Polycystic ovarian syndrome, or PCOS for short, is a condition that the medical community cannot actually attribute to any cause. PCOS is characterized by cysts formed on the ovaries due to hormone imbalance. However, there's a little more to it than that.
Androgens are male hormones. With PCOS they are usually elevated. Due to the elevated androgen levels, women will experience more acne than usual and increased hair production (hirsutism) - mainly facial hair.
So let's get this straight. You have a ton of pelvic pain because of multiple ovarian cysts and a full-on man beard?
The upside is that you could also have a side hustle as the bearded lady in a circus, but likely that wasn’t your life ambition.
No judgment if it was...
The medical community think that PCOS may be genetic, caused by low-grade inflammation, excessive insulin production, and excessive androgen levels. However, the experts cannot pinpoint a direct cause.
Problems Associated With Polycystic Ovarian Syndrome
- If you do get pregnant it is likely you will have pregnancy-inducted hypertension
- Fatty liver
- Metabolic syndrome (high blood pressure, increased blood sugar, increased cholesterol)
- Uterine bleeding
- Uterine cancer
Basically, your hormones are out of wack. This causes you to have insulin resistance and an excessive amount of male hormones that cause facial hair and acne.
Because you have become more resistant to insulin, you end up possibly having full-blown diabetes or having metabolic syndrome, which is a conglomeration of symptoms that make up cardiovascular diseases and diabetes. Due to the insulin resistance, you also have weight gain.
Oh, and just to add insult to injury, you likely have metabolic derangement because your resting metabolic rate is usually a lot lower than someone of the same age and gender would have.
Steps to Lose Weight If You Have Polycystic Ovarian Syndrome
So we went over what polycystic ovarian syndrome is, and now, to the meat of our content. How in the heck do you get this weight off?
Well, I have to say, I have seen many people struggle with this syndrome. It is not as uncommon as you think - one in 10 have this syndrome, so that is fairly common. The two “defining” factors for PCOS is ovarian cysts and increased male hormones.
I can tell you, it is difficult to lose weight if you have PCOS. This is not only due to the metabolic derangement, but also because you may have inflammation as well.
Here are some things that you can do right now that may help your chances to get that weight off.
Eat lower inflammatory foods - Sugar is not your friend if you have PCOS - mainly because of insulin resistance. Examples of low inflammatory foods are: blueberries, fish, leafy greens, some nuts , etc. Processed foods and sugar are inflammatory. Don’t eat cake, kids.
Eat fewer carbs - Don’t stone the messenger. Carbs are not the enemy, but they seem to be for people with PCOS. In a study where participants had a eucaloric intake (meaning a good intake without a calorie deficit) they found that the PCOS participants on the lower carbohydrate diet actually lost fat around areas that were “metabolically harmful” ie around the midsection.
Exercise - Here is the kicker. You can run a marathon, but in PCOS this likely will aggravate symptoms. Cardio has its place, however, how metabolically, are you going to help insulin become more sensitive and have a better resting metabolic rate overall? Hmmmm. Ding ding ding! Yes, it is to make more muscle.
Strength training is even more important in PCOS than it is in women in general because of the metabolic derangement associated with PCOS.
So that's cool. Eat more lower inflammatory foods, eat fewer carbs, less processed foods, and train for strength. Isn’t that what everyone should do?
Well, yes and no.
Again, don’t get all butt hurt, carb lovers, but emerging data has been shown that a ketogenic diet may be of great benefit for those with PCOS.
This is due to the fact that it lowers insulin resistance and decreases inflammation as well as lowers the percentage of free testosterone, too. Which means that your beard becomes a 5’clock shadow, your blood sugar improves and guess what? You lose weight!
That is the gold standard right there.
Keto is pretty controversial, though. You can do a “dirty” keto (my words) or a “clean” keto (also my words). What I mean by this is that you can eat a bunch of processed crap and still be considered in ketosis.
