"The No. 1 treatment for PCOS is not metformin or clomid or birth control
pills or spironolactone; but attaining and maintaining a normal weight through a good diet (low glycemic index) and regular exercise," says Dr. Serena H. Chen,
the director of reproductive endocrine and infertility at St. Barnabas Medical
Center.
"Losing weight or maintaining a normal weight will lower the risk for cancer,
and make PCOS patients much more responsive to treatment. For people who are
trying to conceive, it will improve responses to fertility drugs and not only
improve the pregnancy rate but lower the miscarriage rate."

Since losing all my weight I have gone to 2 different doctors, a holistic doctor specializing in women's care and my fertility specialist, both have repeatedly told me that because I've lost so much weight I have basically taken my fertility into my own hands. The effects of losing weight with PCOS is tremendous. By losing 5% body weight you can control your insulin levels which can restart ovulation and normalize your cycles.

Diet that follows a low glycemic index generally work best for people with PCOS. Carbs are what is most responsible for the spike in your blood sugar, but cutting out carbs completely is not recommended. Eating carbohydrates like whole grain breads and pastas should be included in your diet, but in moderation. 1-2 servings of complex carbohydrates with meals is perfect. A serving is considered 1/2 cup whole grain pasta and/or brown Rice or 1 slice of whole wheat bread. Reading labels to know the serving size is important. 

To help your blood sugar from spiking, it's also beneficial to eat some protein along with the complex carbs. For instance, add a skinless chicken breast with your brown rice or eat turkey with your bread slice. The possibilities are endless! 
 
Losing weight with PCOS can be very difficult but it is possible with the right diet and exercise. Because of the difficulty a lot of times you'll get discouraged and want to give up. Just remind yourself that it won't happen over night, it may not even happen in a month, but it will happen. Knowing that you have so much power in your health can be your biggest motivation.

SEPTEMBER 17, 2012 BY DR. HEATHER RUPE

PCOS Made Simple

I don’t fault patients for finding the diagnosis of PCOS perplexing. It took me nearly 4 years of medical school to fully grasp it.  September is PCOS Awareness Month and with 5 % of  reproductive age women affected, we plan to bring you several posts this month on this often confusing diagnosis.

Polycystic Ovarian Syndrome is a misnomer. It is not an ‘ovarian syndrome’ at all. The root cause of PCOS is a combined genetic and metabolic issue. Women with PCOS do not react normally to insulin. When sugars hit their blood stream, their body requires extra insulin to process the sugar. The higher levels of insulin have several effects in different areas of their body, including messing with their ovaries. The insulin molecule is very similar in shape to another molecule that has receptors on the ovary.  Insulin then falsely attaches to the ovary, causing it to release too much male hormone, leading to lovely features like acne, abnormal hair growth and even male pattern baldness in extreme cases. The extra male hormone gets converted to excess estrogen in the fat cells, which prevents ovulation. The excess insulin makes weight loss more difficult, which can lead to obesity.

Estrogen is the hormone responsible for creating the blood and nutrient rich lining of the uterus. A normal amount of estrogen makes a healthy lining for an embryo to implant.With PCOS, there is an elevated level of estrogen, creating excess tissue, leading to heavy, crampy periods. In extreme untreated cases, it can lead to precancer of the uterus.

It is much harder for women with PCOS to lose weight and keep it off, due to their body’s resistance to insulin. As they get heavier, the fat cells themselves secrete additional hormones that worsen the insulin resistance.  Essentially, the more weight a woman with PCOS gains, the harder it is to loose the weight. This helps explain why 80% of women with PCOS are obese.

Some of you extra smart ladies are already thinking, “Isn’t extra insulin just like diabetes?” Yes and no. PCOS is in many ways a pre-diabetic condition. However, there has to be a genetic predisposition to PCOS as well.  PCOS is caused by how a woman’s body reacts to the excess insulin. Not all diabetics have PCOS. Many diabetics will ovulate regularly and have no excess of male hormone, despite their elevated insulin. We also see that PCOS tends to run in the family.  In studies of identical twins, if one twin has it, there is a 70% chance the other twin will have it as well. This leads us to think that the abnormal insulin metabolism is caused by an inherited genetic defect…yet another thing that we get to blame our mothers for.

Despite the hormonal imbalances going on in the body with PCOS, the ovary tries its best to ovulate. Much like the “Little Engine That Could” the ovary desperately attempts to make its eggs grow each month, but rarely will it mange to get an egg mature enough to fully ovulate. This leads to a swollen ovary with multiple tiny cysts of immature eggs (follicles). The PCOS ovary stays enlarged and swollen, but the ‘cysts’ associated with PCOS are multiple tiny cysts; not the large painful kind that women often need to be surgically removed.

I often see women for second opinions for PCOS. One doctor told them they had it, then another said that they didn’t. They are frustrated and want answers. However, PCOS is a clinical diagnosis, making it subjective. When your throat hurts, you go to the doctor.  She thrusts a q-tip down your throat and runs a test. The test is straightforward: positive or negative. Alternately, PCOS  is based on a collection of findings that can be supported by blood work, but there isn’t a definitive test.

To further add to the confusion, there are currently 3 sets of diagnostic criteria for PCOS floating around. Also, in Europe physicians put a lot more emphasis on ultrasound finding, while in the US clinicians look more at symptoms.

The most common definition in the US is the NIH {National Institutes of Health} criteria:

1. Irregular periods

2. Evidence of elevated male hormone (either lab work or symptoms)

3. Exclusion of other causes of elevated male hormone.

The classic patient with PCOS is overweight, with most of their obesity in their abdomen. Weight loss is extremely challenging due to their body’s insulin resistance.Their cycles are sporadic, every 2 to 3 months. They struggle with fertility due to their ovary’s inability to ovulate despite its best efforts. They get the added bonus of often needing to wax their chin way more than their friends.

Here is another article from www,pcosnutrition.com. It has information about the importance of staying active with PCOS. 

I think staying away from sugar is the hardest thing to do when struggling with PCOS. Our bodies make us think we need the sugar, but that is far from true. Stay away from Sugar!! Read this awesome info from www.pcosnutrition.com