Lean women can get PCOS

lean and obese pcos

With my previous posts about exercise, I thought it would be best for me to clarify that I am lean and I have PCOS.  I’m not trying to lose weight.  I just want to be more toned and be healthier in general.

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This is me today.  I am 168cm tall and weigh 58kg, BMI is 20 (that is 5ft6 and 128 pounds, I think).  When I was diagnosed about 2 years ago, I weighed between 60-63kg (BMI 22).  5 years ago, I was 56kg (BMI 19).  According to the BMI (body mass index) scale, my healthy weight range is 52-70kg.  So I have always been a really good weight.

This post has taken me a while to write, because PCOS is so poorly understood.  It gets even more confusing when you look at lean women with PCOS.  Most things you will read on the internet will say that being overweight is a major factor linked to PCOS.  Approximately 80% of women with PCOS are overweight, this is often linked with insulin resistance and so most treatment/advice is targeted at weight loss and increasing insulin sensitivity.

Now, for women like me who have “lean PCOS” and are not insulin resistant this advise seems to say “you are fine”.  This is what my doctor told me when I was diagnosed, basically “don’t put on weight”.  But we still get symptoms, so what is the go?!?

The main thing that stood out in my research was that even “normal” levels of insulin in lean women with PCOS, without insulin resistance, will lead to higher androgen levels.  There is some indication that there is increased sensitivity of the “androgenic insulin path-way”.  So, basically insulin causes more androgen to be produced in lean women with PCOS than in lean women that don’t have PCOS, even if you have what is considered to be normal levels of insulin.

There was also a bit of discussion on BPA (bisphenol a) causing increased androgen production.  There are studies to say that women with PCOS have significantly higher levels of BPA in their system than women without PCOS.  I know I’m guilty of having a lot of plastic microwave meals.  However, PCOS has been around for long time and I’m wouldn’t think that BPA has really been a contributing factor in the past.

After reading through different studies, I think there needs to be a lot more study done into the cause/causes of PCOS, rather than just focusing on the treatment of symptoms (this is important but does nothing to fix the problem).  It looks like we just have to figure out what works for us.  I really would like to cut out as much processed or unnatural substances in my body.  And then just eat and live healthy.

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23 1/2 Hours

I tend to go on exercise fads… like joining the gym and going for a couple of months as often as I can and then dropping it. Or trying the Couch to 5km programs to get me jogging and I get to week 3 and drop it. We all know how important exercise is for general health but there are specific benefits for PCOS.

I read a literature review on different studies that looked at the effects of exercise on PCOS. These are the benefits:

  • Lower insulin resistance
  • Weight loss – decrease waist to hip ratio
  • Improved ovulation and menstrual frequency (some indication that exercise helps more than diet control)
  • Better insulin sensitivity leads to decreased androgens (which should help acne and hair excess)

(This is the literature review: Exercise therapy in polycystic ovary syndrome: a systematic review by Cheryce L. Harrison , Catherine B. Lombard, Lisa J. Moran, and Helena J. Teede)

The minimum recommended exercise for anyone is 150 minutes/week (you can break this up to 30 minutes 5 times/week). I was at a professional development meeting based around exercise a couple of weeks ago and they showed us this clip.

It was interesting in the clip how that even if you don’t lose weight the exercise will benefit your health.  The Jean Hailes website on PCOS backs this up by saying that reduction in a insulin resistance will occur whether or not you lose weight (http://www.jeanhailes.org.au/health-professionals/medical-observer/1308-exercise-for-pcos-7-november-2011).

So My Plan is to get my 30 minutes of exercise a day.

  • Riding my bike to work as much as possible – This takes me about 15-20 minutes one way (about 4km) so I will be getting 30-40 minutes moderate cardio each day I do it.
  • Do pilates —  I have tried pilates in the past and love the burn it gives you. I have an old “Aerobics Oz Style” pilates DVD and I’ve tried to do it in the past. But I got bored with doing the same thing all the time, plus the lady presenting looks like she has had work done on her face and can’t change her facial expressions (so annoying). I found this blog (http://www.blogilates.com) the other day and am going to try it out. If you subscribe you get a month’s beginner’s workout calendar and you can do all the workouts along with a YouTube video. Then each month you will get a monthly workout. I’m going to try do the first month maybe twice through.

I really hope I can keep it up this time.  All the studies showed that the longer an exercise program lasted the better the benefits. I often get sick about 3-4 weeks into my exercise fads. I think I just don’t have enough nutrients and wear myself out. Does anyone else have this problem?

My story

Hi!  My name is Anna Croft.  I am 26 years old, happily married to the man of my dreams, bit of a career girl, and proud owner of a 1yr old golden retriever.  I have always lived in Queensland, Australia but would love to see as much of the world as possible.  I have been working in the health industry for about 3 years now and really enjoy helping people.

2 years ago, I was diagnosed with Polycystic Ovarian Syndrome (PCOS).  I had been having a lot of abdominal pain and an ultrasound showed multiple cysts on each ovary.  At the time, I had only heard of PCOS once or twice and really had no idea about it.  My doctor told me that I would be fine, just not to leave having kids til to late in life.  She also said that the pill was the best thing for controlling my symptoms (mainly acne) and didn’t really take much notice of the pain from the cysts.  So, I carried on with taking my oral contraceptive pill, Loette, and began to notice excessive facial hair and snail trail (technical name is hirsutism) and I continued to have painful ovaries.  So, my doctor changed my pill to Levlen ED which contains higher doses of hormones.  This seemed to fix the problems.

After getting over the initial shock of being diagnosed with PCOS, I started to read a lot about PCOS.  I really had to dig a bit deeper to find good, reliable information on managing PCOS and the risks associated with it.  I found this website particularly helpful for really good for reliable information : http://www.managingpcos.org.au/about-pcos.

I started reading the PCOS Evidence Based Guidlines (http://www.managingpcos.org.au/pcos-evidence-based-guidelines) and was shocked to find that the pill can actually lead to more insulin resistance.  This is more common in higher doses and the pill I was taking (Levlen ED) is middle of the range dose.  This scared me because, I already knew that I was at risk of diabetes with PCOS and if the pill can cause insulin resistance then the risk is increased.  I’m DO NOT want to have diabetes. I work with people that have diabetes and it is an awful disease.  However, I don’t want acne and facial hair either.

I started reading more into managing PCOS naturally which has lead me to writing this blog.  I am going to stop taking the pill and will not be taking any medication for my PCOS (I do take medication for my asthma as my lungs only function at 70% capacity without it).  This blog is a way of documenting the changes I will make and how it affects my symptoms.  It is also a way of challenging myself to keep going with the changes and not give up.

I’ve been waiting to stop the pill because my acne is the best it has been in a long time and I am maid of honour at my best friend’s wedding in a couple of weeks and don’t want to be covered in spots for that.  I’m going to start making a few changes, do more reading and try to put a post up each week.  I know that if I try to change everything at once I won’t keep it up so I’m just going to take it all one step at a time.