POLY CYSTIC OVARIAN SYNDROME

(PCOS)

Presented by

Marita Radloff, Nutrition student at the University of Alabama

&

Dani Lebovitz MS, RD, CSSD, LD, CDE, Robins AFB Dietitian

TODAY’S TOPICS What is PCOS? Signs and Symptoms Diagnosis Causes Complications Treatment Diet Exercise Final Thoughts Questions

WHAT IS PCOS? Polycystic means “many cysts”

Small, pearl-sized clusters of cysts in the ovaries Fluid-filled follicles containing eggs are premature

Follicles containing the eggs build up in the ovaries Polycystic Ovary Syndrome is the most

common endocrine disorder in females 5-10% of reproductive-age women have PCOS High levels of androgens (male hormones such

as testosterone) are released from the ovary Androgens interfere with ovulation and normal

body regulation

SIGNS AND SYMPTOMS• Heavy, irregular or

absent menstrual cycles

• Infertility• Excessive abdominal

weight (WH ratio >35 inches)

• Intense carbohydrate cravings

• Hair loss from the head• Acne (on the face,

chest, and back)• Sleep apnea• Skin tags• Darkened patches of

skin (around the neck, groin, underarms, or in folds)

• High blood pressure• High cholesterol• High triglycerides• Depression• Anxiety• Decreased sex drive• Type 2 Diabetes• Pelvic Pain• Male pattern hair

growth (face, chest, back, lower abdomen, fingers, and toes)

INFERTILITY AND PCOS PCOS is responsible for 70% of infertility

issues in women who have difficulty ovulating

Androgens affect ovulation and egg development

“String of Pearls” or polycystic ovaries lead to irregular or infrequent periods

DIAGNOSIS Difficult to diagnosis; less than 50% of

those with PCOS know they have it Doctors will look at:

A family history of PCOSUnusual menstrual cycles

Periods lasting 40+ days Very heavy periods Absent periods

Ultrasounds for “String of Pearls” on ovariesTwo or more signs or symptoms of PCOS

WHAT CAUSES PCOS? Exact cause unknown

GeneticsExposure to androgens in the womb

COMPLICATIONS OF PCOS Early detection is key since PCOS is

known as a “Silent Killer”Elevated low density lipoprotein (LDL)

“lousy cholesterol” Low high density lipoprotein (HDL)

cholesterol “healthy cholesterol”High triglycerides (fat circulating in the

blood)Elevated blood pressure above

140/90mmHgCardiovascular disease 4 to 7 times higher

in women with PCOS than women of the same age without PCOS

COMPLICATIONS OF PCOS (CONT.)

Increased risk for endometrial cancer Irregular menstrual periods and the lack of

ovulation cause women to produce the hormone estrogen, but not the hormone progesterone

Progesterone responsible for shedding uterine lining

Overtime, the uterine lining becomes thick and can lead to cancer

Increased risk for breast and ovarian cancerStudies have shown that women with PCOS

have double the risk for developing ovarian cancer

Sleep apnea Most common cause of sleep disorders Brief interruptions during sleep Cause snoring and fragmented sleep When left untreated, can lead to an increased

risk of heart disease and stroke

o Anxiety and depression o Early detection and treatment is key to

avoid chronic diseases later in life!

COMPLICATIONS OF PCOS (CONT.)

DIABETES & INSULIN RESISTANCE

Diabetes Insulin resistance

Insulin is a hormone in the body that regulates blood sugar by bringing sugar (glucose) into the cells for energy

Some women with PCOS have insulin resistance, where the amount of insulin needed for energy uptake has been disrupted – this can lead to Type II Diabetes

About 30% of women with PCOS have some type of insulin resistance

Increases the likelihood of the weight gain cycle

PREGNANCY AND PCOS Women with PCOS tend to have higher

rates of:MiscarriageGestational diabetesPreeclampsia (pregnancy induced high blood

pressure)Premature deliveryCesarean section deliveryNeonatal care

TREATMENT Control all of your symptoms, not just

one, to reduce chronic disease risk Get tested for diabetes regularly Symptoms of PCOS can be improved

with diet, exercise, and quitting smoking Studies have shown that a moderate weight

loss of 5-7% of total body weight may significantly improve symptoms

DIET: HEALTHY CARBOHYDRATES Women with PCOS crave more

carbohydratesCould lead to binge eating and weight gain

What are carbohydrates?Foods that breakdown into sugar in the body

Breads, cereals, rice, pasta, fruits, starchy vegetablesWhole grains (complex carbohydrates vs. refined

grains (simple carbohydrates)

Choose whole-grains over refined grainsThink fiber!

Reduces cholesterol Keeps you feeling fuller longer

DIET: EAT MORE PLANTS Try to make more meals plant-based

A plant-based diet is rich in fruits, vegetables, nuts, legumes and whole grains Limit animal products:

ButterMeat

More vitamins, minerals and fiber that help reduce cholesterol and blood pressure

Lower in calories Take longer to chew: add to full feeling Start slow:

Make one meal or snack a week with no animal products

DIET: EAT HEALTHY FATS Eat foods rich in Omega-3 Fatty Acids

Omega-3s lower cholesterol and triglycerides

Foods rich in Omega-3s: Walnuts Egg yolks Flaxseeds Chia seeds Canola oil Fatty Fish (especially salmon and tuna)

These are higher in fat and calories, so eat in moderation

DIET: GET MORE VITAMIN D

Vitamin D is found in almost every cell and tissue in the bodyHelps to regulate menstrual cyclesDecreases insulin resistanceRDA: 600 IU, but some studies suggest

2000 IU Food sources: Milk, yogurt, cheese, egg

yolks, swordfish, salmon, tuna in water, fortified orange juice, and many ready to eat cereals

Take a supplement or get short 10-15 minutes of sunscreen-free sun exposure

EXERCISE Being physically makes a difference!

Regulate menstrual cyclesDecrease risk of diabetes and heart diseaseHelps with weight management

Women with PCOS who exercise 3 times/week have: Improved ovulation ratesBetter insulin sensitivityLose more inches around their waist than those

who just cut calories

EXERCISE (CONTINUED) Recommended 30-60 minutes 5 days a week Strength training 2-3 times per week

Increases metabolism and promotes muscle growth

Tips to be more physically active: Schedule your day around exercise; if it’s the other

way around, it might not get done! Spread out exercise in 10 to 15 minute increments

instead of all at once Use exercise equipment or body weight exercises

while watching TV or during commercials Take the dog on longer walks, use the stairs, park

further from store entrances Wear a pedometer and aim for 10,000 steps per

day!

FINAL THOUGHTS PCOS is not curable, but is treatable Take steps to stay as healthy as possible Proper nutrition and exercise help to

manage symptoms and reduce risk of chronic diseases

Regularly check blood sugar, cholesterol, and blood pressure

Early diagnosis, proper treatment, and lifestyle changes can manage or reverse symptoms

QUESTIONS?

REFERENCES References http://www.ncbi.nlm.nih.gov/pmc/article

s/PMC3938041/ http://www.pcosfoundation.org/PCOS-Ed

ucation-trifold.pdf http://www.pcosnutrition.com/index.php

?pID=28 http://www.pcosnutrition.com/_files/live/

Understanding_insulin_resistance.pdf http://www.hormone.org/diseases-and-c

onditions/womens-health/polycystic-ovary-syndrome

http://www.womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.html