I am so Scared I have PCOS

A place to get your questions answered from McDougall staff dietitian, Jeff Novick, MS, RDN.

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I am so Scared I have PCOS

Postby Callalilly » Tue Mar 04, 2008 5:16 pm

Hi Jeff,

Great to have you here. I have a question regarding PCOS (Polycystic Ovarian Syndrome). I had very irregular periods all of my life, I would go four months without a period. When I was 21 I went to the see an endoctrinologist and he ran countless tests on my blood, urine, ultrasound, and MRI. He ruled out PCOS (saying it is hard to diagnose and I really did not have the internal symptoms) and concluded my irregular periods were due to stress (I am a chronic worrier). So of course he put me on the pill and I remained on it for about 8-9 years, which of course I had periods like clockwork. I am 30 now and have gotten married and I am considering starting a family so three months ago I came off the pill. I got two periods each right on time, now it is March 4 and I have not had a period since Jan 19. I am so scared I have something wrong with me where I will not be able to have children. Maybe I have had PCOS all this time and masked it with the pill? Can a McDougall type of diet get hormones back on track? What kind of tests do you suggest I get done? Have you ever heard of this kind of problem before? I am not sure if this is your line of work but I figured it would not hurt to ask. Thanks
Calla
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Re: I am so Scared I have PCOS

Postby JeffN » Tue Mar 04, 2008 6:26 pm

Callalilly wrote: Can a McDougall type of diet get hormones back on track? What kind of tests do you suggest I get done? Have you ever heard of this kind of problem before? I am not sure if this is your line of work but I figured it would not hurt to ask. Thanks


Hi Calla.

Thanks. Glad to be here.

High fat (and also low fiber) diets (and alcohol) have been shown to negatively effect hormone levels so following a healthy low fat high fiber diet can be helpful.

I am not sure of what tests you should have done as that is not one of my areas of specialty . Perhaps Dr Mcd can be of help there.

I am familiar with PCOS, if that is what you have, and there are several known important issues that have been shown to help PCOS from a healthy diet and lifestyle. These include reducing weight and reducing insulin resistance.

From...

Farshchi H, Rane A, Love A, Kennedy RL.Diet and nutrition in polycystic ovary syndrome (PCOS): Pointers for nutritional management. J Obstet Gynaecol. 2007 Nov;27(8):762-73.PMID: 18097891

The article states...

"PCOS patients are not always markedly overweight but PCOS is strongly associated with abdominal obesity and insulin resistance. Effective approaches to nutrition and exercise improve endocrine features, reproductive function and cardiometabolic risk profile - even without marked weight loss."

and...

... Conclusions

"PCOS is a complex disorder due, in part but not exclusively to, insulin resistance and overweight. In practice, its management is often not entirely satisfactory from the patient's point of view. Treatment of PCOS may be divided as follows: (1) Attention to lifestyle factors including diet and exercise. (2) Management of specific aspects such as menstrual irregularity, anovulatory infertility, and hirsutism. (3) Dietary and exercise interventions to promote weight loss and improve glucose tolerance. (4) Pharmacological interventions to improve insulin sensitivity or to assist with weight loss. A scheme for management of the overweight or insulin resistant patient with PCOS is proposed in Figure 1. Although there has been a general increased interest in the role of lifestyle modification to favourably alter the clinical features of PCOS, much of what has been learned is by inference from the non-PCOS population. There is relatively little specific information on nutritional recommendations for patients with PCOS (Stein 2006; Hoeger 2006). The focus, to date, has been on the macronutrient components of the diet. Evidence is beginning to emerge that micronutrients are also important. Thus, there may be benefits to supplementation with omega-3 fatty acids and antioxidants (Stein 2006), and low vitamin D levels in some patients may contribute to the metabolic features of the syndrome (Hahn et al. 2006). Some early evidence supports non-pharmacological treatment including herb and nutritional supplements (Dennehy 2006; Westphal et al. 2006)."

The following general recommendations are adapted (and slightly modified by me :) to make them healthier) from the above article ...

