What is PCOS?

Polycystic Ovary Syndrome is a series of conditions that affect black women more than other racial groups of women in America, and is also the leading cause of infertility in women. Despite its name, not every woman has ovarian cysts as a symptom. You can be diagnosed as having PCOS if you have any three of the following:

• Irregular menstrual cycles or no period at all
• Weight gain or difficulty losing weight
• Skin darkening in the creases of the body
• Hirsutism, or hair on the face, chest, or other areas
• Increased acne, especially on the face and back
• Skin tags
• Thinning hair 
• Mood issues

The root cause of PCOS

Based on my experience and from reading hundreds of accounts of women online, the cause of PCOS seems to be Hyperinsulinemia, in essence, over time, the cells in your body become less sensitive to insulin from your pancreas the more they are exposed to it, leading to your pancreas creating more... etc. As ovaries are some of the most sensitive cells in the body (along with your nervous system), they create more testosterone than normal, leading to the facial hair, weight gain, acne, and male pattern baldness symptoms.

The reproductive system is also affected as it slows down ovulation, sometimes stopping it all together. In order to solve the issue of PCOS, you must treat it at the root cause, which is to reduce the amount of insulin your pacreas secretes.

What's stopping you from getting better?

I have found that the number one barrier to living a happy and full life with PCOS is one of mentality and discipline. If you are a woman with PCOS who feels there can be nothing done about it, then nothing will be done about it.

Case in point: I was picking up a prescription for Metformin (one of the treatments for PCOS) and she asked me how I was so slim. I answered that I eat a low carb diet so that I can manage my symptoms, and she seemed curious at first.

She asked if it meant that I would be eating wholegrains instead of white grains and I said "no", it meant I don't eat grains, sugar, or carbs at all. She then responded that this seemed too much like hard work. I had to laugh to myself. Imagine being able to put yourself through Pharmacy school and not having the discipline to choose a salad instead of a biscuit.

Slimming down with PCOS is hard, but it's not impossible because I've done it. I used to suffer through 45minute HIIT and Cardio sessions with a trainer, 5 times a week, without budging an inch of fat. I used to watch women who joined my exercise program later than me get muscles I couldn't dream of, and I finally said enough is enough.

So what works?

Eating a low carb diet is the only consistent way I've found to lose weight and keep it off with PCOS. It would mean giving up sugary drinks, most alcohol (actually cut it out completely for the first month), your favourite snacks, etc. But what you get is the mental clarity, the lack of the mental fog that usually follows you 2 hours after lunch. In effect, you lose the itis. Your teeth and gums are also at a reduced risk for gum disease.

Some medications that women with PCOS are prescribed are:

• spironolactone helps with weight loss and skin clarity
• metformin helps with weight loss primarily
• Combined contrateptive pills like Yasmin and Dianette (you will see the most immediate visible effect from the pill, but it still takes 28 days to see the first effects)

I would recommend that all women with PCOS supplement their diets with inositol and vitamin D3, which helps with endocrine function.

Next Steps

There is a free one week meal plan that's available here on reddithttps://www.reddit.com/r/keto/wiki/one_week_meal_plan

Further reading

Dr Jason Fung's insight on PCOS. I feel like he's one of the few doctors actually taking it seriously start with What causes PCOS? and carry on from there.