Do you have an irregular menstrual cycle? This could be a sign of PCOS, which is an imbalance of hormones from the ovaries. In this article, we go through all the interesting things to know about PCOS.

To fully understand PCOS, you also need to understand your menstrual cycle. If you have your period every month, it usually means that you also ovulate every month and if the egg is not fertilised by a sperm, you will have your period again. This is the menstrual cycle and it is counted by the number of days from the first day of your period until you get your period again.

The length of the menstrual cycle varies from woman to woman, ranging from 21-45 days. Anything within this range is considered normal, but if the number of days varies greatly from month to month, the cycle is said to be irregular, which could be a sign of some kind of hormonal imbalance in the body.

What is a hormonal imbalance?

Your ovulation is controlled by hormones in your body, which in turn control the maturation of follicles in your ovaries. If you have PCOS (polycystic ovarian syndrome), your ovaries make too much of the hormone testosterone, which means your eggs don't develop enough to ovulate at all. As a result, the follicles that have not fully matured may instead remain in the ovaries, filled with several smaller follicles, instead of detaching. These are called polycystic ovaries.

What are the symptoms of PCOS?

There are several different symptoms of PCOS, but usually it is your menstrual cycle that tells you that something is not right in the form of very irregular periods or no periods at all. Difficulty getting pregnant can also be a sign of PCOS, which is not because you don't have any eggs, but because they simply don't mature enough to release.

There are other symptoms that can also indicate PCOS, such as feeling depressed, having a reduced sex drive, lots of hair on your body or a tendency to gain weight. However, sometimes it's so sneaky that you don't have any obvious symptoms.

Why do you get PCOS?

PCOS can be hereditary, but you may not inherit it and at the same time you can get PCOS without having it in your family. There is a link between PCOS and obesity, which is simply because the hormonal system is affected by obesity, which in turn can be affected by insulin levels or imbalances in hormone levels. Insulin resistance is also a factor that can cause PCOS, but in some cases the cause of the diagnosis is not actually known.

When and how to seek help?

If you find that you are menstruating less than four times a year, have a lot more hair on your body than you used to have, or are having difficulty getting pregnant, you should contact a gynaecological clinic or health centre. At the gynaecologist, you will have a blood test to measure the levels of hormones in your blood, a physical examination, a gynaecological examination and an ultrasound scan of the ovaries to see what the follicles look like.

How does treatment work?

A treatment can be of different methods depending on what the main problem is. If you want to get pregnant, one type of treatment can be to stimulate ovulation or to treat with hormones to regulate the menstrual cycle. This method can also be used to relieve symptoms such as acne or unwanted hair growth. Treatment can also be aimed at lifestyle changes through diet, exercise or stress reduction/management.

Other tests may also be part of any treatment, such as measuring thyroid hormones as these may be affected and need to be regulated with medication.

Is there anything you can do yourself?

There are studies showing a link between our female sex hormones and stress, so an alternative route is to try to reduce stress levels on your own through activities that make you feel good and relax. Stress can be triggered by caffeine, so you may want to cut back on caffeine as well to see if your symptoms improve. Lack of sleep is also directly linked to stress, so increasing the number of hours of sleep per night can also be helpful.

A lot of research is now being done on diets that can affect serotonin levels and how diet can affect the brain and mind. What the research has shown is that levels of serotonin in the body affect insulin levels. A lack of serotonin thus regulates your insulin to lower levels, which in turn results in higher blood sugar levels in the body and this is linked to PCOS. High blood sugar can be caused by eating more than you need, not being very physically active or having an increased need for insulin due to stress.

The hormone serotonin is produced in the gut and helps the intestines to process the food we eat, and is a big part of how we feel as the hormone affects both our mood and well-being. The diet you eat can affect your gut flora and the production of serotonin, which can increase your overall wellbeing and which in turn can help with PCOS. A diet that stimulates serotonin production and balances the gut flora may therefore be recommended. You can eat foods rich in vitamin D and B12, such as oily fish and dairy products, meat and cheese. Choosing nutritious forms of carbohydrates, fat and protein is also beneficial.

Finally, by incorporating more physical activity into your daily life, you can help improve your PCOS. This could be cycling to work, taking a walk at lunch, or getting some form of exercise into your week that you enjoy!