PCOS or polycystic ovary syndrome is the most common hormonal disturbance among premenopausal women, affecting as many as one in five women. It is the leading cause of infertility due to lack of ovulation.

Symptoms of PCOS, which vary from the mild to the severe and from woman to woman, include:

 

• irregular periods or lack of periods
• irregular ovulation or no ovulation
• reduced fertility; difficulty in becoming pregnant
• excess facial and/or body hair (hirsutism)
• oily skin, acne
• being overweight, rapid weight gain; difficulty in losing weight

In addition the condition has long term health conditions and is associated with an increased risk of developing obesity, diabetes and heart disease so if you suspect that you may have PCOS it is important to see your doctor for full investigations.

 

No definite cause has been established, but it has been suggested that the problem stems from the ovaries, which are unable to produce the hormones in the correct proportions. This in turn gives the message to the pituitary gland that the ovaries are not working properly and this gland then releases high levels of LH. But PCOS also seems to affect a number of other different kinds of hormonal pathways in the body. Problems with the thyroid and adrenal glands may make some women more susceptible to PCOS. Problems with insulin (insulin resistance) have also been implicated, and PCOS does seem to run in families.

 

And it may even be more complicated than that. Sometimes it is not just the amount of hormones produced by the body that can cause an imbalance. Scientists have found that some women are simply unable to deal effectively with the hormones, which can be the root of the problem. Sex hormone-binding globulin (SHBG) is a protein produced by the liver that binds sex hormones, such as oestrogen and testosterone, in order to control how much of them are circulating in the blood at any one time.

 

It appears that overweight women have much lower levels of SHBG in their blood, which results in more circulating testosterone and increasingly bad PCOS symptoms, such as an excess of hair, which is one of the most distressing symptoms.

 

So, it appears that PCOS is a bit of a ‘chicken and egg’ situation. Do the high levels of androgens (male hormones) create the weight gain or does the weight gain cause the hormone imbalance? It is also known that women with PCOS are more likely to have problems balancing blood sugar, and they can be insulin-resistant. Insulin-resistance happens when insulin levels are high (hyperinsulinaemia), but that insulin cannot transport glucose into the cells. This, in turn, leads to high levels of blood glucose (sugar). And again, back to the chicken and egg, does the weight gain cause the insulin resistance or does the problem with insulin cause the weight gain?

 

Excess insulin lead to an increased appetite, which can cause overweight. The more circulating insulin, the more the ovaries produce testosterone and so the cycle continues. It’s extremely difficult to know which problem is the cause and which is the effect.

 

From the medical perspective, PCOS is often treated with oral contraceptive pills (which also contains an anti-androgen) are used to decrease excess facial and body hair. Medications such as clomiphene can be used to induce ovulation and diabetric drugs like metformin may also be used. 

However, a significant number of women have found that they can beat their symptoms and avoid medication through diet and lifestyle changes.

Until recently, diet was not thought of as an important adjunct in treatment. However, since the fairly recent discovery regarding the role insulin resistance play in PCOS, many experts now believe that diet should be an essential part of the treatment plan. It is believed that diet, along with regular exercise, can help reduce insulin resistance, which can not only help erratic periods, hirsutism and acne, but may decrease the risk of heart disease and diabetes as well. Dozens of medical studies have shown that eating the right kinds of foods can help beat symptoms and reduce the risk of infertility, diabetes, and heart disease.

 

The right diet is so important because nutritional deficiencies can upset blood sugar and hormonal balance and make symptoms worse. A healthy diet also plays a vital role in weight management and numerous studies show that weight is a significant factor in determining how severe symptoms of PCOS are. The more over weight a woman is the worse her symptoms tend to be.

 

It seems that a balanced, nutritious, whole food, low glycaemic diet, according to the PCOS diet guidelines below, has the most positive effect on women with PCOS, easing their symptoms and reducing the long term health risks. If you’ve been diagnosed with PCOS, think of the changes not as PCOS diet rules but as guidelines for a lifetime of healthy eating to ensure your body gets all the nutrients it needs to beat your symptoms and boost the quality of your health and your life. And if you haven’t got PCOS think of the diet rules as guidelines for a healthy diet that can reduce your risk of blood sugar imbalance, hormonal problems, irregular periods, weight gain and premature ageing.

 

PCOS Diet Guidelines

 

Eat more often: When you fast for long periods your body thinks starvation is on the horizon and responds by doing the best it can to hold onto every calorie by reducing your metabolic rate, and preparing to store fat. Long gaps between meals also creates low blood sugar levels, which makes you crave sugary foods and snacks – the very foods that cause a surge of insulin into your bloodstream and add to the likelihood of blood sugar imbalances which can make symptoms of PCOS worse. Women with PCOS should aim to have a hearty breakfast followed by a mid morning snack, a healthy lunch, a teatime snack and then a light supper.

