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What is Polycystic Ovarian Syndrome (PCOS)?

Kelsey Russell-Murray · March 5, 2021 · Leave a Comment

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I personally struggle with polycystic ovarian syndrome (PCOS), so I know first hand how challenging it can be! I treat many clients with PCOS and work with them to manage symptoms, including infertility, weight management, insulin sensitivity and acne. If you are struggling with PCOS-related symptoms, contact me to set-up an initial consultation where we can create a customized plan including targeted nutrient supplementation and diet intervention.

What is Polycystic Ovarian Syndrome? 

PCOS is an endocrine disorder that is caused by an imbalance of reproductive hormones. 

How is PCOS diagnosed? 

PCOS diagnosis is made by combining symptoms, laboratory results and imaging. If the individual has cycles >35 days, or are irregular, and she has PMS symptoms, and/or hirsutism, and/or weight challenges they usually meet PCOS criteria. 

Prevalence: 

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders, affecting ~10% of reproductive age women. However, diagnosis is often missed. 

What causes PCOS? 

The exact etiology of PCOS remains unknown, but the two primary factors that are believed to play a role include: 

  • High levels of androgens, a reproductive hormone. 
  • High levels of insulin. Many women with PCOS have insulin resistance. 

Symptoms of PCOS: 

Some of the symptoms of PCOS include: 

  • Irregular menstrual cycle 
  • Acne 
  • Thinning hair 
  • Hirsutism – increased facial hair 
  • Darkening of the skin – particularly along neck creases, in the groin, and underneath breasts 
  • Skin tags 

Note: many women with PCOS will experience some symptoms, but not necessarily all symptoms. 

Connection with Mood and Eating Disorders: 

  • Women with PCOS have higher rates of anxiety and depression, potentially due to hormone imbalance. 
  • Women with PCOS have a significantly higher risk of disordered eating behaviors. High insulin levels have been associated with increased cravings and binge-eating behaviors. 

Medical Treatment of PCOS: 

  • Hormonal birth control (including the pill, IUD, patch, vaginal ring etc). Birth control can suppress excessive androgen secretion by the ovaries, regulate your menstrual cycle and help improve acne and hirsutism. 
  • Anti-androgen medicines. These medications can block the effect of androgens and improve acne, thinning hair and hirsutism symptoms. 
  • Metformin. Traditionally a medication used in the treatment of diabetes, metformin is an insulin-sensitizing agent and can lower both insulin and androgen levels. Metformin may help restart ovulation and improve weight loss and cholesterol levels. It usually has very little effect on acne and excessive body hair. 

Lifestyle Management of PCOS: 

Diet and lifestyle modifications are often the primary treatment approach for women with PCOS. 

  • Weight loss (as little as 5% of body weight) is associated with improved metabolic and reproductive symptoms 
  • Recommended dietary approaches include a low glycemic index/glycemic load diet with a focus on consuming anti-inflammatory foods and high antioxidants 
  • Women with PCOS have increased levels of insulin and inflammatory markers. An anti-inflammatory diet, with a focus on high fiber intake and anti-inflammatory foods such as fish, legumes, green tea and omega-3 fatty acids. Recommend limiting red meat, processed foods and added sugars. 

Nutritional Supplements: 

  • N-acetylcysteine (NAC): a powerful antioxidant and amino acid. NAC is involved in fighting oxidative stress and inflammation. NAC also has been shown to protect insulin receptors and influence insulin receptor activity and insulin secretion from pancreatic cells. 
  • Inositol: Both myo-inositol (MYO) and D-chiro-inositol (DCI) have been well studied in women with PCOS and are showing promising results as first-line treatment. MYO in particular has been shown to improve insulin sensitivity as well as egg quality and ovulation. Newer research is showing that a combination of MYO and DCI in the ideal 40:1 ratio that mimics the body’s own tissue levels works better than inositol alone for improving metabolic aspects and restoring hormone balance. Inositols are pseudovitamins found in foods such as fruits, beans, cereals, and buckwheat. MYO and DCI help to regulate hormone activity including follicle-stimulating hormone, thyroid-stimulating hormone, and insulin. It’s believed women with PCOS have a defect in their ability to use inositol properly, which could perhaps be a reason why they have higher insulin levels. 
  • Vitamin D: Studies on PCOS show an inverse relationship between vitamin D and metabolic and hormonal disorders. Vitamin D supplementation (100,000 IU/month) has been shown to improve fertility in women with PCOS by increasing the number of mature follicles and improving menstrual regularity, but the results weren’t statistically significant. 
  • Fish Oil: Fish oil offers many benefits to women with PCOS, including helping to reduce elevated triglyceride levels, improving fatty liver, and decreasing inflammation. Omega-3 oil also has been found to lower testosterone and regulate menstrual cycles in both overweight and lean women with PCOS. 
  • Vitamin B12: Metformin affects the absorption of vitamin B12 and therefore Vitamin B12 deficiency is common in metformin users. It is recommended that patients who take metformin have their vitamin B12 levels checked annually and supplement with vitamin B12. The sublingual methylcobalamin form is best absorbed. 

