Top 10 tips to sustainably manage PCOS

Polycystic ovary syndrome (PCOS) is a chronic condition that affects 10% of menstruating people, but about 50% of cases are undiagnosed. It also accounts for nearly 70% of infertility cases, which tends to be the main topic of discussion. 

However, in addition to fertility issues, people with PCOS are more likely to develop other chronic conditions that are often not addressed. This includes mental health issues, diabetes, heart disease, sleep apnea, endometrial cancer, and more, which is why PCOS needs to be treated as a whole-body condition.

Managing PCOS is challenging, especially when most people with PCOS are not given adequate education and resources to understand their own symptoms (1). There is no “one size fits all” solution and each treatment plan should be personalized and aligned with your lifestyle, values, and goals. That’s why we believe in finding long-term, sustainable ways to manage your PCOS while uncovering the triggers behind your symptoms. 

This journey will look different for everyone, so we’re sharing our top 10 tips to help you take control of your PCOS!

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1) Educate yourself with evidence-based resources

The first step to tackle your PCOS is to arm yourself with science-backed information and resources. In a survey, over half of participants diagnosed with PCOS felt they were not provided with proper resources or information to manage their condition. Unfortunately, this means a lot of people with PCOS are left to research the condition on their own, which can be overwhelming and time consuming. 

However, gaining a deeper understanding of PCOS is extremely empowering and can lead to more productive conversations with your doctor. This knowledge can help you recognize your own body and triggers, which is such a crucial part of symptom management. Weeding through all the (sometimes contradicting) PCOS articles can be information overload, so we’ve put together a few resources to help you get started.

• PCOS Challenge
• PCOS Awareness Association 
• American College of Obstetricians and Gynecologists (ACOG)
• Pollie’s education library

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2) Find a doctor that meets your needs

Our next tip is finding a doctor that acknowledges your needs and will support you in finding a treatment solution that feels authentic and manageable for you. This may mean seeking a medical provider that is more familiar with PCOS or seeing a specialist that can help you meet your specific goals. Most importantly, you should feel heard and be comfortable with having conversations about your health. 

If you find yourself needing additional support, you can join Pollie’s PCOS program for a personalized holistic treatment plan to supplement the existing care that you are receiving. 

You can learn more about Pollie’s interdisciplinary approach here.

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3) Ask for specific labs

Labs are incredibly useful to help you and your doctor gain a deeper understanding of your specific condition while also giving insight on what treatment option is best suited for you. Currently, there is not a set of standard labs that are drawn for PCOS, but below are some labs you can ask your medical provider to order that can shed light on what is going on inside your body.

Labs to ask for include:

• Androgens (e.g., Free testosterone, Sex hormone binding globulin (SHBG), Total testosterone, Dehydroepiandrosterone sulfate (DHEA-S))
• Metabolic markers (e.g., Hemoglobin A1c (HbA1c), Fasting glucose, Fasting insulin) 
• Lipids (e.g., HDL, LDL, Total cholesterol and ratios, Triglycerides)
• Inflammatory markers (e.g., CRP)
• Other sex hormones (e.g., Estrogen, Progesterone, Luteinizing hormone (LH), Follicle stimulating hormone (FSH)
• Vitamin D
• Vitamin B12
• Ferritin 

If ordering specific labs through your medical provider is not feasible, you can try finding a service like Ulta Labs that facilitates ordering your own labs. This option would be an out-of-pocket expense, but having these labs conducted allows you to have productive conversations with your doctor, especially if you have felt dismissed or unheard in the past. Unfortunately, this is not an uncommon experience when it comes to reproductive health, which is why entering a doctor’s visit with lab work already completed can be beneficial. 

Read more about medical gaslighting and how you can advocate for yourself here.

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4) Prepare yourself for a bit of trial and error

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Finding the best way to manage your PCOS is undoubtedly going to take a little bit of time and experimentation! You may find you have to tweak your management tools based on how you are feeling on a particular day, which is completely normal. Your body fluctuates daily based on several factors, thus learning how to cope with those changes is naturally going to be a part of your PCOS journey and prepare you for similar future situations. To keep track of your symptoms, you can write them down or document them with an app that includes a symptom tracking feature. There are several apps available to download, so play around and see which one works best for you! 

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Pollie also has a symptom tracking feature, you can check it out here!

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5) Be open-minded to different treatment approaches

In order to discover what regimen serves you and your condition best, we recommend being open-minded to different treatment options. First-line conventional treatment approaches typically include medications like birth control, metformin, and spironolactone. Many people find they are able to effectively manage their PCOS symptoms with a combination of these medications. That said, it should be noted that the trial and error mentioned above really applies here, particularly with hormonal contraceptives since there are so many options. 

On the flip side, we want to also emphasize that medication is not the only option for managing PCOS symptoms. Research shows that lifestyle changes are also effective at symptom management. While incorporating new habits into your routine is challenging and requires just as much trial and error as medication, lifestyle adjustments can make a significant impact on your symptoms. 

You also may find the best method for you is a combination of medication and lifestyle changes. Our goal is to help you find long-term solutions (whatever that may look like) that are sustainable and maintainable to support your PCOS.

