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PCOS (Polycystic Ovary Syndrome)
Nutritionist
Learn how I can help you with PCOS (Polycystic Ovary Syndrome)
London & Online
BOOK AN APPOINTMENTWhat my PCOS patients say about me
Having had a PCOS diagnosis earlier this year, a lot of my symptoms I struggled with all of my life made sense. I knew that going to just any nutritionist wouldn’t make sense and I was happy to find Milena Kaler via the internet who’s specialised in PCOS. I’m 2 months into my journey and seeing amazing results. I’ve lost weight (paired with good exercise, of course) and I feel supported in my journey, no longer bloated, better mood and sleep. I’ve got yummy recipes and a much better understanding of what does wonders for my body. Perhaps most exciting is that my skin has cleared up. My skin wasn’t terrible but I was prone to hormonal acne. Not a single spot on my chin now which gives me an additional confidence boost, no doubt.
I had been looking for someone who specialised in PCOS nutrition and came across Milena’s details. She was able to see me very quickly and took a great deal of time and attention into understanding my symptoms, lifestyle, current nutrition and main concerns that I wanted addressed. I really felt she listened and understood what I wanted out of the consultation which was comforting and reassuring. Since then, Milena has created a nutrition plan with recipes, shopping lists and a supplements plan specific to my needs plus what tests I need to undertake, which has saved me so much time and really got to the crux of the issue. I have also found the dashboard where all my information is helpful as I am able to track my progress and use it whilst I’m out and about. Milena’s approach is professional, warm and thorough and I would advise anyone who is overwhelmed with information and not sure where to turn to go direct to her for help and advice. I’m looking forward to seeing my progress and feeling confident it will work!
Just thought I’d message to say that after my consultation with you around 18 months ago I have since lost 3.5 stone and my testosterone levels are now healthy. Before it was double what it should be. I’ve completely overhauled my whole diet, walk about 15k steps a day which has stopped all my PCOS symptoms.
As someone who’s had food intolerances since childhood and the list of the things I couldn’t stomach only seeming to grow I was really struggling to feel confident in creating a good sustainable diet for myself. Alongside my PCOS, food just felt impossible. Since starting to work with Milena my symptoms have significantly improved and I’m beginning to feel confident in creating meals for myself again without worrying that it may be the wrong choice! She has been very patient and supportive throughout
She has helped me a lot with PCOS and my weight loss journey.
I am so happy to have found Milena! She is so kind, understanding and knowledgeable! Within 3 weeks of using her meal plan and recommendations, which is flexible and has been tailored to my individual struggles, I’m feeling much more in control and capable with more energy too! Such a positive experience so far!
What is PCOS (Polycystic Ovary Syndrome)?
Polycystic ovary syndrome (PCOS) is an endocrine disturbance, caused by increased levels of testosterone, oestrogen, and luteinizing hormone (LH) and decreased secretion of follicle-stimulating hormone (FSH). Polycystic Ovary Syndrome (PCOS) affects about 5-15% of women of reproductive age. The syndrome affects premenopausal women and the age of onset is most often perimenarchal (before bone age reaches 16 years). In lean women with a genetic predisposition to PCOS, the syndrome may be unmasked when they subsequently gain weight.
Based on studies conducted in the UK, around one in twelve females have PCOS. NHS lists the three main features of the PCOS stating that at least two of the following must be met to give a diagnosis:
- Irregular or infrequent periods – indication that ovaries do not regularly release eggs (ovulate)
- Blood tests show high levels of ‘male hormones’ androgens, such as testosterone
- Scan shows polycystic ovaries
How can a Nutritionist help with PCOS?
Working with a Nutritionist
Working with a Nutritionist can be transformative if you suffer from PCOS and struggling to lose weight. If you’re struggling to lose weight despite your best efforts, it may be time to seek professional help. You can get help from your Nutritionist in developing a personalised nutrition plan, identifying nutrient deficiencies, and help you in addressing any other underlying medical issues that might be negatively impacting your attempts to lose weight.
Your Nutritionist can work with you to develop a personalised nutrition plan that is catered to your unique needs and goals. The Nutritionist can also offer recommendations on the best supplements to take and lifestyle choices that can affect your weight, like getting enough sleep and managing your stress.
Book an appointment today if you feel like you need more assistance or direction to reach your goals.
Online consultation with a Nutritionist is available for clients who live outside the London area or who are unable to come to my office in Harley Street, Central London. You can enjoy the online consultation from the comfort of your home or office and you will be given the same level of personal attention and care that you would experience coming to see me in my office.
