Polycystic Ovarian Syndrome

Question:

I have a client with PCOS (polycystic ovarian syndrome). She is not near obesity but is fairly overweight. As I understand it, she has insulin resistance, and when she eats any CHO, it immediately gets stored as fat. She currently has a well balanced diet and she is exercising two to three times a week on weights and three to five times a week on cardio. We have noticed she is putting on some muscle but not really losing the fat on top! She has seen a dietician, but she can't seem to find one that knows very much about PCOS. I have suggested she try eating all low GI carbs. Do you have any suggestions to offer or any resources to check into?

Answer:

Polycystic Ovarian Syndrome (PCOS), also known as Stein-Leventhal Syndrome, is the leading cause of infertility and affects an estimated six to 10 percent of all women, many of whom do not know they have it. Its cause is not known, and though it is not curable, it is treatable with medication, diet and exercise. Although some of the symptoms mimic those found in obesity related disorders such as syndrome X and type II diabetes, there are several that are unique to PCOS and allow for its diagnosis. These include:

• Amenorrhea (no menstrual period), infrequent menses and/or oligomenorrhea (irregular bleeding)
• Oligo or anovulation (infrequent or absent ovulation)
• Though women with PCOS produce follicles (fluid-filled sacs on the ovary that contain an egg ) the follicles often do not mature and release as needed for ovulation, producing cysts
• Hyperandrogenism
• Increased serum levels of male hormones, such as testosterone, androstenedione and DHEA
• Infertility
• Cystic ovaries
• Enlarged ovaries
• Polycystic ovaries are usually 1.5 to 3 times larger than normal
• Chronic pelvic pain
• Obesity or weight gain
• Insulin resistance, hyperinsulinemia, and diabetes

Essentially, women with PCOS have high levels of insulin, androgens (male hormones) and infertility and insulin resistance, with or without the presence of obesity. Diet and exercise modifications have less impact on the symptoms due to their genetic etiology. To lower insulin levels and treat the insulin resistance, insulin sensitizing agents such as metformin are used. This generally leads to a reduction in the androgens and a return of fertility. Overly restricting carbohydrate is not necessary. A diet of 50 to 55 percent carbohydrate is generally recommended, as is an increase in physical activity if the patient is sedentary.

To address your specific concerns, eating lower glycemic index (GI) carbohydrates is a fine plan. If her weight and/or fat mass is not going down, then reduce the amount of calories she is eating by 250 or so. For more information, try the following web site: ttp://www.pcosupport.org.

I hope this information proves useful. Good luck.