How to Overcome PCOS Weight Loss Challenges

May 22

Polycystic ovary syndrome (PCOS) is a prevalent hormonal disorder affecting millions of women worldwide casting a shadow over their reproductive health and overall well-being. It's the most common cause of infertility, with nearly 6 million women in the U.S. affected by it. Often referred to as a 'silent killer,' PCOS presents a labyrinth of diagnostic hurdles, leaving women feeling lost in a maze of uncertainty. Their journey to confirmation involves on average four doctor visits before receiving a diagnosis.

This complex condition manifests in various ways, including irregular periods, unwanted hair growth, acne, and stubborn weight gain. Since each woman's experience with PCOS is unique, a tailored approach to healing is essential. Linked to elevated hormone levels, insulin resistance, and inflammation, PCOS can escalate into diabetes, endometrial cancer, fatty liver, and heart disease.

Despite its prevalence, PCOS remains poorly understood by many healthcare providers, leading to managing symptoms rather than addressing its root causes. In conventional medicine, the most common recommendation is to “lose weight”, even though weight gain is a symptom rather than the cause of PCOS. Additionally, medications like birth control pills are commonly prescribed to “regulate hormones”. However, these medications can come with side effects such as anxiety, depression, and further weight gain, serving as temporary fixes rather than providing long-term healing.

What is PCOS?

PCOS affects various bodily systems, including hormones, reproductive functions, and metabolism.

The condition is characterized by three primary features:

1. Polycystic ovaries
Polycystic ovaries result from the enlargement of ovaries due to the presence of fluid-filled sacs, known as follicles, surrounding the eggs. These sacs, typically up to 8mm in size, don't release eggs, thus hindering ovulation and affecting hormone levels. It's important to note that these aren't traditional cysts despite the name.

While not all women with polycystic ovaries have PCOS, it's significant that around 22% of normally ovulating women possess them. Although many women diagnosed with PCOS may have visible cysts on ultrasound, not all do.

2. Ovulatory Dysfunction

Women with PCOS often experience irregular or absent menstrual cycles due to irregular ovulation. Furthermore, a common consequence of PCOS is unusually heavy, short, or prolonged (36+ days) menstrual cycles.

3. Excess androgen

Excess androgens, often termed male hormones, are a significant symptom of PCOS. Androgens are also present in women but at lower levels. When these hormones become elevated, they can lead to various issues such as oily skin, acne, and excessive hair growth on areas like the chin, chest, and abdomen—a condition known as hirsutism. It's estimated that over 80 percent of women diagnosed with androgen excess have PCOS.

According to the Rotterdam Criteria, the diagnosis of PCOS typically requires the presence of at least two of the three main features mentioned above.

PCOS vs. Adrenal PCOS

Within the realm of polycystic ovary syndrome (PCOS), there exist two distinct types, each with its own set of challenges. Traditional PCOS stems from androgen production within the ovaries, while adrenal PCOS presents a more complex picture, involving an overabundance of androgens from both the ovaries and adrenal glands. This dual source of androgens, particularly evident in cases of adrenal androgen excess marked by elevated DHEA-S levels, adds layers of complexity to the condition.

In the journey toward managing adrenal PCOS, it becomes crucial to recognize the significance of addressing adrenal hormone imbalances alongside managing ovarian hormones and insulin levels.

Androgen Types and Their Sources:

1. Dehydroepiandrosterone sulfate (DHEAS) – produced in the adrenal gland.

2. Dehydroepiandrosterone (DHEA) – produced by the adrenal gland (50%), ovaries (20%), and converted from circulating DHEAS.

3. Androstenedione – produced by both the adrenal gland and ovary.

4. Testosterone (T) – produced by both the adrenal glands and ovaries.

5. Dihydrotestosterone (DHT) – converted from circulating testosterone by the enzyme 5-alpha reductase, with a very small amount originating from the ovaries.

