Your guide to Polycystic Ovary Syndrome (PCOS)

Updated: Apr 29

Irregular menstrual cycles? Weird hair growth? Acne? Perhaps polycystic ovary syndrome is the cause.

PCOS affects 8 to 10% of reproductive age women. Decades ago, PCOS was rarely seen by healthcare providers, now it is one of the most common female endocrine disorders.

It often leads to many complications, including weight loss resistance and obesity, osteoporosis, heart disease, type 2 diabetes and infertility.

Most treatment options for PCOS simply mask the condition with pharmaceuticals. However, addressing the root cause is vital to prevent complications and further ill health. Here I dive into the 4 major types and causes of PCOS, so you can actually address it for good.

Firstly, let’s clarify, what is PCOS?

PCOS is a group of symptoms related to ovarian dysfunction (anovulation) and high levels of androgens or male hormones (testosterone, DHEAS and androstenedione).

Some of the signs and symptoms include:

  • Irregular periods (main symptom)

  • Dysfunctional bleeding (usually prolonged and heavy)

  • Excessive facial and body hair (hirsutism) – especially if on chin, cheeks, belly and around nipples.

  • Acne (Especially around the chin and jaw line. Not a reliable indicator if you’re a teenager though).

  • Hair loss from the head

  • Weight gain is common with a tendency toward apple shaped obesity in Insulin Resistant PCOS. (Ideally your waist should be less than half your height)

  • Infertility

How is PCOS diagnosed?

Despite the name, visualization of multiple cysts or follicles on the ovaries by ultrasound is not reliable indicator of PCOS. For a true diagnosis, the woman must have indications of a failure to ovulate regularly, combined with signs of androgen or “male” hormone excess. Other reasons for high androgens should also have been ruled out.

Blood tests will often show high levels of free testosterone or other androgens such as androstenedione and DHEAS. Lutenising hormone (LH) is also often elevated. Progesterone is commonly low.

High oestrogen levels are also common but may not occur in those with very poor liver function and low cholesterol levels.

The high testosterone and androgen levels are what cause the androgenic or "male" symptoms of excessive hair and acne.

What are the root causes of PCOS?

Insulin Resistant PCOS

Insulin Resistance is thought to be the primary driver for 70% of PCOS sufferers.

Normally after eating, blood sugars (glucose) will briefly rise and the hormone insulin is released from the pancreas to take up the glucose and convert it to energy or to store it in the liver in the form of glycogen. This causes your blood sugar to fall and then your insulin levels to fall.

When you are insulin sensitive, both your sugar and insulin levels are low on a fasting blood test.

With insulin resistance, your body fails to respond to the insulin hormone, so the pancreas produces more and more insulin to try and get its message through. Fasting blood sugars can be normal, but your insulin is high. This situation is highly inflammatory to the body and the precursor to type 2 diabetes.

Too much insulin can also impair ovulation and stimulate your ovaries to produce testosterone, which is why it is a primary driver for PCOS.

What causes Insulin resistance?

  • Excessive sugar and processed carbohydrate consumption (especially products containing High fructose corn syrup)

  • Low muscle mass (usually due to lack of physical activity)

  • Too much adipose (fat) tissue

  • Consuming too many trans fats

  • Nutrient deficiencies such as low chromium, zinc, selenium and magnesium levels

  • Stress and cortiso