Weight gain, hair thinning, excessive hair growth - some 1.5 million people are suffering with a condition that is also one of the leading causes of fertility problems. But lots of people have no clue what it is.
Polycystic ovary syndrome (known as PCOS) affects approximately 1 in 10 women. There is no exact cause and it can be difficult to treat the symptoms.
With so many women affected, you will likely know someone who has it. And in a bid to raise awareness, a range of celebrities are coming forward to tell their experiences of PCOS - including Spice Girl Victoria Beckham, The Saturdays singer Frankie Bridge, Pretty Little Liars star Sasha Pieterse, and Hollywood actress Keke Palmer.
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Speaking to her 1.3 million followers on her Instagram story, Frankie Bridge candidly said: "I've just found out actually that I’ve got polycystic ovaries."
"I had loads of blood tests done a few weeks ago because I was getting irregular periods, I was getting really bad PMT, I was getting really cyst-y spots and really bad skin. I was finding it hard to lose weight, even though I was eating healthily. Loads of reasons, really – and I found out last week that that’s why."
Victoria Beckham opened up about PCOS while struggling to conceive her fourth child, Harper Seven. Speaking to Now magazine at the time, the singer turned fashion icon reportedly said: "Every time I go out, someone says to me 'Are you pregnant,' and at first I tried to dodge these questions with a vague response and a smile, but now, I have resorted to overt, brutal honesty."
She continued: "I keep that big smile and say something like, 'Actually, I’m struggling with infertility because of my PCOS, so my husband and I have been through several fertility treatments. No baby yet, but it’ll happen soon!'"
Raquel Monroy, a fertility and women's health nutritionist, spoke with the Manchester Evening News about PCOS to raise awareness and provide information to the millions who may be affected by this condition - and the loved ones they will have to lean on for vital support.
What is PCOS?
"Polycystic ovary syndrome (PCOS) is a common condition which affects approximately 1 in 10 women," explains Raquel. "However, like endometriosis, symptoms may be attributed to other causes or go unnoticed and therefore PCOS is often misdiagnosed.
"Despite the name, the ‘cysts’ in PCOS are not true cysts. In fact they are ‘stuck’ follicles which have not matured to release an egg, which is why the name of the condition is often confusing.
"Public awareness about PCOS continues to grow, with more and more women sharing their experiences on social media to garner attention in what is again, quite often a condition which goes under the radar. It is one of the leading causes of fertility problems in women.
"Not all women with PCOS will have symptoms and each symptom can vary from mild to severe."
Common symptoms of PCOS include:
Irregular periods or no periods at all
Fertility issues
Hirsutism (excessive hair growth)
Weight gain
Hair loss/thinning hair
Oily skin or acne
In adults, PCOS is diagnosed if two out of three of the following symptoms are present:
Anovulation: infrequent ovulation leading to irregular or absent periods
Hyperandrogenism: high levels of androgen hormones (male hormones such as testosterone) which can lead to symptoms like excess hair growth typically on the face, back or chest.
Polycystic ovaries: defined as the presence of 12 or more follicles (measuring 2-9mm in diameter) in one or both ovaries and/or increased ovarian volume."
The cause of PCOS
"The cause of PCOS is unknown. Genetics can play a part but if you imagine your genes load the gun, it is the environmental factors which ‘pull the trigger’, says the expert.
"Your genetic disposition doesn’t necessarily mean you will develop PCOS but coupled with environmental factors it could drive the onset of the syndrome.
"The main drivers of PCOS are hormone imbalance, insulin resistance and inflammation. Insulin resistance is a condition in which your body can’t effectively use insulin. The body makes more insulin to try and get glucose into the cells, however the extra insulin causes androgen levels to increase which then causes PCOS symptoms to develop, such as excessive hair growth, weight gain, anovulation.
"Insulin resistance signs include weight gain especially around the middle, fatigue, energy drops, skin tags, sweet cravings, brain fog. Inflammation in the body directly stimulates ovarian androgen production.
"An increase in abdominal fat contributes to the inflammatory load so it's important to manage weight. However, bear in mind not all women with PCOS are overweight. Chronic low-grade inflammation may not even show on blood or stool tests but could be showing in clinical signs such as eczema, joint pain, fatigue."
How to improve PCOS symptoms
"As a fertility and women’s health specialist my aim is to help women get to the root cause of what is driving their PCOS not just focusing on the symptoms," says Raquel. "It’s a complex condition which requires in-depth investigations, however to start improving symptoms naturally, I ask my clients to focus on the following:
Balance hormones naturally
"Eat a nutrient dense diet with plenty of fibre rich foods such as vegetables, whole grains, legumes, nuts and seeds. This will help to metabolise and detoxify hormones. Eating a nutrient dense diet will also improve your gut health. Poor gut health can impact circulating oestrogen levels which can increase the risk of PCOS.
Reduce inflammation
"Increase anti-inflammatory foods into your diet such as oily fish like salmon and mackerel which is rich in omega 3. Reduce your intake of processed foods and alcohol consumption. Take steps to address stress which drives inflammation in the body. Introduce stress management tools like regular exercise, meditation, journaling.
Blood sugar regulation
"Eat regular meals with a good balance of protein, fibre and complex carbohydrates to ensure your blood sugar remains stable which promotes a healthy hormonal balance. Getting enough sleep is vital. Sleep deprivation contributes to insulin resistance and chronic inflammation. Sleep is crucial for blood sugar control not to mention healing and repairing the body, so do not underestimate the importance of sleep."
What does the NHS say?
The health service advises: "There's no cure for PCOS, but the symptoms can be treated. Speak to a GP if you think you may have the condition. If you have PCOS and you're overweight, losing weight and eating a healthy, balanced diet can make some symptoms better.
"Medicines are also available to treat symptoms such as excessive hair growth, irregular periods and fertility problems. If fertility medicines are not effective, a simple surgical procedure called laparoscopic ovarian drilling (LOD) may be recommended.
"This involves using heat or a laser to destroy the tissue in the ovaries that's producing androgens, such as testosterone. With treatment, most women with PCOS are able to get pregnant."
Visit www.raquelmonroy.com for more information or visit Instagram @raquelmonroynutrition.
For more information and treatment options from the NHS, head here.
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