Symptoms of PCOS

Weight Gain
Inability to Lose Weight
Accumulation of fat around the stomach
Irregular or absent periods
Abnormal mid-cycle bleeding
Heavy Menstrual Flow
Thinning scalp hair / Hair Loss

Acne (often cystic around the chin, back and chest)
Excess male pattern facial/body hair: particularly around the nipples and upper lip
Blood Sugar Imbalances
Mood swings
Recurrent miscarriage
High male hormone levels
Low Sex Drive
Low levels of sex hormone-binding globulin (SHBG)
Elevated levels of Prolactin

Increased Risk for

Diabetes
High Cholesterol
Heart Disease
Infertility
High Blood Pressure
Endometrial Cancer
Depression

It's essential to understand that PCOS varies from woman to woman, with some experiencing no symptoms at all, while others being burdened by multiple ones.

Root Causes of PCOS

The exact cause of PCOS is still unknown, but various factors are believed to contribute to its development.

Genetics
Elevated androgens starting at puberty
Insulin Resistance
A diet high in Sugar and Starch
Chronic Stress
Increased LH secretion from the pituitary
Smoking
Excessive Alcohol Consumption
Sedentary Lifestyle
High Birth Weight
Exposure to Endocrine Disruptors
NAFLD

The Insulin-PCOS Connection

Insulin resistance is a key contributor to the manifestation of PCOS symptoms, although it's not necessarily the direct cause of the condition itself. It impacts a significant portion, ranging from 35% to 80%, of women with PCOS, with symptoms fluctuating based on lifestyle factors.

At its core, insulin resistance arises when the body fails to respond adequately to insulin, leading to a surge in blood sugar levels. This triggers a compensatory mechanism wherein the pancreas ramps up insulin production, setting off a cascade of hormonal and glucose imbalances within the body.

In the context of PCOS, insulin resistance assumes a multifaceted role, contributing to the overproduction of testosterone and androgens by the ovaries. This hormonal imbalance paves the way for the formation of multiple cysts on the ovaries, a hallmark characteristic of PCOS. Moreover, heightened testosterone levels disrupt the delicate process of follicle development, impeding normal ovulation.

Insulin resistance is closely associated with PCOS, as it can stimulate the ovaries to produce excess testosterone and androgens. This hormonal imbalance can trigger the formation of multiple cysts on the ovaries, a characteristic feature of PCOS. Furthermore, excess testosterone interferes with the development of the follicles where eggs mature and hinder normal ovulation.

Beyond its direct impact on reproductive health, insulin resistance casts a shadow over various facets of well-being, exacerbating PCOS symptoms and predisposing individuals to a myriad of complications, from weight gain and irregular ovulation to diabetes, cardiovascular diseases, and potential cancer risks.

The Link Between PCOS and Obesity

While PCOS is commonly associated with obesity, it affects individuals of varying body sizes, including those with normal weight, a phenotype often termed lean PCOS. While obesity may not directly cause the condition, it can worsen symptoms and speed up their development. Regardless of body size, both lean and obese individuals with PCOS share common ground in facing heightened risks of developing insulin resistance, Type II Diabetes, and Endometrial Cancer. Amidst these challenges, there is room for hope and empowerment. Studies suggest that even modest weight loss can yield significant benefits for individuals with PCOS, enhancing ovulatory function and stabilizing blood sugar levels.

The connection between PCOS and obesity can be attributed to various factors:

Excess fat tissue produces more hormones, which can lead to hormonal imbalances associated with PCOS.
Insulin plays a pivotal role in the irregularities of the menstrual cycle observed in PCOS. Elevated insulin levels can stimulate the ovaries to produce excessive testosterone while reducing the production of sex hormone-binding globulin (SHBG), a protein that binds to androgens. Consequently, low levels of SHBG result in elevated testosterone levels in the bloodstream.
Blood sugar levels have a significant impact on various aspects of metabolic health, including sleep, hunger, energy levels, and cravings. Elevated blood sugar levels can disrupt appetite and mood, affecting weight and metabolism.

It's important to remember that PCOS is a condition that can be managed and even reversed naturally. Remember, you're not alone in this. Download my comprehensive guide on how to reverse PCOS naturally - packed with my favorite holistic supplements and empowering strategies to support you every step of the way. Your journey to wellness and a lean body starts here.