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The PCOS Solution

A simple way to help ease pre menstrual tension

Saturday, October 21, 2017
If there’s a particular thread that runs through the scientific literature about hormone management, it’s that what you eat has a remarkable effect on what your hormones do, particularly the important balance between oestrogen and progesterone.

Each of the cells in your body responsive to oestrogen have a number of stalk-like receptors poking out from the cell membrane. They’re waiting for a passing oestrogen molecule to latch on, which tells them to do their job. For example, the cells of your uterus will work on preparing a lining each month when oestrogen instructs them to.
Ideally, there’s only a certain amount of hormone to go around, to prevent cells ‘overdosing’. Too much oestrogen can lead to some really unpleasant effects, including pre-menstrual tension. To help prevent this happening your body has a helper on the job.

Meet sex hormone binding globulin; or SHBG for short. It’s a molecule on a mission; produced by your liver, it is tasked with the job of mopping up excess hormones, particularly oestrogen. The shape of this molecule is a perfect fit for oestrogen molecules, so they happily latch together; and the next time this conjoined molecule passes through the liver it is removed from circulation and pushed out with bile towards your intestines.

Then SHBG is soaked up by dietary fibre and provided with an express ride out of your body, reducing excess oestrogen and easing pre-menstrual tension. Oddly, the more fibre in your diet the more SHBG is produced and the more effectively excess oestrogen can be mopped up. If there’s not enough fibre in your diet not enough SHBG will be produced and you’ll be vulnerable to the pre-menstrual effects of excess oestrogen: Like mood swings, sugar cravings and fluid retention. So, fibre in your diet has a double benefit for your hormones: Not only can it increase the levels of SHBG that will mop up the excess hormones, but it will also enable removal of excess hormone out of your body.

So to help balance your hormones you need fibre. Vegetables are ideal, the unsung heroes of fibre supplements. Two cups of salad will provide half the minimum fibre your body needs to function well. Have another two cups of vegetables at night, a handful of nuts as a snack, two pieces of fruit each day and some whole grains (like oats) too. Now you’ll have more of that helpful SHBG and an easier cycle.

If you enjoyed this article you might also enjoy 'Flooding heavy periods: what they mean" 

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One key strategy for feeling better

Saturday, September 23, 2017
Feeling tired, out of shape and anxious? You’re not alone; The Jean Hailes organisation for womens’ health released the results of their 2017 survey into womens’ health concerns. It’s interesting reading (you can review the results yourself at ) Although focused on women, the results are useful for men too.

Sometimes the statistics from surveys allow you to see connections between issues that are often thought of as separate. For example, the survey revealed that 40% of women have been diagnosed with depression, most feel anxious to some degree, many are experiencing problems with sleeping, over half are overweight, and aren’t exercising regularly. 

There’s a connection here: if you’re one of the women who isn’t exercising and yet experiences mood problems, feels tired, and has to keep buying larger sizes in clothes,  there’s a way to feel more energetic, happier, calmer and more shapely: exercise.

It’s a paradox, but exercising actually boosts your energy. Although you may feel tired before you strap on those training shoes, once you get moving your body will actually begin creating more energy. It’s a curious thing, but bodies will actually become more lethargic the more you don’t move. This is why you can actually feel more energetic even though exercise takes energy.

There are more benefits too: as soon as you start moving your body’s levels of cortisol (the stress hormone) start diminishing. That helps evaporate feelings of anxiety. Exercise also boosts levels of endorphins, the happiness neurotransmitters. So fitness training actually helps lift depression and soothes anxiety.

But there’s the time factor. We’re all busy, it’s true, and have more to do than we can comfortably squeeze into a day. But most of us seem to be remarkably good at creating time for what’s really important to us. 

With modern technology it’s so easy to get movement into your life. Even if you’re not a gym junkie, don’t like team sports, or if it’s raining, there are now phone apps and online home training sessions easily obtainable, often free. Just Google ‘free home fitness training’ and you’ll be offered so many options you could try out one each day for years and never get through them.

In the end, though it’s up to you to make exercise happen. Through managing yourself to get moving you could feel happier, more energetic and wake feeling refreshed after a good night’s sleep. Worth trying out, today?

If you enjoyed this article, you might also enjoy 'How Being Active Can Help Your Hormones'

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Vitamin B3 and your pregnancy

Saturday, September 02, 2017
The nutritional news wires were on fire recently with the release of a large study about pregnancy and vitamin B3. It’s been touted as the biggest news since the discovery of folate’s importance. 

There’s no doubt it was a big study. The paper was authored by 33 different scientists, and funding came from many government and non-government organisations. The paper was published by a prestigious journal where papers are peer-reviewed. So it ticks many of the boxes flagging “this is a valid study”.

