loss is so beneficial because it results in lower insulin levels, which in turn can reduce testosterone levels. Trouble is, as you’ll see in Part 2, if you’ve got PCOS you’re far more likely to have difficulty losing weight.
But does weight gain cause PCOS? Even though a woman with PCO who puts a lot of weight on might start to get PCOS symptoms, most experts believe that weight gain is a symptom, not a cause, of the syndrome, because research17 shows that slim women can and do report PCOS symptoms too.
DIET AND LIFESTYLE TRIGGERS?
Fertility studies indicate that both eating disorders and poor diets (e.g. diets high in fat, sugar and carbohydrate and low in nutrients) can and do affect the function of the ovaries. This is because a poor diet triggers the release of too much insulin, increasing the risk of an overproduction of testosterone and PCOS. And it’s been suggested18 that nearly two-thirds of women with bulimia may have PCOS.
So does a poor diet cause PCOS, or does PCOS trigger fad dieting because of the need to control weight gain, or even bingeing and purging due to sugar cravings set off by insulin resistance? The jury’s still out, though many women with PCOS believe the link is there.
‘I know science has yet to prove it, but I certainly believe my own PCOS was made a lot worse by my bingeing and starving cycle. As a teenager I was desperate not to be so dumpy and starved myself on stupid diets, but my spots, my weight and my irregular periods just got worse and worse.’
Emma, 32
Some researchers19 believe that when PCOS runs in families it isn’t because of a genetic reason; rather other factors common in families – typically a poor diet and lack of exercise leading to overproduction of insulin. Again, all this has yet to be proved conclusively, but what we do know for sure is that one of the best ways to manage PCOS is to clean up your act when it comes to diet and lifestyle. Part 2 will give you plenty of advice on how to do just that.
‘For centuries, experts in the studies of philosophy, science and medicine have pondered the question of how much of who we are is inherited and how much in due to environment. There is no medical issue that begs the answer for this question more than does PCOS.’20
HORMONE DISRUPTERS
Xenoestrogens or endocrine-disrupting chemicals (EDCs) are widely recognized to be highly toxic in the smallest doses. Despite this, they exist throughout our environment, from pesticide residues on food to pollution in our air and water to medications and the high-sugar, preserved and processed fast foods in our diet.
EDCs are characterized as ‘hormone disrupters’ because they have a molecular structure similar to the hormone oestrogen and can interfere with the natural process of your hormones. They trick your body into a condition known as oestrogen excess or oestrogen dominance, and the resulting hormonal imbalance can trigger a wide variety of PCOS symptoms, from irregular periods and acne to dry hair and weight gain.
‘You hear so much about pollution reducing men’s sperm counts, but no-one talks about how the same pollution affects women. I want to know more!’
Aileen, 37
Research21 about how EDCs affect or trigger PCOS is still in its infancy, but we know enough to suggest that exposure to hormone-disrupting toxins could be a contributory factor – that’s why you’ll find a chapter in Part 2 devoted to this important issue.
IS IT ALL IN THE MIND?
Does PCOS have something to do with your mental or emotional state? Some researchers believe that it might, in two ways: first, studies22 show it may be caused or triggered by epilepsy or at least one of the medications routinely used (depakote or valproate) to treat epileptic seizures. Second, other studies23 indicate that PCOS may worsen mood and anxiety symptoms.
This is a controversial area of research with potentially huge consequences for the recognition and treatment of PCOS as not just a hormonal disorder but also a mood disorder.
If you’ve got PCOS you probably don’t need a study to tell you that the symptoms can turn your mood black and crank up your anxiety levels from time to time – that’s why Part 3 of this book is packed with advice on stress-reduction and getting yourself in the right frame of mind to take charge of your mood and your symptoms.
BETA CELL FUNCTION
Insulin is produced by the beta cells of the pancreas; researchers are currently investigating whether women with PCOS have a beta-cell function that is more responsive to insulin resistance than women without PCOS. Early studies24 indicate that this may indeed be the case. Further research in this field could well lead to discoveries of new therapies and better diagnoses for women with PCOS and insulin resistance.
METABOLIC SYNDROME (SYNDROME X)
Metabolic Syndrome or Syndrome X is a term used to describe a set of risk factors that increase the risk of heart attack by 4 to 20 times. These factors include insulin resistance, weight gain around the tummy, high levels of blood fats and high blood pressure. It’s thought to be caused by the body’s inability to process a diet high in sugary foods and refined carbohydrates. These refined carbohydrates not only drive the body to insulin resistance but also fail to supply the many nutrients the body needs for hormones to function at optimum levels.
Many women with PCOS have symptoms of Syndrome X – and as it seems possible that men could get PCOS too (see page 13) – could PCOS simply be a female version of symptoms that are triggered by Metabolic Syndrome? Could Syndrome X be the cardiologist’s view of what a gynaecologist would call PCOS? Much more research25 needs to be done.
HOW DO THESE THEORIES HELP ME?
In the end, the most important thing about all the research into PCOS is that it will help scientists, the medical community, natural health practitioners and women who have PCOS to work out the best ways of dealing with it. But the underlying results of most research so far has one thing in common – the best thing any woman with PCOS can do for herself is to take charge of her environment – diet, lifestyle, emotional health – in order to redress the hormonal imbalances within her endocrine system and restore better health. That’s why Parts 2 and 3 of this book are packed with practical information on how to get the help that works best for you and your specific symptoms. And the best thing about these self-help measures is that you can use them with whatever type of medication you decide to take.
Chapter 5 will take a look at what the medical community can offer, but before we launch into medication let’s complete this preliminary overview of PCOS by taking a look at how it affects your hormonal life stages from puberty to the menopause and beyond.
CHAPTER 3 PCOSANDYOUR LIFE STAGES – FROM PUBERTY TO MENOPAUSE
It’s clear that there can be different stages of PCOS throughout your life. Studies1 show, for instance, that younger women tend to have substantial difficulties with their periods, whereas older women2 tend to have other problems such as diabetes and hypertension (high blood pressure).
PCOS symptoms often appear first during puberty, though – as mentioned in Chapter 2 – recent research suggests that PCOS may begin even earlier. According to lead author David Abbott, Ph.D., of the Wisconsin National Primate Center at the University of Wisconsin-Madison,3 PCOS develops in the first and second trimesters of pregnancy when excess androgens are present.
But for now, here’s what we know about how PCOS affects your hormonal life stages, from puberty to menopause and beyond.