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Jenny had been overweight and had suffered from irregular menstrual periods, excessive facial hair, and acne most of her life. She didn’t know exactly why until she repeatedly and unsuccessfully tried to get pregnant in her early 30s. By investigating the reason behind her inability to conceive, she found out what many women with similar symptoms have discovered: She had polycystic ovary syndrome (PCOS).
A syndrome is a condition defined by a cluster of related symptoms or disorders. PCOS is characterized by infrequent or absent menstrual periods, obesity, elevated levels of androgen hormones and/or related symptoms (acne, excessive hair on the face and body, and hair loss resembling male-pattern baldness), and skin outgrowths (known as skin tags) or abnormally darkened, thickened skin in folds (known as acanthosis nigricans). Because cysts on the ovaries aren’t always present, some people think polycystic ovary syndrome is not a good term for the condition.
Female Syndrome XX?
A better term for PCOS might be syndrome XX, as some researchers have called it, because only women (with their XX chromosomes) develop it. PCOS is considered a female-specific form of syndrome X, also known as metabolic syndrome, which affects both men and women. Whereas PCOS is marked by a cluster of female reproductive disorders, syndrome X is defined by a cluster of cardiovascular risk factors—including abdominal obesity, unhealthy blood lipid levels (high triglyceride and low HDL cholesterol levels), high blood pressure, and high fasting blood sugar.
A central factor of both PCOS and syndrome X is insulin resistance—a condition in which insulin, a blood-sugar-regulating hormone, doesn’t work as efficiently as it should. The body responds to insulin resistance by pumping out high levels of insulin, which are believed to directly or indirectly lead to the development of both PCOS and syndrome X. Up to half of all women and adolescent girls with PCOS also have syndrome X, and women with PCOS are three to seven times more likely to develop type 2 diabetes, another condition with insulin resistance at its root.
Did you know?
A low-glycemic, high-protein diet that is also high in fiber works better for PCOS over the long term than a diet high in carbohydrates.
PCOS affects 6–10 percent of the female population, making it the most common endocrine disorder of premenopausal women. Traditionally considered a reproductive problem, PCOS is now understood to be a complex disorder that affects women’s reproductive, metabolic, and cardiovascular health. In addition to syndrome X, women with PCOS have an increased risk of nonalcoholic fatty liver disease, sleep apnea, infertility, gestational diabetes, and depression.
Just as with syndrome X, natural therapies for PCOS have focused on treating the underlying insulin resistance, improving menstrual cycles, and assisting with weight loss.
Diet Therapy for PCOS
If you have been diagnosed with PCOS, the following diet strategies can help improve symptoms.
• Restrict refined breads and sugary foods. Women with PCOS tend to eat significantly larger servings of high-glycemic bread products—those that raise blood sugar and insulin levels quickly. Eating large amounts of sugar and bread—both have a high glycemic index—also doubles the risk of diabetes, a common complication of PCOS. It’s just another good reason to avoid these foods.
• Eat low glycemic foods. Diets based on low-glycemic carbohydrates, such as nonstarchy vegetables, legumes, and many fruits, improve insulin sensitivity (or reduce insulin resistance), improve blood triglyceride or good HDL cholesterol levels, and reduce hunger—all important factors for women with PCOS. Many find it easier to lose weight on a lower-glycemic diet, say Walter Futterweit, MD, and George Ryan in A Patient’s Guide to PCOS.
• Cut back on your total carb intake and increase protein, such as fish and poultry, in the diet. A high-protein, low-carb diet significantly reduces depression and improves self-esteem—factors important in long-term weight management—in obese women with PCOS, according to a study published in the journal Appetite. A low-glycemic, high-protein diet that is also high in fiber works better for PCOS over the long term than a diet high in carbohydrates, says Christiane Northrup, MD, in the revised edition of Women’s Bodies, Women’s Wisdom.
Promising Supplements for PCOS
Research into specific supplements for PCOS is just beginning. Many nutrients that combat syndrome X and type 2 diabetes, including antioxidants and minerals that help with insulin sensitivity, also may be therapeutic for PCOS. Here are the most researched supplements.
Chromium, in the form of chromium picolinate or polynicotinate, can improve glucose tolerance and insulin sensitivity in obesewomen with PCOS, just as it can for diabetics. Try 200–1,000 mg daily.
Inositol has been shown to help normalize ovulation. One research review found that women with PCOS who took inositol showed significant improvements in ovulation and metabolic profile. Try 100 mg twice daily.
N-acetyl-cysteine (NAC) is an antioxidant found to increase insulin sensitivity in women with PCOS—and to boost the ovulation and pregnancy rate of women with PCOS treated with a common fertility drug. Try 1,200–3,000 mg daily.
Other antioxidants, including vitamin E and alpha-lipoic acid, may reduce oxidative stress (an excess of free radicals and lack of antioxidants) and improve insulin sensitivity in PCOS, just as they do for syndrome X and diabetes, researchers believe.