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6) Discover what foods and movements feel good for you

If you have ever searched for ways to manage PCOS, you may have noticed a focus on nutrition and exercise. Despite what you see on social media, there is no perfect diet or workout that will fix your symptoms. Keep in mind that crash dieting and excessive exercise does not “fix” PCOS and tends to be harmful in the long run. This syndrome also puts people at a higher risk of developing an eating disorder, so rather than restricting your way of eating and movement, try incorporating a Health at Every Size approach to focus on shifting your mindset on health-promoting behaviors that are sustainable and manageable for you.

 When it comes to nutrition, there are endless discussions debating what style of eating is best for PCOS, whether it be keto, low-carb, gluten-free, plant-based, or a combination of these ways of diets. Every case of PCOS is unique and cutting out entire food groups is not sustainable for a lot of people.

As mentioned, trial and error really applies to finding out what foods and macros fuel your body best. If you suspect you have a food allergy or sensitivity, you can work with a healthcare professional to see what may be triggering your symptoms through an elimination diet or lab work.  

Movement for PCOS also varies on a case by case basis and can depend on what type of PCOS you have. However, you are by no means restricted by what kind of exercise you can do based solely on your PCOS type. The main goal is to move in a way that feels good for you without putting additional stress on your body. So whether that be walking, yoga, running, or something else, be mindful of how it feels for you and obtain the proper nutrition needed to fuel yourself for workouts.   

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7) Prioritize sleep and stress management

In addition to nutrition and movement, sleep and stress management are also key factors to consider if you have PCOS. While not all stress is bad, prolonged stress may cause cortisol dysfunction leading to widespread inflammation, which can exacerbate PCOS symptoms (2). If you are adding strenuous workouts that contribute even more stress on the body, this could worsen your condition (3). This vicious cycle can take a toll on not only your physical health, but mental health as well, which is why prioritizing sleep and finding effective stress management tools is a crucial part of your PCOS journey. 

Read more about sleep and PCOS here.

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8) Find support 

The symptoms and physical manifestations of PCOS are stressful in and of itself, and learning how to maneuver lifestyle changes on top of that takes a significant amount of time and energy. The journey can take a toll on your emotional health, which is a topic that is under-discussed. PCOS increases risk for depression and anxiety by 3x and recent research shows that the cost of mental health disorders associated with the condition reached nearly $6 billion in 2021 (4, 5). 

If you feel isolated, know you are not alone! Try seeking support from friends, family, or community groups. One on one therapy can also be another beneficial option if that is accessible for you. Click here to learn more about the relationship between PCOS and mental health. 

If your mental health needs immediate support, please text HOME to 741741 for free, 24/7 crisis counseling.    

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9) Think about your future goals

PCOS is the leading cause of infertility, but we want to emphasize that having PCOS does not equal infertility. While trying to conceive may come with its own set of challenges, you can absolutely have a safe and healthy pregnancy with PCOS. If starting a family is a goal that you have, start asking your doctor and care team about ways to start optimizing your fertility or egg freezing options. Even if you are not at that stage quite yet, learning about the process and implementing some of those lifestyle changes will set you up for success when you are ready. Read more about how PCOS can affect your pregnancy here.

It is also important to remember non-fertility related goals. As noted at the beginning of this article, PCOS also puts you at a heightened risk of diabetes, heart disease, stroke, endometrial cancer, and mental health conditions. This is important to keep in mind if you are someone who is childfree by choice or years away from starting a family. To learn more about the long term health risks associated with PCOS, click here.  

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10 ) Recognize your condition does not define you

Finally, our last tip is to recognize that PCOS does not define or control you. Learning how to manage PCOS can be all-consuming, but it doesn’t have to be when you have the proper resources. 

If you have questions on how you can manage your PCOS, send us an email at hello@pollie.co or download our app to obtain your personalized PCOS management plan!

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References

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1. Gibson-Helm, M., Teede, H., Dunaif, A., & Dokras, A. (2017). Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome. The Journal of clinical endocrinology and metabolism, 102(2), 604–612. https://doi.org/10.1210/jc.2016-2963
2. Hannibal, K. E., & Bishop, M. D. (2014). Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Physical therapy, 94(12), 1816–1825. https://doi.org/10.2522/ptj.20130597
3. Cortisol, Stress, and Exercise. (2019, January 10). DNAFit. Retrieved March 16, 2022 from, https://www.dnafit.com/advice/fitness/cortisol-stress-and-exercise.asp
4. Blay SL, Aguiar JV, Passos IC. Polycystic ovary syndrome and mental disorders: a systematic review and exploratory meta-analysis. Neuropsychiatr Dis Treat. 2016 Nov 8;12:2895-2903. doi: 10.2147/NDT.S91700. PMID: 27877043; PMCID: PMC5108561.
5. The Endocrine Society. (2022, June 11). Cost of mental health disorders linked with polycystic ovary syndrome almost $6 billion in 2021. EurekAlert. Retrieved July 27, 2022, from https://www.eurekalert.org/news-releases/955090 

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