PCOS Nutritionist London Harley Street

PCOS (POLYCYSTIC OVARY SYNDROME)

Learn how I can help you with PCOS (Polycystic Ovary Syndrome)

PCOS Nutritionist London, Harley Street

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

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.

How can a Nutritionist help with PCOS?

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. 

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) dietsEur 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].

PCOS Nutritionist London Harley Street
London Nutritionist Milena Kaler

Milena Kaler is a is a qualified London Nutritionist, weight loss, digestive health and  autoimmune disease 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.