For the 1 in 10 women living with PCOS - the ongoing pursuit of weight loss, or constant fear of weight gain is a burden to carry.
With no curative treatment currently available, the management of PCOS lies mostly with lifestyle measures. And weight control often takes centre stage in this discussion.
If you have PCOS and have tried unsuccessfully to lose weight or even struggle to maintain your current weight, the odds are that it is not due to a lack of effort. It is well recognised that women with PCOS will have underlying physiological mechanisms that drive weight gain over time.
The 2023 International evidence- based guideline for polycystic ovary syndrome states that “There are benefits to a healthy lifestyle, even in the absence of weight loss”. And that’s a message that I think is really important to hear … In other words, you can see / feel benefits to your health without such an intense focus on weight loss.
So what might that look like?
PCOS is a complex condition – its causes are not fully understood. It affects multiple body systems- endocrine (hormones), cardiovascular, metabolic, reproductive, psychological. A complex condition will require a considered approach. It makes sense that interventions to combat the vast array of symptoms or complications must also be wholistic.
The World Health Organisation describes health as a “state of complete physical, mental and social wellbeing, not merely the absence of disease”.
So what would a deeper dive into holistic health with PCOS be like? Here are some of my own thoughts from my own experience of working with women and PCOS for the physical, mental and social wellbeing dimensions.
- A health check with a trusted GP.
o Check in with a trusted GP, perhaps with an interest in women’s health, for a thorough health review. And do this on a regular basis to keep tabs on any changes. Book a long consult – discuss all things that are bothering you.
Check in about skin, hair, mood, digestion, menstrual cycle, sleep, energy, appetite, fertility, concerns about body image or disordered eating– anything that is bothering you. The symptoms of PCOS are so disparate – it can be hard to see all of the connections so just mention anything that is of concern. Your GP can guide you through any tests needed and a plan for monitoring.
In case you need a reminder, you are entitled to decline your consent for any discussion or measurement of weight.
o Build habits that meet the recommended physical activity patterns. The PCOS guidelines suggest that for optimal health benefits, this means at least 250 min/week of moderate-intensity activities or 150 min/week of vigorous intensities. Incorporate muscle strengthening activities (e.g. resistance/flexibility).
Work with a Women’s Health focused Exercise Physiologist to help you build in helpful activities that you actually enjoy.
- Sleep Well
o Restorative sleep is more than just getting to bed earlier. What actions can you take in the hour before bed to optimise the quality of your sleep? (Hint, think low lighting, calming routines, no screens)
- Nutrition, of course.
o There is no perfect diet to follow for PCOS. But we do know that nutrition can make a significant difference to PCOS symptoms and outcomes.
In working together, we can develop a style of eating to support your unique situation.
We could go in many different tangents but some of them might include nutrition to support a healthy menstrual cycle, optimising gut health, strategies for insulin resistance or high cholesterol, checking micronutrients, managing energy or appetite, pre-conception preparation/ fertility support, understanding weight or intuitive eating skills.
- Manage stress
o This is not just about reducing the stressors in our life. But also, processing the stress cycle of the micro / day to day stress we all experience. Think exercise, connection with loved ones, breathwork, journaling, laughing, crying, something creative.
- Professional psychological support
o Be proactive in seeking support for anxiety, depression, stress or, the experience of living with a chronic disease.
- A supportive social network
o Cultivate positive influences within your social network. Be ruthless with social media accounts and unfollow anyone who erodes your confidence or self-worth. Spend more time with those that help you feel good in yourself, who care for themselves well, and who support you in caring for yourself.
- Build a fab Pit Crew
o Build a support team around you and stay connected together for the long haul. Consider a team with a GP, Psychologist, Exercise Physiologist, Medical Specialists as needed, and of course, an Accredited Practicing Dietitian.
I hope these ideas have been a helpful, albeit long-winded, take on what holistic health with PCOS might entail. And all without a focus on weight loss or calorie counting.
PCOS is a lifelong condition and will take many ebbs and flows across a lifespan. Authentic self-care is going to be unique for everyone and will require ongoing monitoring, tweaks and at times, large-scale pivots.
If you are living with PCOS, I invite you to spend some time today reflecting on how you are tracking and what you might need next?
International evidence- based guideline for the assessment and management of polycystic ovary syndrome 2023. Copyright Monash University, Melbourne Australia 2023. The guideline can be accessed online at: