Debunking 3 Common Myths on PCOS, Nutrition & Fertility

People with Polycystic Ovarian Syndrome (PCOS) experience a widespread of symptoms due to hormone imbalances including fatigue, irregular periods, anxiety, excess hair growth and acne.

Polycystic Ovarian Syndrome (PCOS) is a hormonal imbalance condition that affects 12% of women and gender diverse people in Australia. (1) Up to 70% of PCOS cases remain undiagnosed. (1) This may be due to a lack of awareness regarding this condition and an extensive process for diagnosis. It is the leading cause of anovulatory infertility (2), i.e. lack of ovulation leading to infertility. This can present as irregular periods and prolonged menstrual cycles.

In PCOS, many hormones can be affected. Common hormones include:

• Luteinizing hormone

• Follicle Stimulating Hormone

• Oestrogen

• Progesterone

• Testosterone

• DHEA-S

• Thyroid hormones

• Prolactin

• Cortisol

• Melatonin

• & many many more.

PCOS is the leading cause of anovulatory infertility.

Hormones are like a complex web - many are connected so when one is out of balance, others tend to follow suit, leaving the individual with a wide range of symptoms across the body and mind.

To regulate your cycle and improve your fertility levels, treatment must be tailored to the specific hormones that are imbalanced in your unique PCOS case. PCOS affects every individual differently. There are no two cases that are the same. This is why it can be helpful to consult a knowledgeable health professional, such as a PCOS dietitian, to help you investigate and target the root causes of your unique hormone imbalances.

In this article, you’ll learn about three common nutrition myths on PCOS, nutrition and fertility that is often found on the Internet. Following misinformation can delay your chances to regulate your cycle and delay your chances of fertility.

1.     You must cut carbohydrates (carbs) to improve your PCOS ⮕ Consuming an even spread of carbohydrates throughout the day can help balance hormones.

Our body uses the hormone insulin to digest carbohydrates. However, if you have insulin resistant PCOS, you are sensitive to certain types of carbohydrates. That does not mean that you need to cut out carbohydrates from your diet. Restricting carbohydrates can backfire three-fold:

1) Restriction leads to binging;

2) Low blood sugar levels (aka hypoglycaemia) can lead to lightheadedness, dizziness, difficulty concentrating, irritability, trembling, weakness, headaches and heart palpitations.

3) High insulin levels can lead to primal carbohydrate cravings.

Restricting carbs tends to lead to carb cravings, which can result in binge eating carbs. Having a heavy load of carbs in one sitting can spike your blood sugar levels (hyperglycemia) and insulin levels, resulting in symptoms such as nausea, vomiting, shortness of breath, confusion, abdominal pain, increased thirst, frequent need to urinate, blurred vision, headache, fatigue and dry mouth.

Often the carbs become the suspected culprit for these uncomfortable symptoms and the carb restrict-binge cycle starts again.

People with PCOS are often advised to cut out carbs to reduce carb cravings, weight gain and PCOS symptoms by those who do not understand the body’s complex metabolism process and hormone system.

Instead of restricting, spread low glycaemic index (GI) carbohydrates throughout the day and pair with lean protein, healthy fats and fibre. This will help to keep the blood sugar levels stable and reduce the spike in insulin.

Low GI carbohydrates include:

• most vegetables

• soy products

• legumes like beans, chickpeas, and lentils

• full cream milk

• wholewheat pasta, and

• wholemeal bread.

A study conducted on 96 women with PCOS found that those who consumed low GI carbohydrates had more regular periods, lower levels of inflammation and improved fertility levels compared to those who did not. (3)

2.     Take any ‘hormone balancing’ supplements will help to improve your chances of fertility. ⮕ Choose a targeted prenatal supplement for your unique hormone imbalances.

Many supplements are being sold on the market that promise to keep your hormones balanced. But we know there is more than one hormone, so a single supplement can’t target all the various possible imbalances.

You need to find out which of your hormones are imbalanced and find specific, targeted supplements that will aid in balancing those hormones. Finding a prenatal that contains adequate amounts of key micronutrients for a healthy conception is also key.

Before considering taking such supplements, consult a dietitian to make sure you’re taking the right one for your unique needs.

