PCOS: Learning the Basics
By Marissa Minderler, MS, RDN, Clinical Dietitian
Polycystic Ovary Syndrome (PCOS) is a multifaceted and systemic condition impacting women of reproductive age. Approximately 1 in 7 women are currently managing PCOS, but over 50% of women with the condition remain undiagnosed. This means that many women are suffering without help or even knowledge of how to address their symptoms. Being classified as a syndrome, PCOS often presents as a variety of clinical symptoms which may vary across individuals.
What do I need to know about PCOS?
To be diagnosed, a woman must present with at least two of the following three criteria:
- Elevated testosterone
- Irregular periods or no period at all: <8 per year
- Presence of polycystic ovaries (12 or more cysts visible through ultrasound)
Elevated testosterone can be observed through bloodwork analysis as well as by the presence of hirsutism, which is defined as dark hair growth on the sideburns, chin, chest, back of neck, and possibly stomach. Additional symptoms of PCOS may include insulin resistance, weight gain around the waist, challenges with weight loss, elevated cholesterol, and difficulty getting pregnant
Gynecologist, Dr. Elena Rodriguez shares that women with PCOS are also at higher risk for endometrial and breast cancer due to estrogen dominance causing overstimulation of uterine lining and breast tissue. The higher risk is also due to late diagnosis and delayed treatment for the condition. Dr. Rodriguez encourages women to speak to their gynecologist if they have any irregularity in their menstrual cycles. If the intervals between periods are 35 days or more, that should raise concerns and further testing should be done to assess for PCOS.
What are my treatment options?
While the cause of PCOS is not well understood, it is believed to be due to a combination of genetics, environmental exposures, and diet & lifestyle risk factors. Positively however, medication plus diet and lifestyle can be strong influences in managing PCOS symptoms and presentation. Working closely with an endocrinologist, gynecologist, and a dietitian can greatly improve clinical outcomes. Current medical interventions focus on the control of blood sugar as well as hormone levels.
Below is a common list of medications and their functions as they relate to PCOS.
- Metformin: Elevated blood sugar or A1C
- Improves insulin sensitivity and reduces livers production of glucose
- Hormonal birth control: Irregular menstrual cycles
- Spironolactone: Elevated testosterone
- Lowers testosterone levels and acts secondarily as a diuretic and can improve blood pressure
Dr. Rodriguez explains that Metformin alone can lead to vast improvements in a patient’s insulin resistance, infertility, and weight loss. However, while pharmaceutical interventions can assist with the management of PCOS symptoms, dietary management and addressing lifestyle risk factors are key for long term success.
How do diet & exercise help PCOS?
Research has shown that healthy eating habits and regular physical activity are highly effective in helping patients with PCOS manage their symptoms.
Dietary and lifestyle intervention benefits essential to long term management include:
- Balancing blood sugar and insulin levels
- Promoting gut health
- Incorporating exercise
- Addressing stress management
A dietitian can provide guidance and encouragement for implementing dietary and lifestyle changes and maintaining a regular exercise routine, as well as discuss the use of vitamin/mineral supplementation in the management of PCOS. Working with a dietitian can help you identify your motivations for change, set achievable behavior change goals, and provide needed support.
When PCOS is addressed with Medical Nutrition Therapy, it reduces the chance of developing other associated health issues such as depression, IBS, type 2 diabetes, hypertension, and heart disease.
What vitamins & supplements help with PCOS?
Women with PCOS tend to be nutrient deficient in many common vitamins and minerals thought to be associated with the psychological (depression, anxiety, etc.) and physiological (insulin resistance, diabetes, infertility, etc.) side effects of the condition. Common nutritional supplements that may be required include vitamin D, magnesium, omega-3, probiotics, zinc, and some B vitamins, like B12 and B6. Dr. Rodriguez suggests switching out probiotics every 3 months is essential to promote a healthy microbiome and encourage healthy gut bacteria to flourish.
Additional supplements that may be recommended for women with PCOS include inositol, DIM, palmetto, L-carnitine, berberine or milk thistle, just to name a few. Dr. Rodriguez specializes in functional and integrative medicine, and strongly believes natural supplements can play an important role in PCOS treatment. Research is still being done on the benefits of these natural supplements and possible interactions can occur with other medications, therefore it is important to discuss their use with your healthcare provider prior to starting.
While managing PCOS isn’t always easy, it is possible! If you are having symptoms you believe to be related to PCOS, talk to your primary care physician or gynecologist TODAY!
Visit PCOS Challenge: The National PCOS Association for more information and support.
Marissa Minderler is a registered dietitian who is driven by her motivation to educate and assist people in reaching their health and wellness goals. Graduating from USC with both her B.S in Kinesiology, and her M.S in Nutrition, she has always had an interest in the role of nutrition in weight management, fitness and performance, and in women's health. She was recently published in the Women's Health dietetic practice group on the impacts of PCOS in lean women, and continues to seek educational opportunities as it relates to the role of nutrition in women's health. In college she was a successful track and field athlete, who competed in the throwing events, and has been a dedicated personal trainer for 12 years. She currently teaches the CORE4 adult weight management class, and finds immense value in educating individuals on the role of nutrition and exercise in reaching health and performance goals. Learn more about Nutrition Services at Torrance Memorial
If you have questions or are interested in learning more techniques to help build a healthy and nutritious lifestyle, contact one of our Registered Dietitian Nutritionists at the Outpatient Medical Nutrition Therapy Office or our Diabetes Self-Management Program located in the Torrance Memorial Specialty Center, 2841 Lomita Blvd., Suite 335, Torrance. Call 310-891-6707. Visit https://www.torrancememorial.org/Nutrition for upcoming classes and programs!