 

Go for whole foods: Whole foods are bursting with goodness because they’ve had none of their nutrients or fibre taken away and no chemicals have been added. Whole grains are a good example of a whole food that science has shown to have protective health benefits – from heart health to bowel health. As well as being packed with antioxidants that can prevent disease and premature ageing and other nutrients your body needs for good health, whole foods contain plenty of fibre, or roughage, which has a stimulating effect on the digestive system. A diet rich in fibre is particularly therapeutic for women with PCOS because fibre is thought to prevent excess hormones from being reabsorbed into the blood.

 

Fresh vegetables, fresh fruits, wholegrain cereals and breads, legumes (peas and beans) fresh fish, nuts and seeds are all whole foods, so eat more of them. Legumes, such as peas and beans (great in soups, stews, casseroles and dips like hummous), are a good source of fibre for blood sugar control. Research has suggested that they may be important for lowering cholesterol and preventing cancer. Legumes, along with soya, grains and most vegetables, are also a good source of hormone balancing phytoestrogens.

 

Drink plenty of water (six to eight glasses a day) to help whole foods digest and pass through your system. And if you aren’t used to a whole food high fibre diet you need to introduce it slowly to give your digestive system and your bowels time to adjust.

 

Cut down on sugar: Eating refined sugar has been linked to many health problems, from diabetes to heart disease, obesity and cancer and, of course, PCOS. Sugar has no nutritional value but lots of calories and it goes straight into your bloodstream where it raises blood sugar levels, stimulates the release of insulin, triggers PCOS symptoms, contributes to weight gain and depresses the immune system so you’re more likely to get constant colds.

 

Sugar does have one thing going for it – it gives you energy but only as a quick fix, it is not long lasting.  Your body gets plenty of sugar, which is long lasting from whole foods such as fruits and unrefined carbohydrates such as grains. You don’t need to get it from the sugar bowl or from cakes, sweets and pastries.

 

Make the GI work for you: The glycaemic index was originally designed for people with diabetes to help them keep their blood sugar levels under control. Since improvement in PCOS symptoms is associated with blood sugar balance the glycaemic index can be a very useful tool for women with PCOS. There are plenty of books and websites which list the glycaemic value of various foods but in general foods that have a high glycaemic index tend to be white, high in sugar and additives and foods that have a lower glycaemic index tend to be fresh, low in sugar, additive free and high in fibre (you’ll be doing this already if you’re choosing whole foods).

 

Cut down on salt: The next stage on the PCOS diet is to cut down on salt. Instead of adding salt to your food add herbs, spices lemon juice for flavour. A diet high in salt can increase your already higher risk of high blood pressure and cause fluid retention. Be aware that salt is a hidden ingredient in many foods, in particular processed and pre packed foods so once again you need to read the labels and check the salt (sodium) content. To find out how much salt is in a food, multiply the sodium content on the label by 2.5. You should aim for less than 5g of salt a day.

 

Eat the right fats: Saturated fat is a bad fat and should be reduced. You get saturated fat in dairy products and red meat. These animal fats are not good because they can cause the production of unhealthy prostaglandins that can trigger blood clotting and hormones that can upset your digestive, immune and hormonal systems. If that wasn’t enough saturated fats can interfere with the absorption of other nutrients and stimulate oestrogen production.  In addition to saturated fats you also need to avoid hydrogenated fats and oils, in the form of fried, oxidised or hydrogenated fats found in margarines, vegetable shortenings and many processed foods and fast food snacks as well as cakes, sweets and biscuits. These vegetable oils contain transfatty acids that can increase your risk of diabetes and heart disease.

 

But you shouldn’t avoid fat altogether – because the right fats can protect your health. Unsaturated fats (polyunsaturated and monounsaturated) have a protective effect on the heart and are found in olive oil and foods such as avocados but the most beneficial fats for women with PCOS are the Omega 3 essential fats and to a lesser extent the Omega 6. You can find both these fats in oily fish, nuts and seeds. Every single cell in your body needs these essential fats (EFAs) to maintain a cell wall so that it is flexible enough to take in nutrients and push out toxins. Your body needs them to balance blood sugars, regulate sex hormones and beat symptoms of PCOS.  (For more information on PCOS see my book ‘Nutritional Health Handbook for Women’ or download an ebook on PCOS from www.naturalhealthpractice.com.  A good Omega 3 fish oil supplement I use in the clinic is called Omega 3 Plus, see the Resources Page).

This month’s case study is 27 year old ‘Melanie’ who came to the Clinic with amenorrhoea (absence of periods)

I had taken the contraceptive pill during my early twenties to regulate my periods which worked, but when I stopped taking it, my periods did not return. Three years on I still hadn’t had a period and I went back to my doctor because I was worried about the longer term effects on not having periods. I had read that I might experience difficulties conceiving and the risk of developing osteoporosis may be increased. I went to my doctor to discuss this and he dismissed these concerns and just recommended I go back on the Pill to bring a cycle back. I knew this was only going to give me a ‘false’ period and it would only mask any underlying hormone imbalance so I decided against it. I asked to be referred for further investigation. I had an ultrasound scan which showed I had polycystic ovaries, but it was all very vague and I had no real explanation as to what it meant. I had also stated to gain weight around my middle which I found distressing.

 

I was talking to a work colleague who had mentioned that she had been to see a nutritionist at The Dr Marilyn Glenville Clinic for natural support to help her irregular periods and she had made changes to her diet and taken vitamins and minerals and herbal remedies. Within six months her cycle had regulated without having to take the Pill as recommended by her doctor.

 

I phoned the Dr Marilyn Glenville Clinic and spoke to one of the nutritionists to make sure that they could help with my condition. She explained that hormone imbalance is one of the main areas they deal with and recommended I book a consultation. Having spoken to her it really excited me to think I was being proactive by trying to help myself naturally rather than just taking the easy option by going on the Pill.

 

Before the first appointment I was sent a comprehensive questionnaire which allowed me to write down my main areas of concern and where I needed help and my current diet. My diet in fact was generally very good because I had been to see a naturopath about a year ago. However, I knew there was always room for improvement!

 

During my initial consultation the nutritionist went through my questionnaire thoroughly with me. She had already looked through it and made notes which made me confident that she knew why I was coming. After going through my menstrual history and finding out that I had been diagnosed with polycystic ovaries the nutritionist explained that sometimes women, especially younger women under 30 are diagnosed with this condition when in fact a young woman should appear to have lots of cysts (follicles) on the ovaries and as we get older the follicles become less as egg production declines. She gave me the option of getting a second opinion which I agreed to so she referred me to have another ultrasound scan. The scanning equipment was amazing – 3D colour and it confirmed what the nutritionist said – I didn’t have polycystic ovaries – but simply healthy active ovaries! She also explained that a blood test was needed in conjunction with the scan to check my hormones and this came back normal. I was relieved, yet frustrated because I wanted to know why my periods had stopped.

 

The nutritionist explained that periods can take a while to come back having been on the Pill long term, but fundamentally nothing was wrong with me. She recommended I use herbs to try and reinstate a period. I said that I had used Agnus Castus but it didn’t work. She recommended an herbal formula which she explained was often more effective than using single herbs because they have a more nurturing effect on the whole menstrual cycle. She also explained that the herbs she was going to recommend  were more potent and better quality than the herbs you could freely by over the counter. She did warn me that the herbs may taste bitter, but I was so desperate to get my periods back I didn’t care!!

 

I went away and followed the programme. Because my diet was already quite good, it was the supplements and herbs that seemed to make more of a difference. The only area that the nutritionist commented on in regards to my diet was the long periods I was leaving in between eating. I should be eating every three hours in order to keep my blood sugar levels stable and also have a positive effect on my hormone balance. I was going 5 or 6 hours most of the time, partly due to my busy job and lifestyle but also because I thought I would lose weight by eating less and not having any snacks. She suggested always eating some protein with my snacks so an apple and some nuts for example or oatcakes and nut butter.

 

Within 8 weeks I had a period which was absolutely amazing! I hadn’t had a period in 3 years so to get one was almost like a miracle! I phoned the clinic just to let the nutritionist know what had happened and she told me to continue with everything until my next appointment.

 

I couldn’t believe it, by my second appointment I had already had two periods 28 days apart. The nutritionist explained that the herbs work primarily on my pituitary gland which essentially controls how my hormones work and they have a long lasting effect.

 

I’m now 12 months on and I’ve had regular 28 day menstrual cycles and no longer taking the herbs. I feel so much more in control and so pleased to have a period back without having to take the Pill. Not only has my cycle returned, I have lost weight from around my tummy which has really helped my confidence. It seems strange because I am eating so much more and the weight is steadily coming off. I’m a lot more aware of eating protein and making a conscious effort to eat every 3 hours.

 

I wish I had visited the Dr Marilyn Glenville Clinic sooner, but I suppose time goes so quickly it is easy to lose track of time!