The researchers located families with particular genetic abnormalities, analysed their genes, and developed a hypothesis (theory) about the deficiency of a certain enzyme. They figured that a deficiency was disrupting a biochemical pathway and causing cells to mutate. The scientists aimed to find out more about how mutated genes could create serious lifetime health problems for a baby. Off to the laboratory they went.

Assessing how biochemical pathways work is rather like watching water flow along a river. Deficiencies of certain enzymes can hold up the flow of the process, creating something akin to a logjam. Due to the backup biochemical changes that should happen, don’t. Provide the right raw materials, though (in this case vitamin B3) and the enzyme can work, the biochemical log jam clears, and cellular processes resume flowing smoothly. 

Having identified which genes weren’t working, the scientists then created mice with these genetic defects. To their surprise, the offspring of these mice were normal. Back to the test tubes they went, and found the cause of the genetic problem was actually a deficiency of NAD (nicotinamide adenine dinucleotide). NAD can be produced through tryptophan in food, or the vitamin niacin (B3). Insufficient B3 meant inadequate NAD leading to genetic defects.

The scientists noted that a deficiency of B3 can often occur during pregnancy. In addition, production of that important NAD is affected if you are obese, have type II diabetes, or if your body is inflamed. Keep in mind that this was an extremely focused study, aiming to pinpoint the source of a defective gene. The study didn’t consider any other factors that contribute to a successful pregnancy.

It could be tempting to head to the shops for vitamin B3; but keep in mind it’s not the only vitamin you need in pregnancy, and a good diet is also important. But the study does highlight how useful genetic testing can be in determining the nutritional support you need.

If you enjoyed this article you might also enjoy 'The Right Nutrition In Pregnancy', here

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Hormone life transition challenges for women

Saturday, July 29, 2017
Life for a woman can be one of transitions. After quite a few years of clinical practice I’ve concluded that the transitional times in a woman’s life are when she is more vulnerable to hormone imbalances and needs extra support. But there can be obstacles to getting that help.

In puberty, the body experiences a major transition from childhood to become capable of reproduction. In adolescence young women seem to be most vulnerable to development of chronic hormone disorders like PCOS and endometriosis. Many girls suffer needlessly from lack of information or a belief that their symptoms of painful, flooding periods (or lack or periods) are normal. It’s all too easy to mask period problems with the oral contraceptive pill, but if the underlying problem isn’t dealt with it may re-emerge when trying for a baby.

In child bearing years there are two big challenges: One is infertility, a challenge facing many more women than ever before. The other challenge is the massive hormonal shifts of pregnancy and childbirth (plus the extra demands of child care and sleep deprivation that goes with it). One vulnerability at this time is post-natal depression, and thyroid problems can often arise about now.

In later years there’s the emotional shift of the perimenopause towards menopause. Maintaining hormonal balance at this time becomes increasingly difficult which can result in some appalling menstrual cycles. With the end of periods at menopause comes another challenge: the massive drop in hormone production and the emotional transition of aging. Menopausal depression can appear.

Problem is, not attending to a hormonal problem can exacerbate problems later on. For example, an imbalance between oestrogen and progesterone in puberty can show itself later in fertility problems, post-natal depression and some horrible symptoms in perimenopause and menopause. But when you’re knocked sideways by hormonal problems it’s even more challenging to speak up for yourself when seeking a solution. It’s all too easy for your symptoms to be brushed off as “just a woman’s lot”. 

But when a woman is truly well she is more able to parent her children well, participate fully in her relationships, and really contribute to the wellbeing of her entire community. So perhaps it’s worthwhile to consider the underlying causes of hormones and treat them with a holistic focus. And if the woman in your life is having hormonal problems, consider going with her to her practitioner consultations, support her in accessing the care she needs.

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Could this vitamin boost fertility during summer?

Saturday, July 15, 2017

As you probably know (if you paid attention during school geography lessons), folk living in the Northern American and European continents don’t get to enjoy as much sunlight as we do. They have bitterly cold winters where it’s dark even before the working day ends. No-one spends too much time outside from day to day, and when they do, as little skin as possible is exposed to the bitter weather. Researchers studying fertility of women in areas with these long winters have noticed an interesting trend: a spike in conception rates during summer. Coincidentally, this is when everyone gets more sun exposure. Blood tests confirmed that the vitamin D levels of women rose during summer and dipped during winter.  Could vitamin D be responsible for this boost in fertility rates?

