PCOS – Why an exercise physiologist should be part of your healthcare team

Polycystic ovarian syndrome, or PCOS, is a condition related to hormonal imbalances that can affect girls and women of reproductive age. Currently 8-13% of women of reproductive age are affected by PCOS, though it is thought that almost 70% of cases remain undiagnosed [1]. PCOS has a range of symptoms and presentations, with each individual being affected differently. PCOS is characterised by having at least 2 of the 3 following features:

1. Irregular/absent periods (oligo-anovulation)
2. High levels of androgens, including testosterone (hyperandrogenism)
3. Cysts on ovaries, which are detected via ultrasound

 

There are 4 different phenotypes of PCOS, depending on which combination of the above characteristics an individual may have: Phenotype A (exhibits all 3 features), phenotype B (oligo-anovulation and hyperandrogenism), phenotype C (hyperandrogenism and ovarian cysts), and phenotype D (oligo-anovulation and ovarian cysts). A diagnosis may be through your menstruation history/frequency, blood tests or medical imaging, such as ultrasound.

As mentioned above, symptoms can vary widely but may include:
– Irregular or absent periods (may lead to reduced fertility)
– Excessive facial and/or body hair growth
– Hair loss
– Obesity
– Insulin insensitivity
– Anxiety and depression
– Sleep apnoea

 

There is no cure for PCOS, however there are strategies that can be implemented to help manage the symptoms, and decrease the risk of developing common comorbidities. Medications such as oral contraceptives may be used in order to help regulate a patient’s cycle, which in turn reduces the risk of developing endometrial cancer. Insulin sensitising medications are often also prescribed to reduce the likelihood of developing type II diabetes or metabolic syndrome through reducing blood glucose levels [1].

 

So where does an exercise physiologist fit in?

If you have been diagnosed with PCOS, you will likely have a health care team consisting of your GP, an endocrinologist, gynaecologist, dietician, psychologist, and yes – an exercise physiologist! An exercise physiologist can help you with a tailored exercise program suited to your abilities that can work around your symptoms and compliment your other management strategies. Weight management is an important part of the long term management of PCOS, and this is largely done through diet and exercise. Insulin resistance, a common feature of PCOS, is thought to contribute to symptoms in 2 different ways. The first way is through causing an increase in insulin in the system which increases the production of androgens (testosterone) in the ovaries, leading to increased body and facial hair growth [2]. The second way is that this hormonal imbalance causes an increase in fat deposits in the body leading to obesity and other metabolic complications [2].

Studies have shown that 5-10% weight loss can aid in promoting normal hormone production,
helping to promote more regular periods, and consequently improving fertility [1]. It is also known
to cause mood improvements as well as reducing the risk of metabolic syndrome (high blood glucose
levels, high blood pressure, high cholesterol, obesity and insulin resistance) and cardiovascular
disease. Your exercise physiologist will work closely with you to prescribe a sustainable exercise
program as part of a long-term lifestyle intervention management plan.

If you are looking for an exercise physiologist to include as part of your healthcare team, give us a call on 02 4208 5129 or book online HERE!

 

References:
[1] Better Health Victoria (2019), ‘Polycystic Ovarian Syndrome – PCOS’; accessed 16/01/2023
<https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/polycystic-ovarian-
syndrome-pcos#bhc-content>
[2] National Institute of Child Health and Human Development (ND), ‘Polycystic Ovary Syndrome –
PCOS’; accessed 16/01/2023
<https://www.nichd.nih.gov/health/topics/factsheets/pcos>

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