Clean keto to me is when you take out dairy (yes, it is usually inflammatory for most, and in this case, we want the anti-inflammatory effects of keto) and eat real food that consists of healthy fats, meats, and veggies.
Keto is pretty restrictive depending on how crazy you get on it. Usually, keto is considered 20 grams of carbs, total.
Some women have issues with hormones on keto, and this is likely no different for women with PCOS. Each person is different and each person has a different threshold for things like insulin uptake and other hormonal responses.
Upon more research, I also found that a diet that was all whole foods also seem to have positive effects on women with PCOS. However, it was hard to find scientific data that didn’t relate to low carb.
I am surmising that a Paleolithic diet would also be beneficial as it is all whole foods, no dairy, and no bread - all of which are inflammatory. Yes, carbs are eaten on paleo, but probably not as much as you are fats and protein. Although the potential is there...
So there's that.
Exercise With PCOS
We talked a little about having to make more muscle so as to be more metabolically active and of course so that you will look like Arnold... No, I am kidding - don’t freak out, ladies.
An intense exercise regime for someone with PCOS could actually increase symptoms, which is not the goal. Like I said earlier, cardio has a place, but for this subset of females that happen to have PCOS?
Well, it just isn’t the most effective thing to do.
Weight training increases muscle mass, increases resting metabolic rate and helps to decrease insulin resistance. All very needed side effects for PCOS.
If I was to get all up on my high horse, weight training is just about the best thing for most people, women especially. Just had to throw that in.
Now, to be perfectly transparent, there are no studies that gave me specifics on how weight training can benefit the PCOS sufferer. However, there are a ton of studies on people who have diabetes and insulin resistance (a huge facet of this syndrome) who benefit from weight training.
With that said, a whole host of websites about PCOS associate weight training with the best outcomes for PCOS and weight loss.
As with most resistance training protocols, there should absolutely be compound exercises unless contraindicated.
So, the big three - and before you ask - yes, women can bench. If you are timid in a gym, it may behoove you get a trainer to show you how to do a proper squat, deadlift and bench.
I say the big three, because you get the best bang for your buck.
I think most who weight lift do the big three because it works more than just one specific body part. Let's take the squat - it works your back, butt, legs, hammies and yes, even your abs.
If you are scared of the man side of the gym, I feel you. However, if you have someone who can teach you or you just bust a move and get up the courage to do it, you won’t be sorry.
Check your form, research the crap out of all the exercises you will be doing, and for God sakes be consistent. This is not only about weight loss, but about decreasing symptoms of your PCOS.
PCOS sucks. Metabolic derangement, infertility and multiple cysts, as well as male hormones, are the symptoms of this syndrome. Because of the insulin resistance and metabolic problems, it is extremely difficult to lose weight.
It is important to switch from processed foods to whole foods and if you can, go lower carb. This is to decrease inflammation and decrease insulin resistance.
As far as exercise, don’t be hanging out on the treadmill, sporting your full beard and huge abdominal girth, as cardio can increase those symptoms. Weight training is where it's at with PCOS.
The big three, squat, deadlift and bench really gives you the best bang for your buck. Weightlifting decreases insulin resistance, and increases resting metabolic rate, so why in the world wouldn’t you do it?
References1) Mavropoulos JC , et al. "The Effects of a Low-carbohydrate, Ketogenic Diet on the Polycystic Ovary Syndrome: a Pilot Study. - PubMed - NCBI." National Center for Biotechnology Information, www.ncbi.nlm.nih.gov/pubmed/16359551.
2) "Effects of a Eucaloric Reduced-carbohydrate Diet on Body Composition and Fat Distribution in Women with PCOS." PubMed Central (PMC), www.ncbi.nlm.nih.gov/pmc/articles/PMC4191914/.
3) Tarryn. "Weight Loss with PCOS: Why is It SO Hard? | PCOS Diet Support." PCOS Diet Support | Tackling Polycystic Ovarian Syndrome Naturally!, 19 Feb. 2018, www.pcosdietsupport.com/pcos-symptoms/weight-loss-with-pcos/.