Is PCOS associated with other health problems? 

Women with PCOS have increased risk of the following health problems: 

  • Diabetes 
  • High blood pressure 
  • High cholesterol 
  • Sleep apnea 
  • Depression and anxiety 
  • Endometrial cancer 

Related

Filed Under: Nutrition Articles Tagged With: acne, fertility, hormonal management, insulin sensitivity, pcos, pcos diet, polycystic ovarian syndrome, weight loss

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WELCOME!

Hi, I’m Kelsey, the founder of Gut Healthy Dietitian, a group of Registered Dietitians working together to bring you the most innovative and effective nutrition care in the field of gut health. Through 1:1 and group nutrition counselling, as well as gut healthy recipes and nutrition articles, our goal is to bring you value and knowledge about all things gut health.

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Gut Health Dietitians
Hi, I'm Kelsey! 👋 I’ve never done one of the Hi, I'm Kelsey! 👋

I’ve never done one of these posts, and since my presence on instagram has been terrible recently this felt like a good way to get back to posting. 

I’ve been a Registered Dietitian for the past decade and have worked my entire career in clinical practice, mostly in a hospital setting. Almost 3 years ago I started Gut Healthy Dietitian while on maternity leave. Between being a mom to two young boys (priority #1), working full-time in the hospital and running a growing business life is BUSY, but I wouldn’t have it any other way. 

At Gut Healthy Dietitian our approach is entirely based on two factors: 1) science and 2) being realistic. I am absolutely obsessed with nutrition and spend a ridiculous amount of time reviewing the latest (evidence-based) nutrition recommendations. I have worked with thousands of different clients over the past decade with every health condition you could imagine, but there’s one consistent factor. If the client isn’t ready to make the change, or if it’s too overwhelming, it simply won’t work. 

Although we are happy to see clients with any sort of nutrition goals, my passion is gut health. I truly look at gut health (meaning the function of our healthy gut microbes 🦠) as the foundation of our health.

A few things about me:
1. I have two little boys, Jace and Blake, who are my world 
2. My wife Lily is pretty great too 
3. I’m a lifelong multi-sport athlete, and I still play basketball and soccer 
4. I started Gut Healthy Dietitian after focusing my research on gut health during my Masters of Science degree 
5. Gut Healthy Dietitian now has two other amazing dietitians, Nicole and Elyse, working for us 
6. We run a virtual clinic as well as providing dietitian services on campus at Western University 
7. I have a wild sense of overconfidence that proves me wrong 1-5 times most days 
8. I have been vegan/vegetarian for many years but recently starting adding animal products back into my diet because it felt right 
9. I work on ICU, stroke, medicine and mental health in my in-patient hospital job 
10. I did my undergraduate degree at StFX and my Masters degree at McMaster
FUEL YOUR GUT: GROUP PROGRAM I am so excited to a FUEL YOUR GUT: GROUP PROGRAM

I am so excited to announce the launch of our new group program in January 2023! I outlined the concept for Fuel Your Gut years ago but due to (very) limited time I needed Nicole’s help to develop the program, and the results are so good. This program is built around the feedback we hear from our clients every single day - the biggest limiting factor in making long-term diet and lifestyle change is our crazy schedules. The biggest barriers being a lack of time and energy. So we created a program that would take the stress out of eating well and allow you to achieve your nutrition goals in a way that is sustainable and enjoyable. 