Of all the nutrients, vitamin D is a curious one. We can get a little from food (greens, mushrooms, fish fat, cod liver oil) as vitamin D2, but mostly we soak it up through our skin as vitamin D3. It's a 'fat soluble' vitamin, so we can store some. Cholesterol carries the vitamin molecule through our liver and kidneys so each can play their part in converting vitamin D from UV radiation to become a powerfully active vitamin that is a major player in building bones. Researchers have learnt it isn’t just our bones that utilise vitamin D; cells on the ovaries, on the placenta and endometrium (lining of the uterus) also present receptors seeking vitamin D, indicating they need this vitamin to function properly.

Curiously, the research done so far around vitamin D and fertility is quite, well, “messy” (to use an unscientific term). There are plenty of studies, but each have utilised different supplement quantities  and with sometimes with not enough subjects to reach statistically sound conclusions. Review studies (where all the studies are assessed together) invariably comment that they can’t be sure, for sure, whether vitamin D affects fertility, because the science isn’t strong enough. But at the same time they point to those observations of women’s fertility in the far northern latitudes. 

So if you want to know, definitely, that vitamin D boosts fertility, you’ll have to wait while the science develops further. But in the meantime,  if your desire is to conceive a baby focus on conceiving consider how much sunlight you are exposed to, whether your workplace has windows, whether you get outside to exercise, and whether your vitamin D levels are sufficient for pregnancy. 

If you enjoyed this article you might also enjoy 'The Vitamin You Can Absorb Through Your Skin'

Like to look further? Consider these studies 

Azadi-Yazdi, M., Nadjarzadeh, A., Khosravi-Boroujeni, H., & Salehi-Abargouei, A. (2017). The Effect of Vitamin D Supplementation on the Androgenic Profile in Patients with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Clinical Trials. Hormone and metabolic research= Hormon-und Stoffwechselforschung= Hormones et metabolisme, 49(3), 174.

Fang, F., Ni, K., Cai, Y., Shang, J., Zhang, X., & Xiong, C. (2017). Effect of vitamin D supplementation on polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. Complementary Therapies in Clinical Practice, 26, 53-60.

He, C., Lin, Z., Robb, S. W., & Ezeamama, A. E. (2015). Serum Vitamin D Levels and Polycystic Ovary syndrome: A Systematic Review and Meta-Analysis. Nutrients, 7(6), 4555-4577. doi:10.3390/nu7064555

Irani, M., & Merhi, Z. (2014). Role of vitamin D in ovarian physiology and its implication in reproduction: a systematic review. Fertility and Sterility, 102(2), 460-468.e463. doi:

Muscogiuri, G., Altieri, B., de Angelis, C., Palomba, S., Pivonello, R., Colao, A., & Orio, F. (2017). Shedding new light on female fertility: The role of vitamin D. Reviews in Endocrine and Metabolic Disorders, 1-11. doi:10.1007/s11154-017-9407-2

Pergialiotis, V., Karampetsou, N., Panagopoulos, P., Trakakis, E., & Papantoniou, N. (2017). The effect of Vitamin D supplementation on hormonal and glycaemic profile of patients with PCOS: A meta‐analysis of randomised trials. International Journal of Clinical Practice.

Reis, G. V. O. P. D., Gontijo, N. A., Rodrigues, K. F., Alves, M. T., Ferreira, C. N., & Gomes, K. B. (2017). Vitamin D receptor polymorphisms and the polycystic ovary syndrome: A systematic review. Journal of Obstetrics and Gynaecology Research, 43(3), 436-446. doi:10.1111/jog.13250

Shahrokhi, S. Z., Ghaffari, F., & Kazerouni, F. (2016). Role of vitamin D in female Reproduction. Clinica Chimica Acta, 455, 33-38.

Skowrońska, P., Pastuszek, E., Kuczyński, W., Jaszczoł, M., Kuć, P., Jakiel, G., . . . Łukaszuk, K. (2016). The role of vitamin D in reproductive dysfunction in women–a systematic review. Ann Agric Environ Med, 23(4), 671-676.

Voulgaris, N., Papanastasiou, L., Piaditis, G., Angelousi, A., Kaltsas, G., Mastorakos, G., & Kassi, E. (2017). Vitamin D and aspects of female fertility. Hormones, 16(1), 5-21. doi:10.14310/horm.2002.1715

Xue, Y., Xu, P., Xue, K., Duan, X., Cao, J., Luan, T., . . . Gu, L. (2017). Effect of vitamin D on biochemical parameters in polycystic ovary syndrome women: a meta-analysis. Archives of Gynecology and Obstetrics, 295(2), 487-496. doi:10.1007/s00404-016-4247-y

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6 mistakes that block PCOS recovery

Monday, July 18, 2016

Serious about your PCOS treatment? Check that you aren't making any of these fundamental errors that can hinder your recovery:

Wishing your PCOS would just go away1. Wishing it would just go away

It’s a natural human tendency to do nothing, and sometimes this approach is actually exactly what you need to do. When a health problem emerges our first impulse is to wait and see if it goes away - and sometimes it does. That’s why when you visit your doctor with a health problem, he or she might prescribe nothing and ask you to come back in two weeks. They know that in some cases your symptoms may have emerged from sudden stress, a passing bug, or be something that will resolve itself in time. 

Bodies naturally and automatically work constantly to remain at certain set-points, called allostasis. For instance, if your temperature rises your body will start sweating to cause evaporation that cools you down again. Once your temperature has returned to normal, the sweating process is switched off. 

When you have a complex disorder like PCOS it’s tempting at first to wait to see if things get better. Your next period might be easier.  Maybe you’ll lose weight if you work out harder at the gym. Maybe making the final split from a dysfunctional relationship will change your mood for the better. Your head can start to recite a long list of justifications like this for doing nothing; even more so when life is busy. But when it comes to PCOS, the problem won’t go away on its own.

Hormones tend to fall out of balance in slow motion
, so it’s unlikely you’ll wake up one morning to find you’ve suddenly developed PCOS. One week passes, then another. Some good weeks, some awful weeks. You wish these problems would just go away, but they’re simply reflecting the growing imbalance in your hormones. The longer you put off taking action, the more dysfunctional your hormones are likely to become. The more amplified your symptoms become, the more treatment it will take to restore your hormonal health.

In the meantime, significant relationships can be permanently damaged by your sudden mood shifts, or you might lose your job because your boss is fed up with your mood swings impacting on your work. Your skin may become increasingly scarred from acne and now you have to shop for ‘plus size’ clothes. Your periods, if they happen at all, are more eventful each time with flooding, clots and pain. 

It's natural to feel overwhelmed at this point.

There’s no getting around it. You have a big job ahead of you to treat your PCOS and this is why having the right team around you can make a difference. PCOS is a ‘heterogeneous’ disorder, which means there are many possible contributors and many ways the symptoms can present. Like the causes, there are many changes needed to overcome the problems. At first this can seem overwhelming. You’ve visited several practitioners, both medical and alternative, and been given different explanations for the cause of your PCOS. You’ve been prodded, stuck with needles, had blood drawn, maybe had a glucose tolerance test done, or even been put under anaesthetic for exploratory surgery. By the time you get to the official diagnosis you’re probably emotionally exhausted. But after all that you then have to choose the best treatment for you from the smorgasbord available and make what seems like a multitude of changes to your diet and lifestyle. At this point you may feel like a rabbit in headlights, unsure which way to jump. It’s tempting to do nothing and wish it would all go away, but that won’t make you better. 

The way out of this sense of overwhelm
is to sit down with the practitioner you feel most comfortable with and, together, lay all the information on the table. Your practitioner is accustomed to sorting out what seems like a mountain of information and identifying patterns, then discerning the treatment needed to get results. A good practitioner will be happy to spend as much time as you need explaining what all your information means, and summarising it for you.

Take a deep breath and resolve to do whatever it takes to get your PCOS under control. Life will be more fun when you do!

Don't buy supplements without professional guidance2. Buying supplements without professional guidance

The internet is a wonderful, wonderful invention. We have all the world’s information at our fingertips. Unfortunately, we have the world’s dis-information at our fingertips too, and sometimes it’s hard to tell the difference. A multitude of diagnostic health sites are out there waiting for you to type in your symptoms and produce the instant answer. However, a common pattern emerges when you rely completely on the internet for your health care: Firstly, you could plug your symptom details into a medical diagnosis and ten minutes later you’re convinced what you have is fatal. Or, you get sucked into buying an expensive range of supplements from overseas, or you succumb to the emotive language of a web site promoting an extreme diet as the answer to all health problems. Despite these traps the internet also contains much reliable and credible information you can digest before you visit a practitioner for assistance. 

The reaction you can get from your health professional to your investigative work will vary. Some practitioners may be threatened by your initiative and dismiss your research efforts. If this happens, perhaps you should re-assess your relationship with your practitioner. A practitioner who is comfortable with your research, and the questions that come from it, will be interested to hear what you found. He or she will discuss with you how your research could fit into your treatment. This way your treatment becomes a collaboration, which is even more powerful than traditional practitioner-patient relationships and your results will be even better.

It’s important to become adept at critical analysis when you’re searching the internet for health information. Let’s say you type ‘PCOS treatment’ into the search engine. You’ll be offered several million options. How do you choose what site is worth visiting, what’s worth reading and what’s invalid? First, check the credentials of the web site. Is it a government agency? A PCOS support association? A health writer? An online store? The more reliable the source, the more reliable the information may be - but not always. If what you’re reading doesn’t make sense, just move on. There will be plenty of other sites providing more reliable information. 

Next, form an opinion on why the web site was created. Was it to genuinely provide information and guidance? (Government and association web sites often fall into this category). If there are products for sale, you can reliably conclude that the web site was created to sell you products, so move on. Be very wary if the language of the web site is emotional. Scientific facts and valid information can be presented in an interesting way without having to resort to emotive language that may  distort the facts. As you visit more sites you’ll develop a keen sense of what sounds right and which sites make you feel the web site isn’t for you.

Get a support team behind you for PCOS treatment3. Trying to fix this all by yourself

Solving a problem feels great. You can feel yourself glow with a sense of achievement. Like when something you’re cooking turns out perfectly, or you have a ‘good hair’ day or you make your budget stretch successfully. But when it comes to a complex problem like treating PCOS, you will get better results when you enlist the right help. If you work on this problem alone you have to learn all about PCOS, devise an effective treatment plan and monitor your progress. It’s going to take a lot of time, effort and possibly quite a few failed treatment experiments. Besides, if you go it alone you miss out on the emotional support of having a practitioner behind you. Becoming well informed about PCOS can give you a real sense of empowerment and knowing about PCOS and the treatments available may enable you to select the treatment approach that’s right for you. But while you’re doing that you need to engage the help of a practitioner who is experienced in treating PCOS who understands the human body and your symptoms.

Choice in PCOS treatment4. Not considering other treatments

There are many different treatments available for PCOS, all with the same aim - to get you back to your real self, and reduce the likelihood of developing long term chronic disorders from uncontrolled PCOS. Generally, there are two approaches to PCOS treatment: orthodox and alternative, and sometimes they can work together. When you talk to your doctor about your PCOS, they will think about what they know to help treat you effectively. This can include medication or surgery, but also diet and lifestyle considerations. 

When you talk to your naturopath they work from what they know as well.
It will be a different treatment from the doctor’s because naturopaths use some different tools. Instead of medications or surgery they will consider herbal remedies, homoeopathy and nutrients. Just like the doctor, they consider diet and lifestyle changes as an important part of your treatment.  Sometimes though, when you’ve chosen one style of treatment you can’t apply the other as well. For example, if you choose to utilise the oral contraceptive pill to manage your hormones, your naturopath will not be able to use some of their herbal remedies. If they did the two treatments could clash, bringing on unpleasant and possibly dangerous side effects.

What’s important to realise is that you have a choice about which treatment best suits you. When you’re sitting in a practitioner’s office it’s easy to feel intimidated, or that you have to go along with what they suggest. You don’t. There’s no need to make a decision about the type of PCOS treatment you want until you have the different treatment plans to consider. If you feel intimidated or pressured by your practitioner (whether orthodox or alternative) or feel they disapprove of the choice you make, it’s time to seek out a new practitioner. After all, your treatment is going to be a long term project. You want to feel comfortable and supported with every member of your health care team.

When you have chosen your preferred treatment (orthodox, alternative, or a combination), you can expect plenty of unsolicited advice from other people. Comments like “my sister’s friend’s cousin tried that and it didn’t work” or “that therapy doesn’t work” or “you’re being sucked into their system”. “My friend read on the internet about this great product that cured her”. Really unhelpful stuff and especially discouraging if you are feeling nervous about your choice of treatment anyway. The people who make these comments mean well but keep in mind that it’s your body and your decision about how you get better.

PCOS and sugar dont mix5. Refusing to change what you eat

Here’s one of the trade secrets: what naturopaths do to assess the motivation level of a client. When considering diet changes your practitioner may suggest you drop a particular food from your diet to see what effect this has on your health. If the response is “but I love my [insert name of food]” then your practitioner knows you have very little motivation to make real change in your diet and that your treatment progress will be hindered by your reluctance to change. It’s going to be tough, sure, but you’ll have good support backing you up.

Human bodies are incredibly resilient and adaptive. Consider that throughout the world there are many different countries with different diets that reflect their culture and geographic location. A Mediterranean meal looks different to a Japanese meal, or a central African meal, and western meals are different again. And yet our bodies manage to grow and thrive despite different food inputs.

Women with PCOS are more susceptible to the influence of certain nutritional components than the rest of the population. They generally don’t handle sugar well, or fast-release (high GI) carbohydrate foods like white bread. They need to check dietary fibre intake regularly. In practical terms, that means if you have PCOS and you’re eating mostly take-away, soft drinks and sweets, you can expect your body to develop unpleasant physical and psychological symptoms in return. But if you nourish your body with high quality protein, vegetables, fruit, legumes and nuts, you can expect your PCOS symptoms will recede. What you choose to put in your mouth makes a difference, but that doesn’t mean you can’t eat fun foods ever again.

Making changes to what you eat can be easier than you think and you don’t have to spend the rest of your life deprived of treats. After assessing how motivated you are for change and your food preferences your practitioner will design meal plans that move you closer to your goal of eradicating PCOS and its symptoms. If despite talking with your practitioner you’re still feeling resistant to changing what you eat, take time to ponder what you would gain from changing your diet and what you would lose. Then ask yourself if it’s worth the change.

PCOS fitness exercise6. Believing you don’t have to exercise

From time to time you’ll come across diets or supplements that promise amazing weight loss results without exercise. Indeed, they pledge to make you lose numbers on the scale without exercising but what will happen is exactly what you don’t want to happen. 

There are two types of weight loss: losing muscle and losing fat. Losing muscle is what sets you up to regain the weight, plus a little more, when you stop dieting. You want to lose fat instead, because muscle cells and fat cells behave differently and have different appetites. Muscle cells are active cells. They use energy 24/7, even when you’re not moving, and use even more energy when you are moving. The right amount of muscle cells gives you a toned, healthy look and keeps your metabolism ticking over nicely. Fat cells, however, behave differently. They’re lazy and don’t do much except store fat – rather like that cupboard under the stairs filled with stuff you haven’t looked at for years. Fat cells don’t use any energy, they just sit around. In excess, too many fat cells give you a blobby look. Worse, fat cells emit chemical messengers and hormones that perpetuate the fat accumulation cycle.

When you embark on one of these magic ‘no-exercise-needed’ diets, what you want to happen doesn’t always happen. Instead of reaching for the excess fat cells to make up the calorie deficit, your body will burn up muscle cells instead. The numbers on the scale will go down, certainly, but when you return to a normal diet, or go on a food splurge, the weight can bounce back on plus more. Your metabolism is now running slower because you have fewer muscle cells, so you don’t need as many calories to maintain your body. The extra fuel just gets shoved into fat cells, making you look flabby as well as fat.

This is why exercise is an important aspect of your treatment. It builds muscle cells and these speed up your metabolism, improve your sensitivity to insulin, and burn off stress hormones.

So - what has been holding YOU back in your PCOS treatment?

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PCOS Treatment When Results Don't Happen

Saturday, July 16, 2016
The journey to an official PCOS diagnosis is a long and arduous one, as you’ve probably noticed. On social media like Facebook and Twitter you’ve probably come across many frustrated, even angry women who are valiantly trying to access the appropriate help for their hormonal woes. The journey to diagnosis often goes like this:

At first there’s the suspicion that all might not be right with your hormones: Conception isn’t happening, or you have to constantly reach for the larger clothes sizes on the racks. Perhaps your skin isn’t responding to your rigorous care regime and facials; or hair is growing in the wrong places. Your energy levels soar and crash, and your mood is just as changeable. Clearly, something isn’t right and yet your practitioner doesn’t seem to share your drive to get some answers.

You see your doctor, then one or more specialists. You’re pricked with what seems like a thousand needles drawing blood for endless testing that doesn’t seem to provide a solid answer. You’ve sat in so many waiting rooms you’ve read every National Geographic published. Weeks pass, then months, and still no definitive answer to the question: “Do I have PCOS?” If fertility concerns are what led you to treatment, you can hear your biological clock ticking in the background.

So it’s not surprising that by the time the official diagnosis “PCOS” is stamped on your file, and your doctor has handed over the script for medication, it can seem like you’ve crossed the finish line of this arduous race. At last – you have treatment and now you’ll see results.

But for some women, frustratingly, results don’t happen. You’re still not conceiving, your skin problems and wayward hair growth remain stubbornly in place, as does your weight.  What’s going wrong?

If you find you’re in this situation I’d like to offer some points to consider that could uncover what’s holding back your progress:

1. You’re not exercising (enough). Movement is a key strategy to overcoming the insulin resistance that’s often underlying PCOS symptoms. You don’t have to train like you’re an Olympic athlete, but you’ll have to do more than a sedate walk around the block to get results.  This is the sticking point I see so many women make excuses about – so if you suspect that you’re not doing enough to get results you’re probably right. It might be time to schedule some regular training sessions with an accredited fitness trainer to assess whether your current training regime really is sufficient. 

