Polycystic Ovary Syndrome.
Have you ever heard of PCOS? (That’s Polycystic Ovary Syndrome, to me and you).
‘Polycystic ovary syndrome (PCOS) is a common condition that affects how a woman's ovaries work. The 3 main features of PCOS are:
- Irregular periods – which means your ovaries do not regularly release eggs (ovulation)
- Excess androgen – high levels of "male" hormones in your body, which may cause physical signs such as excess facial or body hair
- Polycystic ovaries – your ovaries become enlarged and contain many fluid-filled sacs (follicles) that surround the eggs (but despite the name, you do not actually have cysts if you have PCOS)
If you have at least 2 of these features, you may be diagnosed with PCOS.’ ¹
Anyway, you’re probably wondering why I am featuring PCOS in my blog? Well, for one, I have it. I was diagnosed in 2016 with PCOS. My sister has also been diagnosed with it, and many of the symptoms run in our wider family.
But another reason I wanted to write about this is that PCOS can heavily affect your diet and weight (cravings and also metabolism) and exercise performance, too. So it's relevant to my personal training studies and to my female clients.
And possibly a good percentage of my female clients, too, here's a fun fact for you…
PCOS effects 1 in every 10 women in the UK
PCOS is such a common condition, yet so many people don’t know about it. And many women won’t even know they have it. It’s thought to affect 1 in every 10 women in the UK. ¹
Here are some common symptoms of PCOS:
- Irregular periods or no periods at all
- Difficulty getting pregnant, as a result of irregular ovulation or failure to ovulate
- Excessive hair growth (hirsutism) – usually on the face, chest, back or buttocks
- Weight gain
- Thinning hair and hair loss from the head
- Oily skin or acne ¹
Anyway, I’m not a doctor, back to the PT business and how PCOS can affect diet and exercise…
PCOS causes a 14-40% reduction in your metabolism
James Smith PT (Yes, I know I reference him all the time, I’m a super fan), did an amazing Ted Talk on female fat loss² which features the topic of PCOS, and I really think it’s worth a watch if you haven’t seen it already. During the talk, he says:
‘Polycystic Ovary Syndrome, again, is something that needs to be spoken about and needs to be understood by people. PCOS has a big impact on fat loss.
Here I can show you the total daily energy expenditure components. These blocks are what make up the energy we burn in a day.
Our BMR is the amount of energy we burn at rest - which is a considerable amount.
Our NEAT is the amount that we burn through being active, that's not planned training. (You opt to take the stairs, instead of the elevator, or you walk up the elevator, you increase your NEAT component.)
Your TEF is your Thermic Effect of Feeding. Eating a high protein diet means that you burn more calories through your body having to work harder to break down protein.
And EAT, at the top, is our Gym based exercise. So as you can see, we don't burn as many calories in the gym as a lot of people think. There are other components outside of that that are much more important.
How does that relate to PCOS?
PCOS has shown to reduce people's BMR from 14 - 40%. 40% for a second is something we need to take into account. That is more calories than four gym sessions in a day, and why aren't people talking about it?
You can make all the efforts by increasing your NEAT - by taking the stairs. You can increase your Thermic Effect of Feeding by increasing the amount of protein in your diet. You can start training in the gym. But if you do not have considerations for PCOS, then unfortunately, you are fighting a battle, and you are going to lose that battle'. ²
Powerful stuff, huh? He goes on to say that PCOS can hinder fat loss so much, that there are women with PCOS that are potentially going to need to diet on less than 1,000 calories a day to lose fat.
PCOS and food cravings...
And, metabolism aside, PCOS can also increase cravings for sugar, which, for obvious reasons, doesn't help with dieting.
'A big reason women with PCOS experience strong, almost urgent like cravings for carbohydrates and sweets is due to elevated insulin. Insulin is an appetite stimulant.' ³
There is a lot of science behind the relationship between insulin and PCOS that I won't go into now, but I'll include links at the end of this post if you're interested in finding out more.
So, given the above, you can start to see how the odds are stacked against women with PCOS when it comes to fat loss and maintaining a healthy weight.
Managing Polycystic Ovary Syndrome
The best ways to reduce the impact of PCOS and lessen symptoms are through exercise, a low GI diet, and fat loss.
Now, this is a wholeeeee other topic for another day. My original intent for this blog was to introduce and raise awareness of PCOS. I will write another within the next few weeks with some tips for actually managing it, so stay tuned.
But before I go, here's something to leave you with...
It’s not all bad...
If you do have PCOS, like me, try not to feel disheartened by it. For every downside, there is an upside...
As a result of having more testosterone, we put on muscle easier and tend to have a higher muscle mass. We’re also stronger than most women. We're more competitive. We perform better with physical exercise.
There's actually a big correlation between female athletes and PCOS.
'Top female athletes are more likely to have higher naturally occurring levels of testosterone and to have PCOS.' ⁴
'Essential hyperandrogenism is beneficial for athletic performance and plays a role in the choice by women to compete in athletic activities.' ⁵
Every cloud, eh? I weirdly kind of like having PCOS. I'll write again soon - Part 2: Managing PCOS.
P.S. For those interested, information about diagnosing PCOS below...
Getting a diagnosis…
If any of the symptoms discussed above sound familiar, it’s worth talking to your doctor to discuss arranging blood tests to check your androgen levels (particularly testosterone), and your insulin and blood sugar levels ideally, too. The doctors may also offer an ultrasound scan to determine whether your ovaries are polycystic.
A common misconception, however, is that you need to have polycystic ovaries to have PCOS. It’s in the name of the condition – you’d think that would mean it’s part of the condition, right? Well no, actually, if you have an ultrasound scan and it shows no fluid-filled sacs – it doesn’t automatically rule out PCOS.
It’s one of the reasons why PCOS is sometimes missed, because it can be tricky to diagnose.
It’s best to thoroughly investigate through both blood tests and an ultrasound scan, and to also make a note of how many symptoms you experience that are listed as common symptoms for the condition.
References and further reading:
¹ NHS overview: Polycystic Ovary Syndrome:
² A perspective on fat loss | James Smith | TEDxBundaberg:
³ PCOS Nutrition: https://www.pcosnutrition.com/cravings/
⁴ Setting fair regulations for top female athletes that have naturally higher testosterone levels: https://www.eurekalert.org/news-releases/738003
⁵ Female hyperandrogenism and elite sport:
All Women With PCOS Should Be Treated For Insulin Resistance: