What Is PCOS?

Polycystic Ovarian Syndrome (PCOS) is a hormonal imbalance affecting 1 in 10 women of childbearing age. Those with PCOS experience irregular menstruation cycles, ovarian cysts, weight gain and abnormal hair growth due to the overproduction of androgens (“male” hormones). The exact cause of PCOS is unknown, but factors including genetic predisposition, insulin resistance, and increased inflammation have all been linked as possible risk factors in developing it. 

Treatment for PCOS is personalized and depends on the severity to which PCOS is causing disruption. Treatments can include birth control pills and medications to prevent PCOS related diabetes and high cholesterol, but the most commonly prescribed treatment is a more comprehensive lifestyle shift, addressing physical activity, a nourishing diet, and mental health. 

The most commonly prescribed treatment is a more comprehensive lifestyle shift, addressing physical activity, a nourishing diet, and mental health.

Shifting to a healthier lifestyle and focusing on weight management has been associated with better outcomes for the most common PCOS symptoms, including improved cholesterol levels, lower insulin rates, and a lower risk of heart disease and diabetes. 

Managing PCOS in Your 20s

Since most women find out they have PCOS in their 20s and 30s, it can be challenging to navigate the lifestyle change with the pressures and indulgences of an energetic work and social life.  

I had a client in her early 20s who traveled frequently for work, often attended networking happy hours, and loved hanging out with her friends. When she received the PCOS diagnosis, it was difficult for her to stay consistent with her doctor's recommendation of limiting sugar intake to control her insulin spikes and making time for physical activity 4-5 days a week. We worked together by first creating a healthy dialogue and then attaching it to feasible actions to achieve a true shift in lifestyle. 

1. Creating a Healthy Dialogue

The first thing we did was address her “why.” What initially compelled her to explore these changes, why was it important to her, why go through the effort? Digging deeper than the short term reasons (i.e., fitting into a swimsuit) and into long term reasons (i.e., living a long and healthy life) brings new levels of motivation and a positive mindset. PCOS can cause feelings of inadequacy and defeat, so building a routine around mindfulness and rooting into your support system is a proven way to reduce feelings of powerlessness. It’s important that she felt living authentically and being in charge of her body was a long-term option. This also prevented her from engaging in yo-yo dieting patterns that could actually worsen her condition.

2. Attaching Feasible Actions

The key for breaking old habits around food, fitness and mental health is to replace them with new ones that are enjoyable and manageable. We worked through each of her goals by determining a plan, addressing accountability, and holding space for grace. 

For her diet, we added in more fiber rich foods and a variety of fruits and vegetables to help wane her refined sugar cravings. She also started incorporating more healthy fats to make meals more satisfying and help prevent the spikes and drops in energy she was experiencing. For fitness, she found a mix of spin and strength training classes that brought her joy and fit into her schedule.

3. From Better Habits to Lifestyle Change

Over the course of four months, she was able to slow her weight gain, minimize bloating, better predict digestive triggers, and have more energy. By addressing her specific needs through food, activities, and a support system she was able to turn these positive changes into habits and then into a lifestyle. Most importantly, she felt empowered to sustain this life in the long-term and not let PCOS define her.

How You Can Work with PCOS

There really is no one solution for everyone, but lifestyle management is very commonly the first form of treatment prescribed by physicians. Try reassessing your diet and physical activity, and of course, see your doctor to figure out the best treatment for you.