2. You’re eating the kinds of food that promote fat accumulation. Like fitness, this is a tough one. PCOS produces moods that can drive you to seek out sugary, carbohydrate-rich foods to relieve your feelings. The emerging research promotes a moderately low (130g or less) daily intake of carbohydrates as the way to overcome insulin resistance and reduce weight – and yet some practitioners and their patients remain stuck on the high carbohydrate (130g +) approach which actually promotes insulin secretion.  If your blood glucose regulation isn’t improving on the diet your practitioner has suggested, it’s time to have a frank discussion with them or find a new practitioner who has embraced the new paradigms of nutrition.

3. You’re relying on medications and/or supplements to do the job for you. Medications and supplements are there to provide support while you address the underlying cause of your PCOS. We’re all attracted to the quick, easy fix. But if you really want results, you need to address the dysfunctional eating patterns, the sedentary lifestyle and the way you manage stress that’s led you into this problem. This is why attending to what you eat, how you move and stress management are regarded as front line therapies for PCOS by both naturopathic and medical practitioners.

Only you can decide whether you’re really doing enough work to make a difference; but it’s also possible that there’s another aspect to your PCOS management that’s actively pushing against your improvement: trying to do it all alone. You need a team behind you: Your medical practitioner and specialist, as well as your naturopathic practitioner, perhaps a fitness trainer too. Each member will contribute their expertise, cheer you on, and even call you out on your excuses that hold you back.

Tough love? Perhaps. But if you’re not getting the results you want, something has to change if you want change.

If you enjoyed this article you might also enjoy 'Empowering Your PCOS Diagnosis' here

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Is it PCOS or is it Hypothyroid?

Tuesday, April 19, 2016
Missing periods? Putting on weight that just won’t budge? You might think it’s PCOS but your practitioner wants to investigate hypothyroidism as well. That’s because many of the symptoms of PCOS and symptoms of hypothyroid match.  Here’s some of the confounding symptoms:

- Weight gain can come from deranged adipokines (messengers from your fat cells) or insulin resistance, or both, but weight gain can also happen because your thyroid isn’t passing on the right messages to your cells, to get active. How your energy goes during the day can be the clue; hypothyroid fatigue can be relentless from sun up to sun-down. Insulin resistance of PCOS can produce energy ‘slumps’ during the day, rather like an energy rollercoaster.

- Chronic low level inflammation is increasingly regarded as a fundamental cause of PCOS; however inflammation will interfere with thyroid production too.

- Your entire endocrine (hormone) system works together, like a symphony orchestra. The instruments aren’t just your ovaries but your adrenal glands, thyroid, pituitary, hypothalamus too. When one part of your endocrine system is affected, other glands are affected too. The key is to find out which one (or more) has the primary problem.

Your practitioner may order blood spot, urine or saliva tests – or all three – to establish how your endocrine system is communicating. You’ll probably get tests for anaemia, inflammation and cortisol (stress) too. If you have a practitioner who is exploring the possibility of hypothyroidism as well as PCOS then congratulations, you have found a thorough practitioner. 

If you enjoyed this article, you might also enjoy my free e-book for you, "The Empowered Hypothyroid"

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The connection between PCOS and inflammation and what you can do

Sunday, April 17, 2016
Source click via MorgueFile

Knowledge about the underlying cause/s of PCOS is growing. Here’s what I’ve found from reviewing a few recent papers (listed at the end of this post)

- Inflammation is becoming recognised now as the dysfunction underlying insulin resistance. This may explain why PCOS happens in slim as well as overweight women.

- Although insulin resistance and obesity promote PCOS, it is proposed that perhaps the true underlying cause is inflammation.

- There’s a strong intertwining of cause and effect; fat cells stimulated by excess androgen promote inflammation, and inflammation promotes excess androgen production. They affect each other.

- The inflammation changes the function of the ovaries, disrupting the ovulation process (which utilises a controlled amount of inflammation to ovulate).

- C-reactive protein, a biochemical marker of inflammation, is greatly increased in women with PCOS regardless of BMI.

And now on to some practical steps: Here is what you can do:

Beyond the theory, this is what the scientists established in studying the effects of diet on ovary function in mice: Saturated fats (butter, coconut oil, red meat) and trans-fats (from processed foods), omega-6 oils (from modern foods) and sugary foods are believed to promote inflammation. Eating more omega-3 oils (from seafood for instance) can help restore the balance. 


