Polycystic Ovarian Syndrome (PCO or PCOS): Definition, Diagnosis & Management

Do you have irregular menstrual periods, sometimes missing cycles and/or experiencing excessive bleeding? If so, you might be one of the estimated 70% of women with irregular menstrual cycles who have polycystic ovarian syndrome (PCO or PCOS). A hereditary disorder that creates a hormonal imbalance, PCO produces higher than normal levels of male hormones, with results such as:

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• irregular periods
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• fertility issues
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• male pattern hair growth or loss
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• acne
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• mood changes
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• sleep apnea or excessive snoring
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• in some women, ovarian cysts.

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In addition, many women with PCOS struggle with weight gain and are at risk for developing elevated cholesterol levels, high blood pressure and type 2 diabetes. Clearly, it's not a problem to be ignored.

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Polycystic Ovarian Syndrome (PCO) & Insulin Resistance

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Physicians use a variety of criteria for diagnosing and/or treating PCOS. One of the more common symptoms – insulin resistance – is also thought to play a role in causing the problem in the first place. When a woman is insulin resistant, blood sugar levels can be elevated, resulting in a variety of problems. Elevated insulin levels also occur, which can create more male hormones and enhance their effect.

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Not all women with polycystic ovaries are insulin resistance, however it is more common in overweight women with PCOS. Women with a waist circumference of more than 35 inches are also more likely to be insulin resistant. As little as a 5% loss of body weight can be beneficial.

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Polycystic Ovarian Syndrome (PCO): Managing Insulin Resistance through Dietary and Nutrition Changes

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While medication is commonly prescribed for women with polycystic ovarian syndrome (PCOS), a healthy lifestyle -- regular physical activity and healthy eating – is generally recommended as the first line of defense for managing insulin resistance. Adopting a healthy lifestyle often leads to weight loss, which can improve PCO symptoms in and of itself. Excess body fat in the abdominal region, where it often accumulates in women with PCOS, contributes to insulin resistance.

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Managing carbohydrate intake is the focus of a healthy eating plan for insulin resistance in PCOS. Carbohydrate intake is often reduced to 40 to 50% of calories and high quality carbohydrate-based foods such as fruits, dairy, and whole grains are best when spread out fairly evenly through out the day. Following guidelines for type 2 diabetes meal planning is helpful for those with insulin resistance.

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Omega-3 fatty acids – found in foods such as salmon, tuna, mackerel, herring, flax seed/oil, walnuts, pumpkin seeds and many fortified foods -- may also be helpful in managing insulin resistance. Omega-3 fatty acids may play a role in ovulation as well as improving insulin sensitivity. Obtaining these fatty acids from fish, as opposed to nuts and seeds, is preferable. Also, a mix of fats rich in omega 3 fatty acids and monounsaturated fats like olive or canola oil is recommended while simultaneously reducing intake of saturated and trans fatty acids, which may actually contribute to insulin resistance. Saturated fats are primarily found in animal foods such as meats and dairy products. Trans fats are mainly found in fried foods, shortenings and margarines as well as many baked goods like cookies, crackers, and donuts, although manufacturers are actively eliminating trans fats from many products. Check the nutrition label for information about the type of fat in foods.

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Generally speaking, an eating plan rich in vegetables, whole grains, fruits, legumes, fish, low-fat or fat free dairy, nuts and seeds is a good place to start to manage insulin resistance. Balancing meals using the Healthy Eating Plate Model is also an easy way to address portion sizes and the need for a lighter carbohydrate intake.

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