When it comes to PCOS

When it comes to PCOS (Polycystic Ovary Syndrome) there is much more research needed in this area. No two women have the same set of symptoms. Any medical diagnosis that is labelled a “syndrome” is harder to treat or repair because IT IS NOT THE DIAGNOSIS OF DISEASE OR ILLNESS. It is a collection of symptoms that have then been titled a ‘syndrome’. In general, PCOS is a condition in which a woman’s ovaries, and in some cases the adrenal glands produce more androgens than normal.

PCOS affects 6-10% of premenopausal women beginning between puberty and early 20’s.

In women with PCOS, immature follicles bunch together to form large cysts or lumps. The eggs mature within the bunched follicles, but the follicles don’t break open to release them.
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PCOS is the most common form of female infertility. Thirty to seventy five percent (30-75%) of PCOS sufferer’s are obese. Approximately 50% of women with PCOS have central obesity which is indicative of insulin or cortisol management issues, proven via blood work. Obesity then leads to hyperinsulinemia, which is a progressive pancreatic beta cell deficiency and impaired glucose tolerance, eventually leading to the development of type 2 diabetes. This explains the overweight and obese statistics of PCOS.
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PCOS symptoms MAY include: Hirsutism (unwanted hair growth particularly on the face), male pattern hair loss, acne/cystic acne, anger/mood Swings, an irregular cycle, a polycystic ovary morphology upon scans, anovulation and difficulty falling pregnant.
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A female can have cysts on her ovaries at any given time period without the other masculine like symptoms of PCOS. As our menstrual cycles are monthly, the health of your ovaries can change month to month with or without symptoms or pain. This is also good news because it gives us a leeway for change.
In saying that a large percentage of those diagnosed with PCOS are misdiagnosed. The symptoms between PCOS and Functional Hypothalamic Amenorrhea (FHA) can be quite similar however an AMH (egg count) blood test can distinguish the two. An AMH reading above 24 indicates the possibility of PCOS. The nutrition and training protocol I would use for PCOS vs FHA are vastly different, if not completely opposite, dependent upon the individual.
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FHA  relates to a dysfunction within the Hypothalamus-Pituitary-adrenal Axis (HPA axis). This can occur when there is chronically high cortisol for extended periods of time. This is but one cause. This is also why correct diagnosis of PCOS is of utmost importance. This includes blood work that includes sex hormones as well as AMH (egg count) testing along with regular scans on our ovaries knowing that cysts can move month to month. This is also why it is important for a female to bleed! This means NOT skipping a ‘bleed’ when on the contraceptive pill.
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I would highly suggest working with an endocrinologist or gynecologist to assist with PCOS. I also find the works on Victoria Felkar and Holly Sinclair highly informative. Before I give you best tips for assisting clients with PCOS I need you to understand that if you do not feel comfortable in tackling this with a client, you do need to refer out to a professional who can help. This will not decrease your credibility as a coach but rather increase it and earn the respect from your client. You can still help influence the client’s nutritional choices and programming to optimize their health or reduce the negative symptoms of the syndrome without being a clinical practitioner. Stay in your lane and ensure duty of care!
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My Top Tips for PCOS:

1- Reduce stress or implement Stress management protocols
as the increase in cortisol will further throw out the HPA access and increase androgen Production worsening symptoms. Meditation, breathing techniques, Yoga and outdoor walks or time with loved ones may assist
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2- Eat an Isocaloric Diet (Even split between fats and carbs) that is high in fibre to assist blood sugar control. Blood sugar control is of utmost importance when it comes to managing PCOS.
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3 - Keep protein on the lower end of the spectrum. High protein intake is associated with lower Sex Hormone Binding Globulin (SHBG). SHBG will assist in the removal of excess testosterone. High protein also increases 5-Alpha Reductase (converts progesterone to the more potent DHT). Along with this if protein increases the insulin response this in turn will increase testosterone production which may lead to further DHT issues.
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4 - Drink Spearmint tea to decrease Hirsutism (unwanted hair growth).It is Anti-Androgenic. This along with controlling cortisol fluctuations will help alleviate these symptoms.
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5 -Include Phytonutrients and SHBG (sex hormone binding globulin) increasing
foods to lower testosterone such as Brown rice & Green Tea. Lentils, broccoli and chickpeas also help to decrease insulin levels.
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6 - MOVE every day and enjoy weight training as this will increase insulin sensitivity with glycogen depletion which is the main factor in insulin sensitivity! In saying that it is best to avoid lower rep schemes of 5 reps and below (85% of 1RM load) as this will elicit an increased testosterone response. The testosterone pathway for someone with PCOS is already dysregulated.
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7 - Avoid Coffee!  This will deplete a vast array of micronutrients which are already low in PCOS patients. Green tea is a fantastic alternative.
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For any further advice please contact me. My experience working with clientele along with some of the greatest female health practitioners is what gives me a lot of confidence in this area to speak publicly on it. The added benefit of being mis-diagnosed with PCOS five years ago which then led me to go down the rabbit hole of female health also gives me first-hand experience in which to pull from to assist others to take control of their health and wellbeing. As always, if in doubt please contact a specialist to ensure client health comes first.