So, is there a cure for PCOS?
Following funding announcements, more transparent social discussions and a raft of clinical resources making their way onto online forums, Polycystic Ovarian Syndrome (PCOS) and multiple other complex women’s health issues, have finally found themselves in the spotlight. Now more than ever, women and clinicians alike are discussing PCOS, how it presents, and how it can be treated and best managed throughout a lifetime.
Unfortunately, there is no definitive cure for PCOS. Like any chronic condition, the thought of not having a cure may sound scary and leave a taste of hopelessness in the mouths of those it affects. Despite the absence of a cure, there are a multitude of easy lifestyle changes and medicines that can manage the symptoms of PCOS.
Having PCOS means your body is experiencing a variety of hormone imbalances, and unfortunately, insulin resistance is one of the physiological imbalances in 70% of cases of PCOS. Insulin resistance occurs when the body generates an impaired response to insulin, then resulting in higher levels of glucose in the blood and more insulin being released. As such, women living with PCOS can really benefit from having a diet that compliments their insulin resistance.
This may include a diet that is rich in whole, unprocessed foods, high in fibre, high in omega-3 fatty acid content, and opts for lean proteins. All of these attributes can be found in the Mediterranean diet. To find out more about PCOS nutrition, visit the education section of the Femma platform.
Moving the body everyday for at least 30 minutes, whether it be a walk, swim, circuit or dance, has excellent general health benefits. For PCOS, doctors recommend a mixed variety of exercises, ranging from moderate aerobic exercise, to strength training and mind body workouts. Strength and resistance training that is centred around endurance, as opposed to short bursts of lifting heavy weights, prevents the spiking in testosterone that those living with PCOS want to avoid, whilst HIIT cardio provides short bursts of cardio that has the best effects on metabolic balance, when compared with slaving away on a treadmill. Meanwhile, mind-body exercises like yoga, pilates and tai chi can combat the physical and mental fatigue that PCOS so often presents.
The contraceptive pill, helps to regulate the reproductive hormones and this helps to counteract the impact of higher oestrogen levels on the endometrial lining. It also balances some of the impacts of higher androgen levels and can help with the skin problems some women experience with PCOS
If someone isn’t keen on going on the pill, this is fine but we must consider how to ensure higher levels of oestrogen don’t increase the risk of endometrial cancer and trigger a period every 3 months. This will involve short courses of progesterone periodically if someone doesn’t naturally have a bleed within that timeframe.
Metformin is a medication which can be used to improve insulin sensitivity and overcome ovarian dysregulation which happens as a result of insulin resistance. This has an added benefit of encouraging ovulation for some women and can be helpful for women with early fertility concerns.
There are other options including letrozole and clomiphene which are used to specifically stimulate ovulation in women who are demonstrated to be anovulatory and this is usually co-ordinated by a gynaecologist with expertise in this field as monitoring to avoid hyper-stimulation of the ovaries and management options for this rare condition need to be available if using these medications.
Where women are struggling with the effects of increased androgens, acne and male pattern hair, spironolactone is a medication which has had some success. It is a potassium sparing diuretic with anti-androgenic properties and has shown some benefits for women with these symptoms. It is used in high doses in this setting and anyone on these medications will need regular monitoring of their kidneys to ensure they process the medication correctly.
There are alternative options to manage hair concerns and they include laser management of unwanted hair. Concerns regarding acne can also be treated with regular antibiotics either as lotions or tablets. The plan for each person should be formed collaboratively and take into account the needs and concerns of each person exploring their management options for PCOS.