A beginner’s guide to Polycystic Ovarian Syndrome (PCOS)

Published on June 01, 2015 by Dr. Colin O'Brien

Polycystic Ovarian Syndrome (PCOS) used to only be considered in overweight women with irregular menstrual cycles and signs of excess androgens such as abnormal hair growth. It is now known that PCOS exists in women of all body types and with many variable symptoms. For example, one woman with PCOS may be overweight with irregular menses while another PCOS sufferer may be of normal weight with acne and facial hair.

With this in mind, it is important to consider PCOS when more than one of the following signs or symptoms are present:

- menstrual irregularities, especially longer than average cycles or absent
cycles
- excessive dark, coarse hair growth on body or face
- male pattern baldness
- insulin resistance and/or high blood sugar levels
- acne or dark skin patch developments (acanthosis nigricans)
- elevated testosterone levels on blood tests
- infertility or recurring miscarriages
- polycystic ovaries (determined on ultrasound)
- excess weight, especially in the abdominal region

So, what if you have been diagnosed with PCOS? Where do you start? As always, you should begin with diet and lifestyle modifications. Many of these recommendations are similar to those made for type 2 diabetics in order to balance blood sugar levels and reduce abdominal fat when present: high fibre, low glycemic-index, high protein, and healthy fats are key modifications to focus on. This means more vegetables, legumes, and lean meats, with less processed foods, refined sugars, and grains. Elimination of foods which may cause sensitivities is extremely important and individualized, with dairy, gluten, and eggs being the most common offenders. The addition of moderate exercise (1 hour sessions of any type, three times per week) can improve many PCOS markers as well, including insulin resistance and reproductive function. 

When it comes to supplementation, the list can be extensive and it is important to speak with a qualified practitioner to determine which ones are tailored toward your particular PCOS presentation. In any case, here are some to consider:

Chromium: Many people are familiar with chromium and its role in regulating blood sugars via insulin receptor sensitivity. Given that PCOS sufferers also exhibit insulin resistance, it is no surprise that 200-1000mcg/day of chromium picolinate has been found to reduce high insulin in women with PCOS. Individuals with PCOS have also been found to have lower blood levels of this mineral when compared to women without the syndrome.

Vitamin D: Vitamin D3 has been found deficient in the vast majority of the population, including PCOS women. Vitamin D3 supplementation in PCOS has been shown to improve menstrual regularity, androgen profiles, glucose metabolism, and follicle maturation in various studies. Get your blood levels tested in order to determine optimal dosing.

Inositol: This nutrient was discussed previously in the context of treating mood disorders with a short bit on PCOS. Check it out here, but know that myo-inositol can improve egg quality and insulin sensitivity. Myo-inositol for the purposes of PCOS tends to be effective at dosages between 0.5-2.0 g/day.

N-Acetyl Cysteine (NAC): This amino acid is best known for its ability to up-regulate the production of glutathione and provide anti-oxidant support. In cases of PCOS, NAC not only acts against oxidative stress, but it has been shown to improve hormonal markers, ovulation rates, and pregnancy rates. Effective dosages typically range from 1000mg-1500mg/day.

As with any health condition, it is most important to determine the root cause and treat accordingly. If there are other key factors that you believe were omitted from this list, leave a comment and let us know!

Images by © 2014 @ICSNAPS 2013/Iain Campbell and © 2014 LoloStock - Fotolia via DollarPhotoClub

Selected References:

Huang G et al. Clinical Update on Screening, Diagnosis and Management of Metabolic Disorders and Cardiovascular Risk Factors Associated with Polycystic Ovary Syndrome. Curr Opin Endocrinol Diabetes Obes 2012; 19(6): 512-519.

Thomson R et al. The Effect of a Hypocaloric Diet with and without Exercise Training on Body Composition, Cardiometabolic Risk Profile, and Reproductive Function in Overweight and Obese Women with Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2008; 93(9):3373-3380

Wang J et al. The effect of Cinnamon Extract on Insulin Resistance Parameters in Polycystic Ovary Syndrome: A Pilot Study. Fertil Steril 2007; 88:240-243

Wehr E et al. Effect of Vitamin D3 Treatment on Glucose Metabolism and Menstrual Frequency in Polycystic Ovary Syndrome Women: A Pilot Study. J Endocrinol Invest 2011; 30(10):757-763.

Wehr E et al. Association of Hypovitaminosis D with Metabolic Disturbances in Polycystic Ovary Syndrome. Eur J Endocrinol. 2009; 161(4):575-82.

Unfer V et al. Effects of Myo-Inositol in Women with PCOS: A Systematic Review of Randomized Controlled trials. Gynecol Endocrinol 2012;28(7):509-515.

Genazzani A et al. Differential Insulin Response to Myo-Inositol Administration in Obese Polycystic Ovary Syndrome Patients. Gynecol Endocrinol 2012; 28(120):969-973.

Saha L et al. N-acetyl cysteine in clomiphene citrate resistant polycystic ovary syndrome: A review of reported outcomes. J Pharmacol Pharmacother. 2013;4(3): 187–191.

  • Jodi Renshaw

    Thank you for including sources in this article. It has been helpful.