Here are some common supplements:

• Inositol: used to manage insulin resistance, inflammation and irregular menstrual cycles. Has been shown to improve ovulation levels and fertility. (4)

• N-Acetyl Cysteine: used to manage insulin resistance and improve gut symptoms. Has been shown to improve fertility levels. (4)

• Omega 3 fish oils: used to reduce inflammation and improve overall fertility levels. (4)

• Prenatal supplements with folate, vitamin D, choline, iron and vitamin B12.

Healthy fats, such as salmon, are essential to a healthy diet, especially for improving PCOS, menstrual regularity and fertility.

3.     You need to cut out fats from your diet. ⮕ Fats are an essential part of a healthy diet.

Cutting out fats from your diet can do more harm than good. This is because our hormones are made of fats, plus they play a huge role in balancing them and improving absorption and digestion of fat-soluble vitamins.

Include more healthy fats such as polyunsaturated, omega 3 and some monounsaturated fats which can be beneficial in balancing your hormones.

 Foods rich in unsaturated fats include:

·      Fish oils and fatty fish such as salmon and tuna (rich in omega 3 fats)

·      Olive, peanut, sunflower and canola oils (Extra virgin olive oil is the best choice)

·      Avocado

·      Nuts

Some fats you want to be mindful of consuming include saturated fats and trans fats. Foods rich in these fats include:

·       Butter

·       Margarine

·       Coconut oil

·       Palm oil

·       Fatty and processed meat.

·       Baked goods such as cakes, cookies and pies

Consuming high levels of omega 3 fats has been shown to improve menstrual symptoms and balance your hormones. A study conducted in 104 women with PCOS aimed to find out the effects of consuming omega 3 fats on PCOS symptoms. This study found out that consuming more omega 3 fats led to balanced hormone levels in these women and improved their fertility levels.  (5)

In short, PCOS is a complex condition and dealing with it alone is no easy feat. There is an abundance of misinformation on the Internet that provides advice that, at best, will set you back on finding symptom freedom, and at worst, can cause further physical and psychological damage to your health.

The most efficient and effective way to manage this condition is to find out the root cause of your PCOS and manage it accordingly by developing sustainable healthy habits in nutrition, movement and self-care with the help of a knowledgeable dietitian, who has a deep understanding of this complex condition and can help you navigate your unique case.

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In this program, you will be supported in developing healthy habits that actually stick so that you can balance your hormones naturally to reduce your symptoms, regulate your cycle, feel confident in your body, and improve your fertility so your body is ready when you are!

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References:

1.     Varanasi LC, Subasinghe A, Jayasinghe YL, Callegari ET, Garland SM, Gorelik A, Wark JD. Polycystic ovarian syndrome: Prevalence and impact on the wellbeing of Australian women aged 16-29 years. Aust N Z J Obstet Gynaecol. 2018 Apr;58(2):222-233. doi: 10.1111/ajo.12730.

2.     Barbosa, G, de Sá, L. , Rocha, D. and Arbex, A. Polycystic Ovary Syndrome (PCOS) and Fertility. Open J Endocrine and Metabol Diseases. 2016; 6, 58-65. doi: 10.4236/ojemd.2016.61008.

3.     Marsh KA, Steinbeck KS, Atkinson FS, Petocz P, Brand-Miller JC. Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome. Am J Clin Nutr. 2010 Jul;92(1):83-92. doi: 10.3945/ajcn.2010.29261.

4.     Arentz S, Smith CA, Abbott J, Bensoussan A. Nutritional supplements and herbal medicines for women with polycystic ovary syndrome; a systematic review and meta-analysis. BMC Complement Altern Med. 2017 Nov 25;17(1):500. doi: 10.1186/s12906-017-2011-x. 

5.     Phelan N, O'Connor A, Kyaw Tun T, Correia N, Boran G, Roche HM, Gibney J. Hormonal and metabolic effects of polyunsaturated fatty acids in young women with polycystic ovary syndrome: results from a cross-sectional analysis and a randomized, placebo-controlled, crossover trial. Am J Clin Nutr. 2011 Mar;93(3):652-62. doi: 10.3945/ajcn.110.005538.