Discover the latest evidence-based strategies in treating polycystic ovary syndrome (PCOS), from lifestyle modifications to medical options.

Key takeaways

• PCOS is a hormonal disorder caused by insulin resistance and excess androgen production.
• PCOS diagnosis usually involves assessing symptoms, performing laboratory tests, and conducting a pelvic ultrasound.
• Treatment options for PCOS include lifestyle modifications, medication, and lifestyle medicine.
• Regular exercise, a healthy diet, stress management, and adequate sleep form the pillars of managing PCOS.

Polycystic ovary syndrome (PCOS) presents a challenge for many Australian women. Characterised by hormonal imbalances, this condition affects numerous areas of a woman's life, including her fertility, physical appearance, and mental wellbeing. The main culprits behind PCOS are generally insulin resistance and an overproduction of androgens (male type hormones).

Although there's no definitive cure for PCOS, there are strategies available to manage the condition, including a personalised PCOS treatment plan that focuses on reversing the symptoms.

By implementing a suitable PCOS diet plan, improving other aspects of your lifestyle and working in conjunction with your doctor, you can reduce symptoms and improve your overall health.

How is PCOS diagnosed?

Identifying PCOS generally involves a doctor's assessment. A PCOS diagnosis is established when at least two of these three conditions are satisfied:

• Periods are irregular or absent
• Elevated androgen levels are detected in the bloodstream, which can be identified through a blood test or symptoms such as facial or body hair, thinning of hair on the scalp and acne.
• Polycystic ovaries as revealed by an ultrasound — visibility of more than 20 follicles (partially matured eggs) in one or both ovaries, or an enlarged size of one or both ovaries (beyond 10ml).

What are the symptoms of PCOS?

The symptoms experienced by people with PCOS vary from person to person, however some of the common symptoms include:

• Irregular periods or absent periods
• Weight gain or difficulty losing weight, particularly around the abdomen
• Acne, oily skin and skin tags
• Sleep problems such as insomnia
• Excess hair growth e.g. on the face and chest
• Scalp hair loss
• Fertility issues
• Mood swings, anxiety and depression
• Body image issues

Women with PCOS are also at a higher risk of developing other conditions such as type 2 diabetes and heart disease.

If you're experiencing issues with your menstrual cycle or any of these symptoms, please speak to your healthcare professional.

Choosing the best PCOS treatment plan

Selecting the most effective PCOS treatment in Australia involves personalising an approach that best suits an individual's circumstances and needs. It’s important to guided by your health professionals.

In cases where insulin resistance is present, metformin, a type 2 diabetes medication, may be prescribed. This medication aids in weight loss and lowers insulin levels. Additionally, birth control pills may be administered to suppress androgen production. Always consult with a medical professional before starting any new medication.

Adopting a healthy lifestyle is an important component of PCOS management. This approach includes changes across all aspects of life, from diet and exercise to mental health and sleep. Not only that, but it can also help to improve your glucose control, which can help to manage insulin resistance and hence improve symptoms.

Regular exercise

Engaging in physical activities such as walking, cycling, weightlifting, Pilates, or swimming can help to alleviate symptoms. Regular exercise enhances insulin sensitivity, reducing symptoms and minimising the risk of cardiovascular disease and type 2 diabetes. It can also help women with PCOS lose weight.

A physiotherapist or exercise physiologist can provide tailored guidance to find an exercise routine that fits individual preferences and addresses any physical obstacles.

Adopting a nutritious diet

Maintaining a healthy, nutrient-rich diet can be an effective tool for managing PCOS. Choosing foods high in fibre and protein, and low in simple sugars can provide immense benefits.

Eating regular balanced meals can help to stabilise your glucose levels, which is important for managing insulin resistance. Aim to consume fresh fruits, vegetables, lean protein, healthy fats and whole grains. Look to minimise your intake of processed foods, saturated fats, and alcohol, as this can significantly improve PCOS symptoms.

Consult with an accredited practising dietitian for more personalised advice with your PCOS diet.

Stress management

High stress levels can exacerbate PCOS by increasing cortisol production, which in turn elevates androgen levels. Stress reduction techniques such as yoga, breathing exercises, relaxation exercises, and counselling can effectively manage symptoms.

Sleep optimisation

Sufficient sleep plays a critical role in hormonal regulation and metabolism. Studies suggest that women with PCOS who receive adequate sleep have improved hormone levels and a higher chance of ovulation than those with poor sleep habits. Good sleep hygiene can also assist in weight management by regulating hunger hormones.

Monitoring your glucose with a CGM

Given that insulin resistance is a key feature in many women with PCOS, monitoring glucose levels regularly may be beneficial. With a continuous glucose monitor (CGM), you can track your blood sugar levels continuously throughout the day and night. This can help you to understand how different foods, physical activities, sleep and stress levels affect your glucose levels. This can allow you to make necessary adjustments to your diet and lifestyle to better manage your glucose and thus your PCOS symptoms.

Additionally, a CGM offers real-time data and trend analysis of glucose levels. This means that individuals with PCOS can identify trends and patterns. By keeping blood glucose levels within a target range, the hormonal imbalances associated with PCOS, primarily caused by insulin resistance, can be significantly reduced.

By leveraging these lifestyle modifications and CGMs, PCOS symptoms can be managed effectively, reducing the risk of long-term health complications like type 2 diabetes and heart disease.

Apps like Vively, which focus on metabolic health, could offer valuable assistance in this process alongside your existing treatment. Vively helps women with PCOS manage their glucose levels via their CGM integration. The app also helps you to improve your lifestyle in a sustainable way. Check in with your doctor to see if you think it could be helpful for you.