And exercise, of course. That’s fundamental to overcoming PCOS, and one of its markers, insulin resistance.  But how much do you need to do? The Rich-Edwards et al paper crunched data from the Nurses Health Study (a large epidemiological study) and found that for every one hour of vigorous activity there is a 5% reduction in infertility, regardless of weight and diet. So, imagine what you could achieve with an hour of intense fitness training every day or so!

If you enjoyed this article, you might also enjoy 'Quenching The Fires of Inflammation'

Want to delve into the papers? Here they are. (The Boots paper includes a useful model)

Alanbay et al (2012) ‘A macrophage activation market chitotriosidase in women with PCOS: Does low-grade chronic inflammation in PCOS relate to PCOS itself or obesity?’ Arch Gynecol Obstet 286:1065-1071 DOI 10.1007/s00404-012-2425-0

Boots, C & Jungheim, E.S (2015) ‘Inflammation and Human Ovarian Follicular Dynamics’ Semin Reprod Med July 33(4) 270-275 doi: 10.1055/s-0035-1554928

Dhindsa G, Bhatia R, Dhindsa M, Bhatia V (2004) ‘Insulin Resistance Insulin Sensitization and Inflammation in Polycystic Ovarian Syndrome’ J Postgrad Med Vol 50 Issue 2

Dumitrescu, R et al ‘The Polycystic Ovary Syndrome: An update on metabolic and hormonal mechanisms’ Journal of Medicine and Life Vol 8 Issue 2 pp. 142-145 

González, F (2015) ‘Nutrient-induced inflammation in Polycystic Ovary Syndrome: Role in the development of Metabolic Aberration and Ovarian Dysfunction’ Seminars in Reproductive Medicine Vol 33(4) pp. 276-86 DOI 10.1055/2-0035-1554918

Kurt et al (2014) ‘The effect of obesity on inflammatory markers in patients with PCOS: a BMI-matched case-control study’ Arch Gynecol Obstet 290:315-319 DOI 10.1007/s00404-014-3199-3

Rich-Edwards et al (2002) ‘Physical activity, body mass index and ovulatory disorder infertility’ Epidemiology Vol 13 (2) pp. 184-90

Shorakae et al (2015) ‘The emerging role of chronic low-grade inflammation in the pathophysiology of polycystic ovary syndrome’ Seminars in Reproductive Medicine’ Vol 33(4) pp. 257-69 DOI 10.1055/s-0035-1556568

Spritzer et al (2015) ‘Adipose tissue dysfunction, adipokines, and low grade chronic inflammation in polycystic ovary syndrome’ Reproduction 149 R219-R227 DOI: 10.1530/REP-14-0435

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Seven clues you may have PCOS - and what to do next

Sunday, March 27, 2016
PCOS (or polycystic ovarian syndrome) is a widespread hormone condition that can steal your fertility, erode your self-esteem and increase your vulnerability to adult onset diabetes. Here are seven clues you may have PCOS, and what to do next.

1. Your periods are irregular, or completely absent; perhaps only every few months. This is the clue that often prompts women to seek help; because your periods should slip into a regular monthly-or-so rhythm within a year of starting.

2. You have thick male–pattern hair growing on your face and body. Hirsutism is the technical term for this self-esteem eroding symptom of PCOS. It’s caused by over-sensitivity to increased levels of androgen hormones.

3. You have intractable acne despite good skin care. Like hirsutism, acne diminishes your self-esteem, and is also caused by too much androgen (male) hormones in circulation.

4. You have had trouble conceiving a baby. Like infrequent periods, difficulty in conceiving can be the way many women discover they have PCOS. This can especially happen when you’ve come off the pill to try for a baby, because the dysfunction of your ovaries was masked by the pill’s artificial cycle.

5. You have to keep topping up with sugary or carbohydrate foods otherwise your energy slumps
, and it feels like immense sugar and carb cravings have control of you. Insulin resistance is a core trigger for PCOS and also a core focus for treatment. 

6. Your waist measurement is greater than 88cm and weight loss just doesn’t happen despite doing all the right things. The complex interplay between fat cells on your tummy, your ovaries, and the hormones they help produce can make weight really stick to you, unfairly.

7. Your moods aren’t the best – perhaps anxious or depressed, or experiencing mood swings. If the symptoms of PCOS weren’t enough to dampen your mood, then your insulin resistance can promote mood swings, and systemic inflammation can promote depression.

These are just some of the signs of PCOS. Your medical practitioner can ascertain the official diagnosis and offer medical treatment options. Your naturopath can also help, through natural remedies and by coaching you through the diet and lifestyle changes essential to successful treatment of PCOS. 

Ready to take the next step? Have a look at this article about how to empower your PCOS Diagnosis. 

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Olwen Anderson @olwenanderson


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