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PCOS; Everything you need to know about, and how to manage, Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is one of the most common endocrine (hormone) and metabolic disorders faced in pre-menopausal women. Affecting approximately one in five women (based on the new, more inclusive diagnostic criteria), it is a shame that, although the body of research surrounding the condition is growing within the scientific community, little appears to be being done internationally and or by local health authorities to adequately identify and address the issue.

PCOS is frequently associated with abdominal adiposity, insulin resistance, obesity, metabolic disorders and cardiovascular risk factors. There is also some suggestion it can leave women more susceptible to autoimmune diseases. It can be a truly debilitating disorder, one that we've helped people with but seen many more women suffer from.

In this article we're going to briefly cover;

  • What is PCOS?

  • Identifying PCOS

  • The underlying causes of PCOS

  • How we can address them through dietary, supplementation and lifestyle means 

What is PCOS?

PCOS is a condition defined by a combination of signs and symptoms of androgen excess (hirsutism (male pattern hair growth in women) and/or hyperandrogenaemia), ovarian dysfunction (oligo-­ovulation (irregular ovulation) and/or polycystic ovarian morphology (PCOM) i.e. excessive amounts of follicles within the ovaries (currently defined as greater than 25). 

To note, the term androgen simply refers to the group of hormones which have an important role in defining male characteristics and traits.

Contrary to the term, PCOS can be anything but "polycystic". Not every patient with PCOS necessarily has the "cysts" which the name suggests and, to make things even more confusing, the cysts aren't even cysts; they incorrectly refer to the accumulation of the egg cell containing follicles which create a "cyst" like appearence.

The name PCOS is confusing for many. Not just those who suffer from the condition but also those healthcare professionals whose job it is to diagnose and treat the condition. Many suggestions for alternative titles have been proposed but, due to lack of consensus agreement, none have been adopted (at least in a widespread and or recognized capacity).

Identifying PCOS

So, by far the easiest and most straight-forward diagnostic criteria in identifying an individual that may be suffering from PCOS (or however you'd like to call it, but for the sake of this article we'll be sticking with PCOS) is that... they're female. 

After that it's a bit of a crap shoot.

You see, PCOS is non-heterogenous both in terms of it's diagnostic phenotype and the severity of it's health consequences / disorders.  Not all individuals with PCOS have all the possible manifestations of the disorder nor are they exposed to the same health risk factors. If you can imagine it, instead of appearing as a definite black and white diagnoses (like a broken leg would for example), it appears along a spectrum from mild to the most severe symptoms.

There are different classifications of PCOS (in terms of clinical diagnoses) based on diagnostic criteria. There are three major groups of diagnostic criteria; hyperandrogenism, oligo-ovulation and PCOM, of which we'll discuss too. These will be important as if we can address the underlying causes of the diagnostic criteria, we can then improve the symptoms of the condition.

Let's first look at the clinical phenotypes (i.e. how the condition is expressed in relation to characteristics/traits in an individual). As a rule of thumb, the more diagnostic criteria met by an individual the more severe her particular phenotype is (in terms of health consequences and again thinking more so along the lines of a spectrum rather than "black and white" diagnoses).

"Classic" PCOS

The most "severe" of the clinical diagnoses, "classic" PCOS, presents with b