5 Things I Wish I Knew When I Was Diagnosed with PCOS
When I was diagnosed with PCOS in 2016, the only thing I was told was get an ultrasound, lose weight and stop eating chicken. The obvious response from my teenage self was to starve myself, avoid chicken like the plague and as a result crave it more than ever before and blame all my weight gain, acne and mood swings on PCOS instead of my unhealthy lifestyle. While in hindsight, avoiding chicken with antibiotics and making a lifestyle shift to a more healthier sustainable one was good advice, it was poorly communicated with zero reasoning or clarity. And a LOT of valuable information was left out. So let me be a source for you to find some of it so next time you pay a visit to your doctor, you can debate on it! The more you know, am I right?
Disclaimer: I am not a medical professional. This is just my personal experience, what I learned from my own research and what has worked for me in the past.
You can have PCOS without having cysts
If you’re thinking, “but doesn’t the C in PCOS mean cystic? So what are you on about?” I hear you.
Doctors diagnose PCOS if the patient has at least two out of three main symptoms: high androgen levels, irregular periods OR cysts in the ovaries. So, you see? You may not have a cyst but still have PCOS. I was one of the few that had cysts. Unfortunately, those who don’t have cysts but still have PCOS go undiagnosed and consequently, all the frustrating side effects that follow goes unexplained.
My gut told me I needed probiotics (pun intended)
It is safe to say that in 2016, I didn’t know what gut health was or why I needed to care for it more than others. As you may know, our gut bacteria aids our immune system, supports the integrity of the gut lining, assists in food digestion, synthesises specific vitamins and produces short-chain fatty acids.
Researchers have found that women with PCOS have less diverse bacteria present in their microbiome and higher levels of certain “bad” bacterial strains in their stool sample than non-PCOS women. The gut microbiota also appears to play a role in the regulation of androgens aka the hormones giving you acne and facial hair. So a lot of women with PCOS have some gut impairment – whether it is chronic constipation, IBS, SIBO, or bloating and don’t realise its correlation with PCOS symptoms. Focusing on getting enough prebiotics and probiotics in the morning along with enough fibre, anti inflammatory spices and herbs and cruciferous vegetables really helped regulate my poop cycles.
The 3 S’s - Stress, Sleep, Steps
I got all my symptoms in control after making drastic lifestyle changes for the better and was living life having forgotten I ever had PCOS. I was looking and feeling better than ever. Then, for 3 days in January 2020, I was stressed. Extremely stressed. 3 months later, my period gets delayed, I start getting acne for the first time in my life and my blood report confirmed my hormones had gone haywire. I couldn't believe 3 days could send me off on a downward spiral that would take me 13 months to fix. Yes, THIRTEEN!
Apart from the daily stresses of life, we place additional stresses on our bodies in the way we eat, exercise and our inner voice or self talk. If you constantly put yourself down with negative messages and place stress on the body, it disrupts the hormonal/endocrine system – resulting in the possibility for PCOS. Stress causes the production of the adrenal androgen hormones. These hormones, in increased levels are believed to contribute to ‘adrenal PCOS’, one type of PCOS that isn't cyst-driven but will still give you all the symptoms including acne and hirsutism.
Along with managing my stress levels (through meditation, yoga, low impact workouts, music etc) getting the recommended 6-8 hours of sleep along with hitting at least 10k steps everyday has been a game changer for me personally for managing my symptoms.
Birth control/hormone pills for PCOS is just like putting a bandaid on a bullet wound.
Endocrinologist > gynaecologist. While there may be cysts in your ovaries and that may indicate PCOS, that isn't what is taking hits on your insecurities aka it isn't the underlying reason causing acne, facial hair, the weight gain and and an array of other symptoms that truly makes PCOS feel like it’s been specifically designed by Satan to shatter your self confidence. In my case at least, it was the hormonal imbalance and insulin resistance I had to fix.
If you have PCOS, it’s highly likely a gynaecologist has offered you birth control pills to control your symptoms and “regulate” your period. They may help reduce the acne and excessive body hair after a point, but can it really regulate your menstrual cycle? No.
Why? Because there is a difference between getting your period because you ovulated and getting your period because hormones are artificially withdrawn. A natural “all on your own” period that happens after ovulation is an indicator of your overall health and hormonal balance. A “fake” bleed due to the pill is not. The minute you stop the pill, all of your PCOS symptoms will come back, since the underlying cause or causes weren’t addressed.
Insulin resistance is something you might want to google
Inositol/Vit B8 shouldn’t be the last resort much like birth control pills shouldn’t be the first.
I used to eat a “healthy” smoothie bowl, then feel faint and in need of something sweet 30 minutes later. I used to snack on fruit and then get even hungrier than before said snack a few minutes later. The skin in the nape of my neck was also getting darker. No, it wasn't the pesticides from the fruit or a tan like my mom tried to convince me. I, like 30-40% of women with PCOS, have insulin resistance.
Energy crashes from a meal that is only carbs/sugars are common if you don't slow down the absorption of sugars with protein and fats i.e. if the meals aren't balanced. When I learned of this, I obviously turned to google to learn more. What I found: cut off everything; gluten, dairy, meat, carbs, caffeine and the list goes on. I wasn’t a big fan of this, honestly. While cutting off everything shouldn't be the answer, eating everything isn't either. Find out what fuels your body and what disturbs it. See what meals make you feel good and what make you sluggish.
Every instinct has an underlying reason. If I’m craving more sugar, it’s probably because I either ate an unbalanced meal causing my sugar levels to spike and then crash much like the current stock market. This crash leaves my body craving more sugar to overcompensate and the vicious cycle continues. Or it could be that I haven't eaten enough food that day and the body needs energy and of course carbs give energy. I also learned that inositol or vitB8 helps control it to an extend and started supplementing it in my diet
Google has a lot of answers. Both right and wrong. It’s up to you to research and filter, do trial and error. Even doctors don't know your body better than you. In fact, no one else does. So take the time to understand your body and see what works for you. Of course, ALWAYS seek expert advice. But don’t just swallow pills blindly. Understand that PCOS does not have a quick fix. It is a chronic condition that is designed to somehow target all your insecurities and it is okay to cry about it.
Apply your knowledge to what your body requires, improve your lifestyle and eating habits and control your symptoms. The healthy habits I consciously made an effort to adopt into my life eventually became my new normal. I now eat the foods that fuel me, work out everyday, regulate my stress and sleep better because it is good for me, rather than to control PCOS. PCOS is no longer controlling every decision I make either.
About the writer:
Riya is a model and a nutritionist. She also looks after PR at Cosmix and is our resident nutrition-nerd. Ever since she was diagnosed with PCOS in 2016, she has committed herself to researching and demystifying the condition for herself and those around her. When she's not helping Cosmix celebrate health over aesthetics, she's geeking out over all things nutrition, especially for PCOS. You can follow her on Instagram.