1. Focus your diet on low calorie foods to lose weight without hunger.

2. Exercise regularly: 30 min of moderate exercise daily will help to maintain body weight. More prolonged or vigorous exercise may be needed to produce weight loss.

3. Eat no more than 15% of daily calories from fat, restricting saturated fat to <5-7% total calories.

4. Eliminate refined carbohydrates. This is especially important in the beginning. For a better understanding or refined vs unrefined, read the newsletters at my website on this topic

5. Focus on higher soluble fiber foods like beans, oats, yams, barley and berries

6. Avoid red meat. Ensure adequate essential fat and Vit D intake. A TB of ground flax or 1 oz of English walnuts per day can help with essential fats and 10-20 minutes a day in the sun can help with the Vit D.

7. Eat at least 12 servings of fruit or vegetable per day. This promotes satiety, supplies fiber and maintains the micronutrient content of the diet.

8. Eat regularly and focus food intake on three (maximum four) meals per day.

9. Avoid calorie-dense snacks as they promote hyperinsulinaemia and drive hunger. Avoid liquid calories especially fruit juices, and alcoholic drinks which are often forgotten but are rich in calories and carbohydrates.

10. Even modest weight loss has health benefits. Achieving this requires creating an energy deficit which is best achieved thru a diet of low calorie foods with 30-60 minutes of vigorous exercise a day.

I hope this helps

In Health
Jeff Novick, MS, RD
Last edited by JeffN on Tue Mar 04, 2008 7:00 pm, edited 1 time in total.
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Postby Callalilly » Tue Mar 04, 2008 6:41 pm

Thank you very much for the quick response, very thorough too. I will take your recommendations into account and watch my fat intake, I do eat a vegan diet with maybe a bit too many nuts and oils. I am a thin girl and always have been except around my mid section. Also I have had no excercise this entire winter, have not seen the sun in weeks, and have been under a lot of stress in the workplace. I am in northeast, we don't have much sun here these days. I will add some excercise and try to elminate oils and white flour products, also I wil go easy on the nuts and seeds (I was on the Fuhrman diet which encourages nut and seed eating). I very appreciative of your speedy reponse, thanks.
Calla
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Postby Callalilly » Tue Mar 04, 2008 6:42 pm

Thank you very much for the quick response, very thorough too. I will take your recommendations into account and watch my fat intake, I do eat a vegan diet with maybe a bit too many nuts, oils and alcohol. I am a thin girl and always have been except around my mid section. Also I have had no excercise this entire winter, have not seen the sun in weeks, and have been under a lot of stress in the workplace. I am in northeast, we don't have much sun here these days. I will add some excercise and try to elminate oils and white flour products, also I wil go easy on the nuts and seeds (I was on the Fuhrman diet which encourages nut and seed eating). I very appreciative of your speedy reponse, thanks.
Calla
Callalilly
 
Posts: 366
Joined: Thu Jan 04, 2007 7:40 am

Postby Autumn » Thu Mar 06, 2008 6:21 pm

I was told I had pcos in 1998. I had infertility and treatments to have my daughter and I also dealt with miscarriages due to it. I have an atypical form. as I do not have any symptoms of it but insulin resistance, weight gain, and infertility. I did not have hair issues or acne. When I found out I had celiac disease and went gluten free I started getting my periods on a regular basis (something that never happened on its own) after around six months of being on the diet and I have been getting them monthly three years later. If my eyes were in better shape I would be able to conceive easily as everything appears to be in working condition now. My sister who has pcos also was an atypical case too with no hair issues or acne and she used IVF treatments to become pregnant with her first and second child. Thanks to a gluten free diet her third child came as a surprise to her after a year of going gluten free.

Im not sure if I truly have pcos. There are others who have celiac/gluten intolerance and had fertility problems prior to the diet. There is a website of a lady named Cassie who became a raw vegan (getting rid of gluten and animal products) and all of her pcos symptoms disappeared.

This may not answer it for you but I thought I would mention it :) I wish you the best of luck with having children I know personally how hard infertility is.
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