 

 

Marilyn’s Comments

 

Melanie’s story is remarkable and so inspiring to see just how powerful nutrition can be. We often see similar cases in our clinic where young girls are experiencing menstrual problems –whether that is no periods at all or perhaps they have become irregular. The conventional medical approach is to address this is with the contraceptive pill, as Melanie was offered, but this only covers up any potential underlying hormone imbalance so as soon as the Pill is stopped, the hormonal problems often kick back in.

 

With a lack of periods for such a long time as Melanie experienced, it is certainly very important to have this investigated by a doctor, however, once you have a diagnosis, there are many options available if you feel that taking the Pill isn’t right for you.

 

If you would like to find out more about our clinics in London and Tunbridge Wells, Kent then please call 0870 5329244.

This hot and pungent root can be used fresh or dried and has been cultivated since ancient times. In Ayurvedic medicine, ginger is known as the ‘universal medicine’ and it’s not difficult to see why. The root and its essential oils have traditionally been used to calm the digestive system and treat rheumatic conditions, nausea and respiratory tract infections, and modern research can confirm many of these uses.

Clinical studies indicate that ginger reduces nausea and vomiting after operations, during pregnancy and in motion sickness. Its anti-emetic (anti-vomiting) properties are thought to be due to two powerful phytochemicals: gingerol, which give ginger its hot and spicy flavour, and shogaol. Together, these stimulate the flow of gastric secretions, bile and saliva as well as improving peristalsis and intestinal muscle tone – all of which improve digestion.

 

Animal studies confirm that gingerol has anti-inflammatory and pain-killing properties, and a recent human trial found that using extracts of ginger to treat arthritic knee pain and immobility was significantly more effective than a placebo. Ginger has potent antioxidant properties, too, while its gingerol component is a known anti-carcinogen that reduces the activity in the body of nuclear transcription factor kappaB (NF kappaB). NF kappaB is linked with a variety of inflammatory diseases, including arthritis, heart disease, allergies, diabetes, MS, osteoporosis, psoriasis and cancer. Preliminary animal studies suggest that gingerol may inhibit the growth of human colorectal cancer.

 

One placebo-controlled study found that ginger extract can also help to reduce abnormal blood clotting in people with atherosclerosis (which can restrict blood flow and potentially lead to thrombosis) and recent animal research highlighted its ability to lower blood pressure. It also has an antibacterial effect against the bacteria responsible for respiratory infections, including Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae and Haemophilus influenzae. Ginger may even be able to protect against Alzheimer’s disease.

 

Nutritionally, dried ginger is a good source of iron, with one tablespoon (5.4g) providing 7% of a man’s and 4% of a woman’s RNI and an excellent one for manganese, with one tablespoon meeting up to an impressive 143% of daily needs. Manganese is an essential co-factor in the potent antioxidant enzyme, superoxide dismutase (SOD), as well as being important for bone health. Fresh ginger also contains good amounts of copper and epidemiological evidence suggests that high levels of SOD are linked to lower risks of cancer. Never mind ‘knock down ginger’ – it’s more like ‘pick me up ginger’!

Top Ginger Tips

Fresh or dried? For maximum flavour ginger is most often used fresh. The dried form is more potent than the fresh root, so you need less. Dried ginger tends to be used more in baking.

Preparing: Using it in cooking isn’t as daunting as you may think – simply peel off the outer skin and slice, chop or grate according to the recipe. If grating, squeeze the juice out of the woody pulp and discard what’s left behind. If you keep it in the freezer, you can grate it direct from frozen – ideal when making curries. There’s no need to peel.

Storing: Fresh ginger should keep for up to a couple of weeks in the fridge, but it’s best to wrap it to prevent it from drying out or becoming mouldy. Ginger also freezes well, either whole or grated into ice cube trays. Jars of grated or finely chopped ginger are a useful storecupboard standby when you’re out of the fresh.

Eating: The great news is that it doesn’t matter how you eat ginger – fresh, ground, dried, infused – include it in your everyday cooking and you’ll still reap the health benefits. Because of its origins, ginger is perhaps at its best in spicy Asian dishes, but also blends well with sweet and fruity ingredients such as lemon, pineapple and honey. 
If you have morning sickness or suffer from travel sickness, try nibbling on a piece of stem ginger.

Drinking: For something different, try a warming ginger tea: grate 1cm of fresh ginger into a warmed cup, add boiling water and leave to stand for 5-10 minutes. Strain off the grated ginger, add a little honey and freshly squeezed lemon to taste, and sip slowly. Blend a splash of aromatic ginger juice with apples, carrots and orange for a revitalising smoothie.

(Ginger is also available in supplement for those who do not like the taste or need a stronger version, the one I use in the clinic is called Ginger Forte – see the Resources Page).