Polycystic Ovarian Syndrome - PCOS Presented by: Shannon Lynch, MSU Dietetic Intern 2017-18
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Polycystic Ovarian Syndrome - PCOS Presented by: Shannon Lynch, MSU Dietetic Intern 2017-18
Objectives • Identify two nutrition recommendations for those with PCOS. • Be able to refer patients to two different resources for PCOS nutrition information.
PCOS - What is it?
• The most common endocrine/reproductive disorder for women of reproductive
age.1,11
• Ovaries produce more male hormones than normal. 2,3,6,9,10
• Insulin resistance1,6,9,11
• The ovaries may develop numerous small cysts. 2,3,6,9
• Wide variety of symptoms/signs: 2,3,6,10
• Fatigue, irregular menstrual periods, infertility, acne,
weight gain, excessive hair growth on face, chest,
stomach or thighs and or patches of thickened skin.
No one body type!
Affects of Elevated Insulin Levels –
Insulin Resistance
Irregular
High High Hormone Body
menstrual
Insulin Androgens disruption image
cycles
• High CHO cravings • Hirsutism • Less than 8 per year • Satiety signaling • Anxiety/depression
• Growth hormone • Balding • Heavy/painful impacted • CHO cravings
• Potential for • Acne cramps • Increased appetite • Current “standards”
weight gain • Fatigue of body image
Diagnosing PCOS Irregular
LAB TEST RESULT periods
Testosterone 57 ng/dL (2-45 ng/dL)
total
Cysts
Glucose fasting 80 mg/dL (65-99 mg/dL) Lab
on
tests
Glucose Tol 1
hr
66 mg/dL
Ovaries
Glucose Tol 2 60 mg/dL (65-139 mg/dL)
hr Need a combination of these to
clinically diagnose.
Nutrition Implications Eating for PCOS
CCHO
Nutrition Therapy
• Main focus: improving insulin function7,10,11,14
• High fiber, CCHO, whole grains3,6,7,14
• Vitamin D6, Zinc4,5,11
• Physical activity2,3,6,9,10,14
Balance MNT Activity
• Mindful eating7,10,11 – when hormones are
stable!14
• Remember the CHO cravings/satiety signaling being
impacted. Mindful
Eating
• Increasing gut microbiome diversity13
Nutrition Related Complications • Type 2 Diabetes or Prediabetes.2,3,9,10,14 • Metabolic Syndrome. 2,3,9,10,14 • Depression & Anxiety. 2,3,9,10,14 • Higher Risk for Eating Disorders2,3,7,14
Medication Options:
Oral Contraceptives
Anti-Androgens
Metformin
Thiazolidenediones (TZD)Resources for Patients/RD’s
PCOS Nutrition Center
• http://www.pcosnutrition.com/category/pcos-
diet/
• Personal website for Angela Grassi
PCOS Network
• www.PCOSnetwork.com
• Helps locate professionals, books/resources
Project PCOS Polycystic Ovary Asssociation
• www.projectPCOS.org • www.PCOSupport.org
• Awareness, information and support • Locate professionals who treat PCOS.
• News letter
Soulcysters
Gurze Books
• www.soulcysters.net
• Message board where you can ask questions • Online catalog specializing in disordered
eatingSummary CCHO
Treatment plans focus on
improving insulin function
RD’s play a major part of the
care team Balance MNT Activity
Credible sources of
information is key!
Mindful
Everyone’s experience is Eating
uniqueCitations 1. http://www.nichd.nih.gov/. (2018). How many people are affected or at risk for PCOS?. [online] Available at: click here [Accessed 26 Mar. 2018]. 2. Medlineplus.gov. (2018). PCOS | Polycystic Ovary Syndrome | MedlinePlus. [online] Available at: https://medlineplus.gov/polycysticovarysyndrome.html [Accessed 26 Mar. 2018]. 3. Mayoclinic.org. (2018). Symptoms and causes - Mayo Clinic. [online] Available at: https://www.mayoclinic.org/diseases-conditions/pcos/symptoms- causes/syc-20353439?p=1 [Accessed 26 Mar. 2018]. 4. Grassi, A. (2018). What Does Zinc Have to Do with PCOS? A Lot! - PCOS Nutrition Center. [online] PCOS Nutrition Center. Available at: http://www.pcosnutrition.com/zinc-for-pcos/ [Accessed 26 Mar. 2018]. 5. Siahbazi, S., Behboudi-Gandevani, S., Moghaddam-Banaem, L. and Montazeri, A. (2018). Effect of zinc sulfate supplementation on premenstrual syndrome and health-related quality of life: Clinical randomized controlled trial. 6. Reference, G. (2018). Polycystic ovary syndrome. [online] Genetics Home Reference. Available at: https://ghr.nlm.nih.gov/condition/polycystic-ovary- syndrome?_ga=2.197868463.1457263996.1521490155-1773287265.1521490155#inheritance [Accessed 26 Mar. 2018]. 7. Grassi, A. (2018). New Data on Polycystic Ovary Syndrome - Today's Dietitian Magazine. [online] Todaysdietitian.com. Available at: http://www.todaysdietitian.com/newarchives/0517p12.shtml [Accessed 26 Mar. 2018]. 8. Moreira, M., Pinto, I., Mourão, A., Fajemiroye, J., Colombari, E., Reis, Â., Freiria-Oliveira, A., Ferreira-Neto, M. and Pedrino, G. (2018). Does the sympathetic nervous system contribute to the pathophysiology of metabolic syndrome?. 9. Medical Institution (2018). Polycystic Ovarian Syndrome - Made EASY. [image] Available at: https://vimeo.com/89742256 [Accessed 26 Mar. 2018]. 10. Grigorescu, V., Comeaux Plowden, T. and Pal, L. (2018). Polycystic ovary syndrome | womenshealth.gov. [online] womenshealth.gov. Available at: https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome [Accessed 26 Mar. 2018]. 11. Grassi, A. Mattei, S. (2015). PCOS Workbook. Your Guide to Complete Physical and Emotional Health. Luca Publishing, Bryn Mar PA. www.PCOSnutrition.com. 12. This Photo by Unknown Author is licensed under CC BY-NC 13. Pedro J Torres, Martyna Siakowska, Beata Banaszewska, Leszek Pawelczyk, Antoni J Duleba, Scott T Kelley, Varykina G Thackray; Gut Microbial Diversity in Women With Polycystic Ovary Syndrome Correlates With Hyperandrogenism, The Journal of Clinical Endocrinology & Metabolism, Volume 103, Issue 4, 1 April 2018, Pages 1502–1511, https://doi.org/10.1210/jc.2017-02153 14. Bruere, Terrill. All Fired Up Pod Cast: Weight Loss and Women’s Health. www.untrapped.com.au .
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