Polycystic Ovary Syndrome (PCOS), which is often mistakenly confused for a condition restricted to the female ovaries, is in fact a metabolic disorder that is under-diagnosed and under-treated.

A diagnosis for PCOS is made by meeting two out of the three criteria, which include:
1. elevated androgens (male hormones)
2. multiple un-ovulated follicles in the ovaries (aka “cysts” that are a result, not cause, of PCOS)
3. irregular menstrual cycleshealthy eating

PCOS is often tied to overweight, obesity, and insulin resistance, but is not found in all cases. Insulin resistance may potentially be to blame for increased hormone production and resulting hypoglycemia and metabolic dysfunction.

Commonly those affected by PCOS will experience increased hair growth (hirsuitism), acne, lipid abnormalities, sleep apnea, mood disorders, infertility, acanthosis nigricans (a thickening and darkening of the skin), and skin tags.  Newer research has emphasized both the prevalence and seriousness of PCOS: PCOS affects up to 10% of women of reproductive age, and those with PCOS have higher rates of type 2 Diabetes, hypertension, and coronary artery disease, and general medical care costs.

This past Fall I had the amazing opportunity to hear PCOS expert and dietitian Angela Grassi, MS, RDN, LDN, of the PCOS Nutrition Center speak on dietary strategies and lifestyle treatments for addressing PCOS. According to Grassi, those affected by PCOS will benefit from working with a  health professional to target the central goals of reducing the risk of developing type 2 diabetes, lowering risk for cardiovascular disease, improving fertility and reducing factors associated with excess weight (if applicable), and enhancing quality of life and treating other accompanying symptoms.

If you are affected by PCOS, work with a registered dietitian nutritionist (RDN) to learn more about how to incorporate the best evidence-based lifestyle interventions, which may include: 
• Anti-inflammatory and antioxidant-rich diets (think Mediterranean or DASH diets) for promoting weight loss and lowering inflammatory markers
• Limiting saturated fats and incorporating more foods containing poly- and mono- unsaturated  fatty acids to increase insulin
sensitivity and improve lipid levels
• Reducing refined carbohydrates and emphasizing low glycemic, high fiber and whole grain choices
• Supplementing with Myo-inositol and D-chiro- inositol (related to B-vitamins) or eating more foods containing them, like certain fruits and buckwheat.
• Vitamin D Supplementation
• N-acetyl cysteine (NAC), 1.6-
• Yoga for stress management and androgen regulation
• Strength training
• Sustained weight loss and management
• Sleep Hygeine

A RDN can assist with dietary adjustments and education related to insulin sensitizing agents like metformin. For the most effective interventional approach, a RDN can coordinate care with your entire healthcare team, which may include an endocrinologist, ob/gyn, or primary care physician.

More information can be found at PCOSnutrition.com, www.pcoschallenge.com,
https://www.asrm.org,  ae-society.org and IVF.com.

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