1. See your doctor regularly, especially if you are actively symptomatic or trying to conceive.
PCOS is a complicated disorder to treat and diagnose, and no two people with the syndrome exhibit symptoms in the same way.
2. Take the right meds for your exact needs.
In women with PCOS, the ovaries may produce too much of the hormone testosterone. This can interfere with ovulation, as well as cause other symptoms, such as excess hair growth and acne. Other hormones, such as luteinizing and follicle-stimulating hormones, may also be out of whack. Common medications can include spironolactone (a diuretic used in the regulation of high blood pressure that is also known to lower testosterone throughout the body), metformin (a diabetes pill that sensitizes the liver to glucose and insulin regulation signals), estradiol (synthetic estrogen), and birth control pills. Keep in mind, that if you are not seeing an endocrinologist as part of your treatment you may not get the right medications in the right doses. Some of the treatments may even be counterproductive. For example, estradiol can make ovarian cysts worse. Make sure your doctor is an expert with PCOS.
3. Don't be afraid to seek out a second opinion.
Let's be real: Doctors are generally insensitive and downright mean when they talk to overweight women, as if being rude will help them overcome a complicated disease exacerbated by society, environment, behavior, and biology. The patient only has control over one of these factors -- their behavior -- but much of that is also influenced by biological forces. Find a doctor who understands this dynamic and puts you, the person, before the number on the scale. It's important to find doctors who work well with you because this disease has no cure, only symptom control.
4. Be realistic and forgiving of your body.
There is no cure for PCOS, including menopause and hysterectomy. The name is an unfortunate misnomer because it incorrectly places all focus on the fertility issues that can come with a PCOS diagnosis. Yes, you may develop cysts on your ovaries, but did you know that many women with PCOS do not have cystic ovaries at all? You read that right. You can have healthy ovaries and still have this disorder. That is because PCOS is a full-body syndrome that affects all of you, not just the lady bits. It's probably more accurate to think of PCOS as the canary in the type II diabetes coal mine. The most dramatic symptoms are caused by systemic hormonal disruptions throughout the body: thyroid hormones, reproductive hormones, ghrelin and cortisol (hunger and stress hormones), insulin (another hormone), etc. This is why most treatment for PCOS begins with expensive hormonal blood panels that must be replicated by a competent endocrinologist (hormone specialist) regularly. Scrutinizing your hormonal compositon in this way is even more important if you have an atypical presentation, you're actively trying to conceive, or your case of PCOS is particularly severe.
5. Focus your attention on healing your liver -- and not just your ovaries -- to experience symptom relief much faster.
This often requires a change in dietary lifestyle. Chronic exposure to things like high fructose corn syrup -- which is entirely processed in the liver -- can lead to fat deposits in the liver and, eventually, blood sugar regulation issues. This is why fatty liver disease and other metabolic problems often go hand in hand with a PCOS diagnosis. Most common advice doctors give their patients in response to the disease -- diet, exercise, and even metformin -- will act on the liver first, well before other changes occur throughout the rest of the body. TAKE THE HINT. An inflamed liver cannot regulate body processes as well as a healthy liver. Losing weight, exercising regularly, and even taking metformin will help you restore your liver to a more functional state and minimize many of the most damaging and disfiguring symptoms of PCOS.
6. Maintain a healthy weight.
Weight loss is often recommended as a treatment for PCOS. Losing as little as 5-10% of your body weight can make a significant difference in your symptoms. For example, if you weigh 200 pounds, losing just 10 pounds can improve your menstrual regularity and help regulate your hormones. Weight management should not be considered just "losing weight" or a diet, but instead a life-long journey with ups and downs. It won't always be smooth sailing. Because of this, it's important to be compassionate and honest with yourself throughout the process. Surround yourself with people and activities that support a healthy lifestyle. Avoid making food the center of your social life.
7. Break a sweat as often as possible.
Exercise can help to regulate your hormones and improve your insulin sensitivity. How? By helping remove excess fat and glycogen deposits from the liver so it can regulate your body's insulin levels more effectively. Aerobic exercise is essential for "cysters" who want to avoid the nasty side effects of a sluggish metabolism on a PCOS body, which include brain fog, blurry vision, headaches, weight gain, fatigue, mood dysregulation, and other symptoms that can make life miserable.
8. Eat a healthy diet.
A low-sugar grain-free diet with lean protein and low-starch vegetables can help to regulate your hormones and improve your fertility. Medical science has only scratched the surface of identifying the relationship between blood glucose, insulin, thyroid hormones, and reproductive hormones. While classic dietary advice focuses on "whole grains," this advice can often frustrate women with PCOS because they're much more sensitive to spikes in their blood glucose levels than the general population. (PCOS is a precursor to type II diabetes.) While medical professionals may advocate for a balanced diet, many PCOS "cysters" swear by keto and low-carbohydrate diets to restore fertility, heal inflamed livers, minimize acne and hair loss, lower testosterone levels naturally, and keep weight in a healthy range for their unique bodies.
9. Reduce stress.
Stress can undermine weight management as well as interfere with ovulation and conception. Try relaxation techniques such as yoga or meditation to help reduce stress. We know this is easier said than done, particularly since many women with PCOS also experience elevated levels of the stress hormone cortisol. Cortisol can also trigger hunger, often thrusting PCOS cysters into a vicious spiral of stress and comfort eating. The situation is difficult, but not impossible. Focus on eliminating stress in small doses every day. This can pay off big over time.
10. Honor your natural circadian rhythm and get plenty of sleep.
Getting good sleep can be a challenge for a lot of women with PCOS. It may require giving up things like alcohol, marijuana, nicotene, or even coffee if it's too late in the day. Sleep is important for overall health and can help to reduce stress levels and promote hormone balance. Think of sleep as a cleanup crew for your brain. Good quality sleep is great for your thinking power. Sleep can minimize the brain fog that often comes with the territory when you have chronic inflamation or too much stress hormone in your system.
