
What is PCOS?
Polycystic ovary syndrome (PCOS) is one of the most prevalent hormonal conditions in women. However, did you know it is also recognised as one of the most under diagnosed conditions, with around 70% of women with PCOS going undiagnosed!
When is PCOS diagnosed?
There is no single test to diagnosis PCOS, and it is important to understand that there are a number of definitions of PCOS. However, the Rotterdam criteria is widely used to diagnose PCOS. PCOS is currently diagnosed with the presence of two out of three of the following features:
- Polycycstic ovaries is often unreliable for diagnosis)
- Hyperandrogenism
- Oligo/anovulation (Irregular or absent period)
Women with PCOS often experience insulin resistance placing them at higher risk of developing pre-diabetes and type 2 diabetes, as well as developing increased cardiovascular risk factors. It is important to talk to your GP about getting a blood test to monitor.
Signs and Symptoms:
The presence of the above features can cause a wide range and varying intensity of the following symptoms for each individual:
- Hair thinning
- Facial hair growth
- Irregular or absent period
- Reduced fertility
- Poor mental health – anxiety, depression, stress, body image concern
- Insulin resistance and increased risk of pre-diabetes and type 2 diabetes
- Increased cardiovascular risk factors such as high cholesteril
- Weight gain
It is important to note that not all women will experience all of these symptoms and symptoms will vary from person to person.
PCOS Management:
- Talk to your doctor who is experienced in women’s health:
They will help with medical management and also provide referrals to appropriate allied health professionals when necessary - Engage in regular exercise:
The current guidelines recommend 2-3 days of resistance training per week and approximately 30 minutes per day of aerobic exercise. However, we recommend that if you are new to exercise that you start at a level that you are able, and to increase your exercise dose gradually. We recommend talking to an exercise physiologist who is experienced with women’s health to assist you in developing an exercise program that is tailored to you and your needs. - Look at your nutrition:
We recommend talking to a dietitian to assist. A healthy diet can help with addressing insulin resistance and cardiovascular risk factors. It can also help with managing symptoms including acne, regulation of our menstrual cycle, fertility, correcting any nutrition deficiencies and helping with our mental health. - Take care of your mental health:
Seeking advice from a psychologist, mental health or social worker or counsellor can be very helpful in improving our mental health, which is often impacted for many women with PCOS. By exercising and making mindful nutrition choices, this can also have a positive impact on our overall physical and mental health. - Weight management:
Please know that you can achieve significant improvements to your PCOS and overall health management independent to losing weight. Whilst weight loss is an important goal for many women with PCOS, there are a) many women who have PCOS not needing to lose weight, and b) even without weight loss, making some healthy and balance lifestyle changes around exercise, nutrition, sleep and mental health can improve our PCOS management WITHOUT the numbers changing on the scale.
Benefits of Exercise and PCOS
- Exercise can help to reduce insulin resistance:
By exercising regularly, we can look at either preventing the onset of pre-diabetes or Type 2 Diabetes, or we can better manage diabetes if already diagnosed. Exercise helps to lower levels of glucose in the blood by increasing the sensitivity of insulin. Improving insulin sensitivity helps to take blood glucose from the bloodstream to be used by the muscle cells for energy. - Exercise can help to improve cardiovascular health:
Along with PCOS comes with increased risk of developing cardiovascular conditions. By engaging in regular exercise we can look at reducing cardiovascular risk factors including reducing cholesterol levels, reducing blood pressure and reducing waist circumference. This will assist in reducing risk of developing conditions including heart disease and stroke. - Exercise can help to improve our mental health and mood:
Research indicates women with PCOS have higher levels of anxiety and depression, body image and self esteem issues, increased prevalence of eating disorders and a lower quality of life score. It is well researched the benefit exercise can have on improving mood, motivation and acceptance with body image with the release of endorphins. Even short bouts of exercise can release these hormones which help us to regulate our mental health and improve the above-mentioned outcomes. In addition, exercise can greatly improve our sleep quality, with improved sleep improving our mental health and mood. - Exercise helps us to maintain a healthy weight:
As stated above, with modification to lifestyle factors including increasing exercise and making nutrition changes, there can be some very positive health improvements for women with PCOS independent of weight loss. However, weight loss is an important goal for many women with PCOS, and exercise is an important tool to include in a weight management plan.
Types of exercises recommended:
- 2-3 days per week of resistance training: this can include weights, resistance bands and band exercises. This is recommended at moderate intensity exercise.
- 30 minutes of cardiovascular exercise on most days of the week: this could be brisk walking, cycling, swimming, running, etc. This is recommended to be performed at moderate intensity exercise
- Also including regular core, pelvic floor, stretching and relaxation in the above routines. So adding in stretching components to your workouts, attending pilates classes, yoga etc
If you are unsure about how to create your exercise program here are some tips:
- Keep it simple
- Start with something simple, even if your initial goal is going for 3 walks per week
- Gradually increase intensity of exercise over time
- Seek advice from an exercise physiologists for advice if you are unsure
To summarise, exercise is widely recommended and used as a tool to help manage PCOS and prevent further disease risk/progression. We want to uptake exercise as a long-term management strategy so it is vital that exercise is appropriate to your goals, something you enjoy doing, is achievable and realistic, and can be performed regularly. Working with an exercise physiologist is a great option to help determine what is appropriate and incorporate beneficial exercise to help achieve your goal.
https://www.jeanhailes.org.au/health-a-z/pcos
https://link.springer.com/chapter/10.1007/978-981-15-1792-1_8 – Exercise and Polycystic Ovary Syndrome (Physical Exercise for Human Health)
https://www.racgp.org.au/afp/2012/october/polycystic-ovary-syndrome