Polycystic Ovarian Syndrome, PCOS, is one of the most common endocrine disorders affecting people with uteruses in the world. It is estimated that 1.4 million Canadians alone have PCOS. Despite how common it is, PCOS is still very much misunderstood in its diagnosis, treatment, and associated health risks, such diabetes. 

PCOS is a condition where the ovaries produce an abnormal amount of male sex hormones, known as androgens. The polycystic part of PCOS comes from the common occurrence of small, pearl-like cysts that develop in the ovaries. Unlike endometriosis which can cause large blood-filled cysts on the ovaries, known as endometriomas, cysts that are present in many PCOS cases are multiple, small cysts inside of the ovaries. 

Until recently, there needed to be these small cysts present in the ovaries (which can be seen in uterine ultrasound) in order to be diagnosed with PCOS. However, with more research, it is now clear that not every individual with PCOS actually has these cysts. 

The exact cause of PCOS is still not clear to scientists and doctors. Many, but not all, with PCOS have insulin resistance, which is turn may be causing the higher androgen levels. This insulin resistance can also cause issues with hair loss, hair growth, and trouble managing body weight. 

PCOS, like endometriosis, has been found to run in families. If you have a mother, sister or aunt with PCOS, your likelihood of having PCOS yourself goes up. 

PCOS can look different in every body, however here are the most common symptoms of PCOS:

• Missed periods, irregular periods, or very light periods
• Anovulation
• Ovaries that are large and/or have many cysts
• Excess body hair, including the chest, stomach, and back (known as hirsutism)
• Weight gain, especially around the abdomen
• Acne or oily skin into adulthood 
• Male-pattern baldness or thinning hair
• Infertility 
• Small pieces of excess skin on the neck or armpits (known as skin tags)
• Dark or thick skin patches on the back of the neck, in the armpits, and under the breasts
• Fatigue and brain fog 
• Thyroid issues

You could experience all of these symptoms, or just a few. If any of these symptoms resonate with you, speak to your doctor about running tests to see if you may have PCOS. Diagnosis can involve running blood tests for excess androgens, running through your symptoms such as hair thinning, fatigue and brain fog, and ultrasounds to see if you have small cysts. 

Unfortunately, many people who have PCOS also have other uterine health issues, such as endometriosis and adenomyosis. However, these illnesses are not mutually exclusive and you can have one without the other. 

If you are diagnosed with PCOS, your doctor may suggest going on birth control, taking a low dose of metformin (which is a diabetes medication used for insulin resistance), diet and lifestyle changes, and charting your cycle to record if you ovulate. Whatever treatment option you chose, be sure to speak in detail with your doctor about the reason for the treatment option, and any associated side effects.

A Note on Social Media and PCOS 

There is a lot of misinformation circulating social media about PCOS. For example, you may see nutritionists claim that cutting out carbohydrates fully from your diet will cure your PCOS. There is currently no research suggesting PCOS can be cured. You can reverse symptoms, which can come from medical treatment like metformin and/or diet and exercises changes that suit your body. You can use diet and exercise to help your body ovulate and function better, for example, and while depending on your condition and circumstances cutting some carbohydrates down in your diet may assist with this, there are no one or two diet changes that will get rid of your PCOS. 

Unfortunately, you may have medical professionals who push a diet and exercise only narrative on you. We at pip can understand that this may be triggering for those who struggle with their relationship with food, body image, or even disordered eating. Know that these feelings are real and valid. PCOS care is far more than eating a certain way or exercising a certain way. There is no one-way to treat your PCOS because no two bodies are the same. 

Remember that no one knows your body better than you do. If you are interested in ways that diet, exercise, and maybe even integrative health options may be able to supplement your treatment plan, you can look into seeing a registered dietician, a naturopathic doctor, or a personal trainer who understands the physiology and biology behind PCOS if these are within your means. You can also look at resources on social media with accreditation behind them. A large following doesn’t give you a medical degree.

While going carb-free may have worked for one person’s PCOS, there is no guarantee this will work for yours as well. You can never be sure of what else that individual you see on social media is doing for their treatment plan that may be contributing to less androgen production and increased ovulation. We can almost guarantee it isn’t just from not eating a bagel. If social media accounts like this are triggering for you to see while navigating your own PCOS, mute the account or simply unfollow them! 

Some things that work for us at pip who are living with PCOS include:

• Drinking lots of water every day 
• Eating whole grains, such as sprouted grain bagels and fermented rye breads
• Eating whole-fat dairy, such as whole-fat yogurt 
• Eating veggie-filled meals and snacks throughout the day
• Getting 8 hours of sleep and adding is quiet guided meditation before bed to help with slowing the mind 
• Having tea alongside our daily coffees
• Practicing exercise that isn’t too high intensity, such as yoga and long walks 
• Taking metformin as prescribed by a specialist doctor 
• Adding rosemary oil into shampoo to help with hair growth 
• Never forcing too much restriction or harsh change to our daily routine and diets!

We are also sure to give our bodies grace when we are feeling extra tired or brain foggy. We don’t force intense exercise on our bodies when it is telling us that’s not what it needs. We also love to eat a bagel with cream cheese when we feel like it.