WHAT DOES THE PROGRAM INCLUDE?
• 4-weeks of meal plans (quick, easy and delicious high fiber, anti-inflammatory meals)
• Weekly grocery lists (to save you time and energy)
• Weekly check-in from your dietitian for accountability and support 
• Weekly education sessions and Q&A 
• Access to a private group forum for motivation and accountability 

This program is for you if:
• You want to support your overall health and wellness
• You feel stressed or overwhelmed about your diet, or don’t have the time to make sustainable changes 
• You know gut health is important, but you don’t know what that means or how to support gut health
• You need to improve your diet for management of a chronic disease (heart disease, high cholesterol, high blood pressure, diabetes etc)
• You want more energy and improved digestion
• You want to commit to your health but know you need accountability to make long-term changes 

BONUS: if you have private insurance benefits you may be eligible for reimbursement of this program!
This program is not for you if:
• You have significant digestive symptoms. We would recommend you contact us for a 1:1 consultation for individualized recommendations as you may not be able to tolerate a high fiber diet right now. 

Limited space available! Join the waitlist today to claim your spot - link in bio
5 EASY TIPS TO SUPPORT GUT HEALTH 1. Eat more fib 5 EASY TIPS TO SUPPORT GUT HEALTH

1. Eat more fiber
2. Diversity is key 
3. Think INclusion instead of EXclusion
4. Manage stress 
5. Move your body, everyday 

Straightforward, but effective strategies to start supporting your gut health today. A gut health diet is the anti-diet. I break these 5 tips down in depth in the new free PDF download available on my website. Link in bio to download the resource and join our newsletter? Check it out!

#guthealthdiet #guthealthdietitian #dietitianlondonontario #diversitydiet #guthealthtips #guthealthnutritionist #guthealthnutrition #guthealthydietitian
I want to welcome Elyse, the newest member of our I want to welcome Elyse, the newest member of our Gut Healthy Dietitian team! 

Elyse is available for virtual sessions for all clients and on-site at Western for Western-affiliated clients (students, staff, faculty). We are so happy to have her!

A bit about Elyse: 

Hi, I am Elyse, a Registered Dietitian looking forward to helping you meet your nutrition goals! I obtained a Bachelor of Applied Science and Master of Applied Nutrition (MAN) degree from the University of Guelph and am a current member of the College of Dietitians of Ontario.
 
Nutrition is my passion and I have experience in several sectors including Long Term Care, Nutrition Management, and Public Health. I am committed to using an evidenced-based approach to nutrition counselling and strive to deliver individualized advice to meet my client’s needs. My goal is to work with clients to identify their nutrition goals and offer realistic advice to fit their lifestyle. I have a particular interest in chronic disease management such as diabetes and kidney disease, as well as gut health disorders. I am committed to being a lifelong learner and look forward to expanding my knowledge in all things nutrition & health related.
 
Other interests of mine include cooking, baking, reading, running, and relaxing with my friends and family!

#guthealthdietitian #guthealth #privatepracticedietitian #westerndietitian #westernuniversity #westernu #ibsdietitian #pcosdietitian #sportsdietitian #dietitiansofinstagram #dietitianapproved
The most fun I’ve ever had during a consultation The most fun I’ve ever had during a consultation.

It’s not every day you get the opportunity to provide nutrition counselling to an Olympian. So when Miranda Ayim, 3x Olympian and our flag bearer at the 2020 olympics 🇨🇦 asked for a session in our new offices at Western I was honoured. 

I can’t stress enough the importance of getting an outside opinion or review of your diet periodically. Miranda knows far more than the average person about nutrition from being a lifelong athlete, but since retiring from basketball her nutrition needs have changed. Getting a different perspective helps to set new goals and identifying any areas for improvement. 

Thanks so much for trusting me with your nutrition @mjayim. A true beauty of a person in all ways. Swipe through to see an old-school picture of us on the basketball court together in high school. Her basketball career may have gone slightly further than mine…but she retired first while I’m still going strong in women’s league 😆

📸: @jomoriah.photos 🤍

#sportsnutrition #sportsdietitian #sportsnutritionist #westerndietitian #guthealthydietitian
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