Polycystic ovary syndrome or PCOS

Polycystic ovary syndrome is a condition encompassing a broad spectrum of disorders affecting the hormonal, metabolic, and reproductive systems. It is estimated to affect 10% of women of reproductive age[1].

Symptoms of polycystic ovary syndrome (PCOS)

Among the most common signs found in women with the condition:

Long menstrual cycles (35 days or more) and/or irregular or absent cycles (amenorrhoea, or absence of periods), or cycles without ovulation (anovulatory).

Fertility difficulties and challenges conceiving (since ovulation may be absent, infrequent, or irregular). It is also possible to have a ovarian reserve low. 

Being overweight or obese. 

Cardiovascular disease. 

Adult acne, particularly on the lower face.

Hair loss, particularly on the top of the scalp.

Excessive hair growth or hirsutism, meaning hair growing in places where it would not typically grow on a woman (chest, nipples, chin, cheeks, back, neck…). 

The majority of these symptoms are caused by an imbalance in hormone levels. This is notably due to elevated androgen levels (acne, hirsutism, etc.), or an imbalance in the LH-FSH ratio affecting fertility and the menstrual cycle. 

Not all of these signs need to be present to have PCOS. Many women with PCOS have no weight concerns or fertility difficulties. It is important to keep in mind that pcos and pregnancy are not incompatible. 

Diagnosing PCOS

To diagnose polycystic ovary syndrome in patients, 2 of the following 3 criteria must be present:

A certain number of follicles of a certain size on the ovaries.

Excess androgens (hyperandrogenism) — in other words, hormones associated with masculinity (testosterone and its derivatives).

A disrupted cycle (long, absent, irregular, anovulatory).

You can therefore have PCOS without having cysts on your ovaries, or have cysts on your ovaries without having PCOS. The name is a little misleading!

To establish the diagnosis, a pelvic ultrasound alone is not sufficient — a hormonal blood panel and observation of menstrual cycles over several months are also required.

Traditionally, a low level oflow anti-Müllerian hormone (AMH) is an indicator of a fertility issue. However, it is also quite common to have a high AMH level with PCOS. Even when AMH is elevated, fertility difficulties remain very frequent. This is why measuring AMH levels in the body is not necessarily a reliable indicator. 

One important clarification: if you do not have hyperandrogenism but experience all the symptoms of PCOS, it is possible that your cells are hypersensitive to androgens. In other words, a normal amount can still produce signs associated with excess, and you may have PCOS nonetheless.

PCOS is a complex, multifactorial syndrome involving many different systems. Here are three of the most commonly present risk factors. 

The first risk factor of PCOS: hyperandrogenism

This refers to a hormonal excess typically associated with men (testosterone and its derivatives) [2]. In patients with PCOS, androgens are produced largely by the ovaries via LH secreted by the brain to trigger ovulation. In people with PCOS, LH is often secreted in excess, leading to excessive hormonal production. This can inhibit or delay ovulation. When present in excess, androgens can also contribute to the appearance of "masculine" characteristics, such as hair loss at the top of the scalp (similar to male-pattern baldness), hair growth in areas where it typically grows in men, and acne — particularly along the lower face, where a beard would grow.

The second risk factor of PCOS: insulin resistance and hyperinsulinaemia (and type 2 diabetes)

Blood sugar (the level of sugar in the blood) is a parameter that must remain more or less constant. Insulin is the hormone secreted by the pancreas to redirect excess sugar from the blood into cells, which then store it as energy; this allows blood sugar levels to return to a normal value. 

Women with PCOS are often prone to insulin resistance. Their cells refuse to respond to insulin and decline to absorb the excess sugar in the bloodstream. As a result, blood sugar levels remain elevated, and the pancreas continues to produce ever-increasing amounts of insulin in an attempt to "get through" to the cells — to no avail. Excess insulin (hyperinsulinaemia) contributes to the excessive hormonal secretion of androgens, and vice versa [3] [4]. Everything is connected. This can lead to complications such as type 2 diabetes, and may also affect weight gain. 

The third risk factor of PCOS: chronic inflammation

Inflammation is triggered when something goes wrong (an injury, a virus…) or to support certain normal bodily processes (menstruation, ovulation). Inflammation is therefore meant to be temporary. However, when inflammation becomes chronic, it turns harmful and stimulates the overproduction of androgens, hyperinsulinaemia, and insulin resistance [5]. This contributes to the onset of numerous symptoms: weight gain, acne, type 2 diabetes, and so on. Once again, everything is connected…

There is no medication or treatment that directly treats polycystic ovary syndrome as such. However, solutions may be offered to help reduce the symptoms.

