GIRL'S TIP: PCOS

Polycystic Ovarian Syndrome (PCOS) is becoming increasingly common among Australian women – in fact it is the most common hormonal disorder affecting women today. The symptoms can be both embarrassing and distressing and unfortunately the diagnosis of this syndrome can be difficult.
Common symptoms of PCOS include:
< irregular or no periods

< infertility

< hirsutism - excess hair growth on the face, chest and abdomen

< alopecia – scalp hair loss

< acne

< acanthosis nigricans - dark skin pigmentation which is most commonly found on the back of the neck, under the arms and on the breasts

< obesity and/or difficulty losing weight Suffers also have an increased risk of miscarriage.

The symptoms of PCOS usually start in teenagers during puberty, but are also common in the mid 20s. However, PCOS can occur at any time.

Officially PCOS affects 4 to 7 per cent of Australian women, but the true figures could be much higher, with the Polycystic Ovarian Syndrome Association of Australia (POSAA) suggesting that the real figure could be as high as 12 per cent of Australian women. The reason for this difference has to do with the fact there is no simply test for diagnosing PCOS.

Diagnosis of PCOS usually involves testing hormone levels (including insulin), considering a combination of the symptoms and performing an ultrasound to look for cysts and enlargement of the ovaries. Currently, women need to have two of the following three symptoms to be diagnosed with PCOS:

1. Polycystic ovaries

2. Irregular or absent periods

3. High level of male hormones in the blood or symptoms of excess male hormones such as excess hair on the face and body or acne.

Why does it happen?

Unfortunately exactly why this syndrome develops is unknown, but for the majority of women that it affects, it is caused by high levels of insulin in the bloodstream (insulin resistance). Insulin resistance occurs when a woman’s body (or male’s body) becomes insensitive to the hormone insulin, which is produced in the pancreas and helps regulate blood sugar levels. Because the insulin that is being produced does not work effectively, their body needs to produce increasing amounts to keep the blood glucose levels under control.

It is these high insulin levels in the bloodstream that can cause many of the health problems related to PCOS. High insulin levels act on the ovaries to increase production of male hormones, which disruption the normal ovulation cycle, causing many of the symptoms associated with PCOS. This link means women with PCOS are at an increased risk of developing health problems such as impaired glucose tolerance, type 2 diabetes and heart disease. Improving insulin resistance addresses many of the problems of PCOS.

How to control it?

With treating PCOS, the key thing to focus on is controlling the insulin resistance. You can do this through lifestyle modification such as:

• Exercising – starting or increasing exercise can help improve insulin resistance. It is recommended to include at least 30-40 minutes of physical activity on most, preferably all days of the week. Also it’s also good to combine aerobic exercise with resistance training.
• Weight loss – a reduction of just 5-10 per cent of body weight has been shown to reduce insulin and testosterone levels, improve hirsutism and acne symptoms, improve menstrual function, restore ovulation and increase fertility.
• Diet – the best eating plan to follow incorporates foods that are low in saturated fat and high in fibre, as well as carbohydrates that have a low glycaemic index (GI). It’s also advised to spread intake evenly across the day and avoiding eating large amounts of carbohydrate foods at the one time can also help, as this will prevent large rises in blood glucose and insulin levels.
  Medication – medication is only effective if used in combination with healthy living. Metformin (used by people with Type 2 diabetes) is now being used to treat PCOS in women.

For more information visit the Polycystic Ovarian Syndrome of Australia www.posaa.asn.au.