Debunking PCOS

What is Polycystic Ovarian Syndrome?
Polycystic Ovarian Syndrome, or more properly known as PCOS, affects nearly 10% of
the women ages 18-44 and is one of the most common female disorders of the
endocrine system2. It is also often overlooked and can lead to elevated risk for several
medical issues including infertility and metabolic syndromes such as hypertension,
diabetes and cardiovascular disease2. Additionally, the continued hormonal imbalance
caused by PCOS can cause numerous ovarian cysts, acne and irregularities of the
menstrual cycle1.

The direct cause of PCOS is still continued to be studied, however there are theories
regarding the pathogenesis. One theory states that PCOS is caused by the dysfunction
within the Hypothalamic-pituitary gland causing disruptions in the lutenizing hormone
and gonad-otropin-releasing formones, then resulting in dysfunction within the ovarian
hormones2. Another is that there is a presence of an ovarian defect which then results
in an overproduction of androgens (hyperandrogenism)2. Lastly, the pathogenesis is
believed to be caused by a metabolic disorder, such as insulin resistance, having a
negative impact on the hypothalamus, ovaries, pituitary and even the adrenal glands2.
Risk factors often include genetics (i.e. CAPN10, Isulin gene, AR and Cytochrome family
p4501) and lifestyle factors (i.e. obesity).

PCOS patients usually present with numerous ovarian cysts over 8mm in size1.
Additionally, medical professionals do an evaluation to focus on symptoms (such as
visceral obesity, acne and ogliomenorrhea) and count out any other hormonal
conditions through lab work and a physical exam2.

Where Nutrition Comes in
Believe it or not, nutrition plays an integral role in the management of PCOS. Due to the
connections between insulin resistance, metabolic syndrome and PCOS, food and
nutritional lifestyle changes can make a real difference for patients. In fact, obesity has
been known to worsen the symptoms of PCOS, making weight loss a primary goal for
several patients and healthcare practitioners3. While there is little debate on whether or
not weight loss and diet can benefit PCOS, there is debate over which dietary pattern is
best suited for the job. As the most common and arguably most balanced dietary
pattern, we will look at the Mediterranean Diet today.
The Mediterranean Diet
The Mediterranean diet is a way of eating that consists of consuming whole grains,
legumes fruits, veggies and high quality proteins and fats, such as omega-3 fatty acids
(olive oil, fish). There have been studies conducted on the therapeutic use of the
Mediterranean diet for treatment of PCOS, often tracking body composition3 and CRP
levels (inflammation markers). In one study, high adherence to the Mediterranean diet
with a focus on MUFA and PUFA (monounsaturated and polyunsaturated fatty acid)
intake, led to significant decreases in BMI and inflammatory CRP levels4.

The Role of Resveratrol
One of the key beneficial elements, not often discussed, within the Mediterranean diet
is “resveratrol.” Resveratrol is found within food sources such as red wine, grapes, grape
seed, pistachios, and dark colored berries (blueberries, cranberries, raspberries,
blackberries, etc.). It has been found that consuming these foods have the ability to
appease the hyperandrogenic affects of PCOS, lowering androgens and reducing
hyperinsulinemia6. In on study, treatment with resveratrol over 3 months reduced
testosterone and dehydroepiandrosterone sulfate excess by 23% in PCOS patients6.
Something to note, however, is that many of these studies are conducted with high
concentrated amounts of resveratrol (ex: 1500m), which would be better consumed via
supplement than food form.

Dietary Supplements
While we are on the subject of supplements, it is important to note other supplements
that can be beneficial for and supportive of PCOS management.

Omega-3s
While the Mediterranean diet is a great way to get healthy omega-3s, PCOS patients
often find benefit from additional supplementation with higher doses. In one study,
patients were given 2mg of omega-3 capsules per day for 6 months, resulting in
significant decreases in waist and hip circumferences, fasting blood sugar, and size and
number of ovarian cysts7. Research has also shown an increase of high-density
lipoprotien7 and overall reduction in CRP levels when supplementing with omega-3s2.
Chromium
An essential trace mineral, chromium has been found to reduce hyperinsulinemia and
increase the action of insulin2. One study, specifically focused on PCOS patients, showed
that daily supplementation with 1000 mcg of chromium for 2 months could result in
improving insulin sensitivity by 38%2. Chromium supplements are often found to be
combined with Picolinate (an amino acid) to support absorption2.


Supportive Treatments
Generally, the doctor that treats patients with PCOS in a traditional medical setting is an
Endocrinologist. There are, however, supportive therapies that can help manage
symptoms and support medical treatment. One such treatment is acupuncture, which
gained more popularity over the past few years for benefiting endocrine issues. The
reason for this is because studies have shown acupuncture to have a positive impact on
reproductive hormone5. In one study on PCOS patients, acupuncture treatment for 12
weeks showed reduction in LH/FSH ratio, LH, BMI and beneficial results on testosterone,
menstrual frequency and PCOS symptoms5.
Moving Forward
PCOS can be a challenging condition to manage with many uncomfortable symptoms,
however, quality of life can be improved with proper nutrition and supporting therapies.
In addition to health practitioners, many PCOS patients from comfort and support in
connecting with others who have the condition, a well as finding resources for
management tips within the PCOS community often found on social media. Instagram
pages, such as ours (@novamammawellness) can be a great place to learn
more and connect with others!

RESOURCES:
1. Ajmal N, Khan SZ, Shaikh R. Polycystic ovary syndrome (PCOS) and genetic
predisposition: A review article. Eur J Obstet Gynecol Reprod Biol X.
2019;3:100060. Published 2019 Jun 8. doi:10.1016/j.eurox.2019.100060
2. Rakel D. Integrative Medicine: Expert Consult Premium Edition - Enhanced Online
Features and Print. 3rd ed. W B Saunders; 2012
3. Barrea L, Arnone A, Annunziata G, et al. Adherence to the Mediterranean Diet,
Dietary Patterns and Body Composition in Women with Polycystic Ovary
Syndrome (PCOS). Nutrients. 2019;11(10):2278. Published 2019 Sep 23.
doi:10.3390/nu11102278
4. Szczuko M, Kikut J, Szczuko U, et al. Nutrition Strategy and Life Style in Polycystic
Ovary Syndrome-Narrative Review. Nutrients. 2021;13(7):2452. Published 2021
Jul 18. doi:10.3390/nu13072452
5. Cao Y, Chen H, Zhao D, et al. The efficacy of Tung's acupuncture for sex
hormones in polycystic ovary syndrome: A randomized controlled
trial. Complement Ther Med. 2019;44:182-188. doi:10.1016/j.ctim.2019.04.016
6. Mirabelli M, Chiefari E, Arcidiacono B, et al. Mediterranean Diet Nutrients to
Turn the Tide against Insulin Resistance and Related Diseases. Nutrients.
2020;12(4):1066. Published 2020 Apr 12. doi:10.3390/nu12041066
7. Khani B, Mardanian F, Fesharaki SJ. Omega-3 supplementation effects on
polycystic ovary syndrome symptoms and metabolic syndrome. J Res Med Sci.
2017;22:64. Published 2017 May 30. doi:10.4103/jrms.JRMS_644_16

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