The contraceptive pill

It inhibits the production of sex hormones by the ovaries, including androgens. This may help ease the symptoms associated with this excess, such as hair loss, acne, excessive hair growth and hirsutism. However, stopping the pill generally causes polycystic ovary syndrome to resurface, and may worsen it, since upon stopping the pill some people experience a "rebound effect" linked to post-pill overproduction.

Anti-androgens (for example spironolactone)

They act as antagonists at the receptors, thereby reducing androgenic activity and the symptoms associated with excess.

Metformin for PCOS

It is a treatment traditionally prescribed to people with diabetes that may be prescribed to reduce the metabolic issues of insulin resistance and hyperinsulinaemia [6].

If you wish to have a child and are having difficulty conceiving, you may be offered the option of starting a fertility treatment pathway (medically assisted reproduction).

Polycystic ovary syndrome is often presented as a lifelong condition. Yet it is possible to turn the situation around, provided all the multiple aspects of PCOS are taken into consideration. Here are some avenues to explore.

Regulating blood sugar and insulin

Cut refined sugar from your diet

It is very rapidly absorbed into the bloodstream, requiring an insulin spike which, over the long term, may contribute to insulin resistance. It is found in sweets, cakes, biscuits, desserts, etc., but also in ready meals, processed foods, and refined grains (white rice, white pasta, white bread…). Opt instead for wholesome treats such as dried fruit, nut butters, dark chocolate, and wholegrain cereals. This may also contribute to weight loss. 

Eat protein and healthy fats at every meal and snack

They help to slow the absorption of carbohydrates (i.e. sugars) into the bloodstream, preventing excessive fluctuations in blood sugar levels and therefore insulin. Protein will also be your ally if you wish to lose weight. 

Reducing inflammation 

Adopting an anti-inflammatory diet

Avoid processed and industrially produced foods, which are inflammatory, and favour high-quality whole and natural foods, which are anti-inflammatory.

Avoid overly frequent or intense physical activity

Because they generate inflammation. Opt instead for gentle sports such as walking, yoga, pilates, or gentle movement practices such as tai chi or qigong [7].

A hormonal rebalance

Reducing stress

When our brain perceives stress, it triggers the production of cortisol and DHEA by the adrenal glands. Cortisol generates inflammation and disrupts blood sugar levels. As for DHEA, it is an androgenic hormone from which all other androgenic hormones can be produced. In other words, stress is a major contributor to inflammation, insulin issues and this hormonal excess… and therefore to PCOS. To reduce stress, everyone has their own approach: breathing exercises, yoga, meditation, reorganising your schedule…

A women's food supplement, based on magnesium, is beneficial against stress as well as for a good night's sleep. Indeed, sleep can be particularly affected in cases of PCOS. Our sleep food supplement is compatible with this condition and may help. 

Eat foods rich in zinc

Such as oysters, seafood, pumpkin seeds… or supplementing with zinc* [8] as it is an anti-androgenic nutrient.

Beyond these tips, the ideal would be to work with a healthcare practitioner who can understand the other contributing factors and underlying causes at play in your polycystic ovary syndrome. Because the issue rarely stops at insulin, inflammation and hormonal concerns alone — underlying elements may be quietly holding the reins.

Our supplement multivitamins for women is rich in zinc and vitamin B6 for hormonal balance. 

Pink Balance, a delicious red berry powder for hormonal imbalance. It contains maca and shatavari to help rebalance hormones, beetroot to reduce inflammation, and it is naturally rich in B vitamins! Ideal to use alongside PCOS supplement. It can be combined with a supplement PCOS inositol. In particular, the myo-inositol powder is very effective in relieving associated signs and certain fertility-related issues [9].

Our food supplement to conceive Ovo+ contains zinc, Coenzyme Q10 and NAC, which are very effective in cases of PCOS.

Whilst it is possible to reverse polycystic ovary syndrome, there is no "quick fix": as it is a complex, multifactorial syndrome, the journey towards better health takes time and personal commitment over several months or even years. This can feel discouraging, but the prospect of a life free from this condition is a priceless goal! Many natural options are available, including myo inositol, which is highly effective.

* Be careful not to self-supplement — food supplements are not without risk; they can interfere with other supplements, foods and medications, and may not be suited to your personal situation, not to mention the importance of choosing them carefully and adapting the dosages. It is therefore preferable to seek advice from a healthcare practitioner specialising in nutrition (such as a naturopath or nutritional therapist).