOS can improve if you take steps to manage the causes. Recognizing the symptoms of PCOS early and working on improving insulin resistance through diet and exercise can help prevent complications of PCOS, including infertility.

9 common PCOS symptoms

Medical professionals gave the disorder the name polycystic ovary syndrome (PCOS), rather than polycystic ovary disease, because it shows up as a group of signs and symptoms that can occur in any combination and without a clear cause. (A disease has a specific, identifiable cause and clear treatments.) Here are some of the symptoms of PCOS:

• Abnormal menstrual cycle: When you have PCOS, your periods may be heavier, lighter, irregular, or absent altogether. However, you may have completely normal periods and still have PCOS.
• Weight gain: In women who have PCOS, weight gain is mostly due to high levels of insulin circulating in the blood. Cells normally absorb glucose with the help of insulin. When cells don’t respond normally to insulin (called insulin resistance), your body produces even more insulin to try to force the cells into responding. When insulin levels rise, other hormonal changes can lead to increased appetite and decreased fat burning, which both lead to weight gain. Insulin resistance can lead to diabetes and heart disease.
• Acne and oily skin: Women who have PCOS tend to have higher levels of androgens (male hormones), which cause acne and increased skin oiliness.
• Excess hair growth: Your body may be hairier in certain places (such as your chest, thighs, face, and back) as a side effect of androgens.
• Hair loss: The hair on your head may thin if you have PCOS, another side effect of higher androgen levels.
• Sleep problems and fatigue/exhaustion: These symptoms can occur because of fluctuating hormone levels and increased anxiety.
• Emotional issues: Depression, anxiety, irritability, and mood swings may happen because of disrupted hormone levels.
• Fertility problems: The hormonal imbalances that come with PCOS can disrupt ovulation.
• Metabolic issues: These problems can present as a cluster of symptoms, including insulin resistance, high blood pressure, and high cholesterol.  

7 tips to help you manage PCOS

If you’re willing to overhaul your diet if it is not ideal, and start a simple exercise program, you can gain a great deal of control over your PCOS symptoms. You can help control insulin resistance, which causes many PCOS symptoms, with diet and exercise. These tips can help you make lifestyle changes to help you manage PCOS:

• If you’re overweight, lose weight. Limit yourself to 1,500 calories per day to start with. Losing weight is one of the biggest factors in controlling PCOS symptoms, particularly if you’re trying to get pregnant.
• Eat regular meals and pile your plate with vegetables. If you get ravenous between meals, allow yourself a healthy snack or two.
• Eat slow-release energy sources only. The starch in these foods breaks down slowly to glucose in your digestive tract so that your blood sugars remain stable. Wholegrain and high-fiber foods generally contain slow-release carbs, as do fruits and vegetables.
• Limit the bad fat in your diet. Cut down particularly on excessive amounts of saturated fats, such as and fatty meat and butter, and try to  avoid all trans fats, found in processed foods such as cakes, pastries, and cookies.
• Use as little salt as possible. Look at the labels of processed foods to try to keep your total sodium intake below 2,400 milligrams (mg) a day.
• Eat at least five helpings of fruit and vegetables every day.  This is actually a minimum amount that everyone should have for good health. Over many years, studies have shown that at least five helpings of fruit and vegetables a day provide essential vitamins, minerals, and fiber that lower your risk of serious illnesses like heart disease, stroke, type 2 diabetes, and some cancers. They support gut health, boost immunity, help with weight management, improve skin, energy, and mood, and provide vital nutrients for bones and eyes, all while being generally low in calories and fat.
• ‍Get some physical activity every day. Half an hour is great, but an hour is even better to help keep your weight under control. Remember to start slowly and incorporate both aerobic and weight-bearing exercise into your routine. You don’t have to do all your exercise at one time — 10 minutes of exercise three times a day is just as good as 30 minutes in a row.

Pregnancy and PCOS

PCOS can interfere with getting pregnant in a number of ways. You may need to see a fertility specialist to get pregnant if you have no menstrual periods at all, very irregular menstrual periods, or periods that are extremely heavy when they do come. To determine whether PCOS symptoms are interfering with your ability to get pregnant, a fertility doctor may do the following:

• Perform an ultrasound of your ovaries. Women who have PCOS may have multiple cysts on each ovary — this symptom gives the disorder its name. Cysts form when follicles that contain eggs don’t develop and mature properly.
• Check the hormone levels in your blood. When you have PCOS, you may have an abnormal ratio of luteinizing hormone (LH) to follicle-stimulating hormone (FSH). This type of hormone imbalance interferes with normal egg production.
• Check for physical signs of high insulin levels. High insulin levels can impact reproductive hormones. Women who have high levels of insulin may develop a skin condition known as acanthosis nigricans, characterized by dark, velvet-like skin around body folds and creases in areas around the neck, armpits, knees, and knuckles. High insulin levels can also cause skin tags (small fleshy growths around the neck, armpits, and eyelids).

To get pregnant, you may need to

• Take fertility medications. These medications induce egg development and ovulation and include clomiphene citrate (brand name Clomid), as well as injectable hormones called gonadotropins that promote fertility.
• Undergo in vitro fertilization (IVF). IVF is a multi-step process. First, you take medications to improve egg production. After the eggs mature (normally after several weeks), your provider removes the eggs from the ovaries. The eggs and sperm are then put together in the laboratory to form an embryo. The embryo is put back into the uterus after two to five days, depending on your fertility clinic’s practices. At this point, hopefully the fertilized egg implants and begins developing.