My approach to dealing with PCOS
As a Nutritionist and Nutritional Therapist, when working with patients in my clinic in Harley Street, London, I take a holistic approach. Rather than suppressing the symptoms, I work on finding the root cause of PCOS and restoring the hormonal balance using diet, supplements and lifestyle.
PCOS symptoms
PCOS affects women in different ways and not all women will have all the associated symptoms. Symptoms usually starts in adolescence, however some women will not develop them until their early to mid-twenties. In many women, the only symptoms are either a failure to conceive or menstrual problems.
Common symptoms of PCOS include:
- Weight gain, obesity or difficulty losing weight – especially around the middle (a common sign)
- Oily skin or acne
- Infertility or subfertility
- Hirsutism (60% women with PCOS) especially on the upper lip, chin, around the nipples and in the line beneath the umbilicus.
- Oligomenorrhoea (irregular periods)
- Amenorrhea (no periods at all)
- Alopecia – male-pattern balding
- Acanthosis nigricans (patches of thickened, dark, velvety skin) may be present. It is thought to be a sign of insulin resistance.
- Occasionally- increased muscle mass, clitoromegaly and deep voice
- Skin tags
- Pain in the pelvic area, especially around the ovaries, including chronic pelvic discomfort as well as acute episodes of sharp pelvic pain that gradually resolves within a few hours or days.
- Depression and mood changes.
- Obstructive sleep apnoea
PCOS and resistance to insulin
PCOS is associated with peripheral insulin resistance and hyperinsulinemia, and obesity strengthens the degree of both abnormalities. Insulin resistance in PCOS has also been associated with adiponectin, a hormone secreted by adipocytes that regulates lipid metabolism and glucose levels. Levels of adiponectin are lower in lean and obese women with PCOS than in women without PCOS.
Insulin resistance is a condition in which the body’s tissues are resistant to the effects of insulin. The body in order to compensate has to produce extra insulin. Due to high levels of insulin, ovaries produce too much of testosterone, which interferes with the development of follicles and prevents normal ovulation.
When the body does not respond to insulin, blood glucose levels increase, which may cause more insulin to be produced as the body tries to move glucose into cells. Insulin resistance can lead to diabetes mellitus. It is also associated with accanthosis nigricans (patches of thickened, dark, velvety skin). Women with PCOS are seven times more likely to develop diabetes.
PCOS and hormone imbalance
Hormone imbalance in women suffering from PCOS include:
- Raised levels of testosterone
- Raised levels of luteinising hormone (LH) – a hormone that stimulates ovulation, but increased levels in some women with PCOS may have abnormal effect on the ovaries.
- Raised levels of prolactin – a hormone that stimulates the milk production in pregnancy
- Low levels of sex hormone binding globulin (SHBG) – a hormone that helps reduce the effect of testosterone.
Prognosis
Having PCOS can increase the patient’s chances of developing other health problems later in life. Complications include type 2 diabetes mellitus and consequent cardiovascular complications, depression and mood swings, as well as high blood pressure and high cholesterol, which can lead to heart disease and stroke.
The oligomenorrhoea and amenorrhoea increase the risk for endometrial hyperplasia and endometrial cancer in untreated cases. The risk of developing gestational diabetes in pregnant women with PCOS may be more than double, and there is a higher risk of pre-term birth and pre-eclampsia.
Evidence suggests that maternal PCOS was associated with increased hospitalizations for their offspring, including disease of the nervous system, metabolic disorder, and asthma.
References
Doherty, D., Newnham, J., Bower, C. and Hart, R. (2015). Implications of Polycystic Ovary Syndrome for Pregnancy and for the Health of Offspring. Obstetrics & Gynecology, 125(6), pp.1397-1406. Available at: http://journals.lww.com/greenjournal/Citation/2015/06000/Implications_of_Polycystic_Ovary_Syndrome_for.19.aspx [Accessed 18 May 2015].
Ehrmann, D. (2005). Polycystic Ovary Syndrome. New England Journal of Medicine, 352(12), pp.1223-1236. University of Chicago [online]. Available at: http://pediatrics.uchicago.edu/chiefs/adolescent/documents/pcos_nejm.pdf [Accessed 17 May 2015].
Elton, S. and O’Higgins, P. (2008). Medicine and evolution. [e-book]. Boca Raton: CRC Press. p. 79-80. Available at: Books.google.co.uk < https://books.google.co.uk/books?isbn=1420051377> [Accessed 20 May 2015].
Futterweit, W. and Ryan, G. (2006). A patient’s guide to PCOS. New York: Henry Holt. p. 20-22 [Accessed 18 May 2015].
Glenville, M. (2012). Natural solutions to PCOS. London: Macmillan.
Glenville, M. (2012). What is Polycystic Ovary Syndrome? [online] Marilyn Glenville. Available at: http://www.marilynglenville.com/womens-health-issues/polycystic-ovary-syndrome/ [Accessed 18 May 2015].
Harding, M. (2014). Polycystic Ovary Syndrome | Doctor | Patient.co.uk. [online] Patient.co.uk. Available at: http://www.patient.co.uk/doctor/polycystic-ovary-syndrome-pro [Accessed 17 May 2015].
Lucidi, R. (2014). Polycystic Ovarian Syndrome. [online] Emedicine.medscape.com. Available at: http://emedicine.medscape.com/article/256806-overview [Accessed 18 May 2015].
Myers, T. (2009). Mosby’s dictionary of medicine, nursing & health professions. St. Louis, Mo.: Mosby/Elsevier. p. 1476
NHS 1 (2012) Polycyclic Ovary Syndrome – Introduction. Available at: http://www.nhs.uk/conditions/Polycystic-ovarian-syndrome/Pages/Introduction.aspx [Accessed 17 May 2015]
NHS 2 (2012) Polycyclic Ovary Syndrome – Symptoms. Available at: http://www.nhs.uk/Conditions/Polycystic-ovarian-syndrome/Pages/Symptoms.aspx [Accessed 17 May 2015]
NHS 3 (2012) Polycyclic Ovary Syndrome – Diagnosis. Available at: http://www.nhs.uk/Conditions/Polycystic-ovarian-syndrome/Pages/Diagnosis.aspx [Accessed 17th May 2015]
NHS 4 (2012) Polycyclic Ovary Syndrome – Causes. Available at: http://www.nhs.uk/Conditions/Polycystic-ovarian-syndrome/Pages/Causes.aspx [Accessed 17th May 2015]
NHS 5 (2012) Polycyclic Ovary Syndrome – Treatment. Available at: http://www.nhs.uk/Conditions/Polycystic-ovarian-syndrome/Pages/Treatment.aspx [Accessed 17th May 2015]
Paoli, A., Rubini, A., Volek, J. and Grimaldi, K. (2013). Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr, 67(8), pp.789-796.
Sorensen, L., Soe, M., Halkier, K. et al. (2011). Effects of increased dietary protein-to-carbohydrate ratios in women with polycystic ovary syndrome. American Journal of Clinical Nutrition, 95(1), pp.39-48. Available at: http://ajcn.nutrition.org/content/95/1/39.full [Accessed 12 June 2015].
The American College of Obstetricians and Gynecologists, (2015). Polycystic Ovary Syndrome FAQ. [ebook] The American College of Obstetricians and Gynecologists. Available at: http://www.acog.org/publications/faq/faq121.pdf [Accessed 18 May 2015].
The effect of a healthy lifestyle for women with polycystic ovary syndrome. (2011). John Wiley & Sons, Ltd, [online] (PMID: 21735412). Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0014488 [Accessed 17 May 2015].
Verity-pcos.org.uk, (2015). What is PCOS | Verity – PCOS Charity. [online] Available at: http://www.verity-pcos.org.uk/guide_to_pcos/what_is_pcos [Accessed 17 May 2015].
Milena Kaler is a qualified Registered London Nutritionist and skin specialist, stubborn weight loss, sports nutrition, and digestive health specialist, trained in the principles of Functional Medicine. She practices from 10 Harley Street, London, W1G 9PF. Milena sees patients with chronic health conditions, as well as clients looking for support to optimise their health. Some of the areas Milena can help with include: weight loss, digestive, hormonal, immune and skin health. Scientific and holistic in approach, Milena looks at all aspects of a client’s health. She embraces a systems-oriented approach aiming to get to the root cause of health and weight issues instead of simply focusing on the symptoms. Milena sees every person as an individual with different problems and different goals. She takes time to listen to her clients’ specific concerns to develop customised nutrition and lifestyle plans, based on laboratory test results. Having overcome her own chronic health and weight loss issues, Milena really understands how it is to feel overwhelmed by poor health and can relate to her clients when they first come to see her.
