The second part of our PCOS series is about how to manage your PCOS through your lifestyle. Polycystic Ovarian Syndrome (PCOS) is a metabolic endocrine condition defined by high levels of androgens, driven by various underlying causes such as insulin resistance, adrenal dysfunction and inflammation, to name a few. But don’t worry, there are plenty of ways for you to manage your PCOS.
What happens when you have PCOS?
This hormonal imbalance can result in failed attempts at maturing and releasing an egg, leading to follicles (or cysts, as they are more commonly called) can develop on the ovaries which can lead to irregular cycles, absent periods and sometimes further driving those levels of androgens.
The awkward imbalance of these sex hormones, stress hormones, insulin and in some cases, thyroid hormone, can result in acne, weight gain or stubborn weight, hair loss or dark hair growth (in places you don’t want it) and many wonderful things that every woman wants to experience day in, day out.
How to manage your PCOS
If you’re yet to read part one of this three-part series on managing your PCOS, I highly recommend you head over there now. It goes into much more depth on the symptoms of PCOS, traditional allopathic treatment and medication and how you can naturally maintain optimal health with PCOS through nutrition.
We’re now going to deep dive into how you can manage your PCOS through specific lifestyle adjustments and important practices. Arguably, this piece of the puzzle is just as important as the nutrition side of things, yet for most of us can be a little harder to implement.
Managing PCOS by Reducing Stress
We know that stress is detrimental to our health, but how exactly does it influence PCOS? High levels of stress hormones, chronically, can raise circulating androgens (those unfavourable hormones that when in high amounts, can cause acne and hirsutism, for example) by lowering a binding protein called sex-hormone binding globulin.
Cortisol can further stimulate the enzyme 5-alpha reductase which converts testosterone into a more potent form, DHT, which again is often the culprit behind those symptoms. Furthermore, high levels of stress can lower progesterone, which we need for healthy cycles, and increase the conversion of testosterone into oestrogen (estradiol) via aromatisation which in itself can amplify symptoms.
Finally, stress can interfere with insulin secretion (potentially exacerbating insulin resistance, somewhat typically underlying in PCOS) by influencing blood sugar levels. In part one, we looked into how you can effectively balance blood sugar, one of the fundamental aspects of any PCOS protocol. But if you’re running full speed ahead, cortisol levels chronically elevated, it could undo all of your hard work balancing blood sugar. Managing stress is therefore crucial when it comes to supporting blood sugar levels and insulin.
Why is it important to reduce stress?
For PCOS bodies, stress reduction is a non-negotiable and similarly to diet. Most of us have to go above and beyond when implementing these practices but it really is paramount in helping you manage your PCOS. The way that you look after your body may be different from how your best friend looks after hers. Here’s a list of the practices that you can implement into your life to help actively regulate those stress hormones and soothe the adrenal glands, in turn supporting hormonal balance endocrine function.
How to reduce stress
– Prioritise sleep:
Set clear bedtimes and implement a strict wind-down routine away from tech and bright lights. Invest in a pair of blue-blocking classes as blue light lowers melatonin, a major sleep hormone.
– Start a mindfulness routine that works for you:
Consider daily meditation or breathwork (yes, daily!). Breathwork around mealtime may also help you to digest your food more efficiently.
– Set a timer on your phone to breath every hour on the hour for two-five minutes.
– Set clear boundaries for both your work life and personal life:
This means sticking to a strict schedule of emails but also ensuring that you are saying no enough to people that do not bring you joy.
– Omit caffeine if you feel it is further amplifying symptoms:
Some might argue against this, but in my opinion, if you’re feeling anxious or wired, the coffee needs to go.
– Stop dieting. Seriously:
For a lot of us, we’ve spent a huge portion of our lives trying to lose weight, especially if weight loss can be a little slow as it can be with PCOS. Constantly restricting calories and fasting is a form of stress on your body. This takes time, but we want you to be able to maintain the way you’re eating for the rest of your life.
– Get outside:
Especially if you are trying to regulate your cycle. Daylight and getting in touch with our circadian rhythm may play role in the menstrual cycle. Set outside and breath as soon as you wake up and ensure you’re getting out throughout the day.
– Find a hobby that has nothing to do with your job:
Paint, sew, knit, learn a new instrument or language, colour, cook, bake… the list goes on.
– Keep off any PCOS support groups that fearmonger rather than uplift:
This has been a personal realisation and since speaking with a client realised that whilst some of these support groups have good intentions and can help to share useful information, they can also create a lot of fear around the condition. My advice is to stick to what you know is working for you and research new practices through research-backed sources. Working with a professional, be it nutritionist, endocrinologist or naturopath is the best way to tailor a plan for your body if you are unsure.
What else can you do to reduce stress?
If you’re on it when it comes to those stress-busting practices, close to living your life as peacefully as a monk does yet are at a loss for what could still be driving your PCOS symptoms, I highly recommend working with a professional (someone who specialises in PCOS!).
A professional will be able to piece together any symptoms to determine if there are any underlying root causes or stressors that haven’t been addressed. These typically include issues within the digestive tract such as SIBO, increased intestinal permeability (also known as leaky gut), parasites, low stomach acid, to name a few, all interfere with hormone homeostasis and how well you’re absorbing your food. Other factors that are hidden forms of stress in the body include mould toxicity, heavy metal toxicity and mineral deficiencies, again, all of which are tricky to determine yet make such a difference to our health.
Reducing Stress through Movement
The way that you exercise also falls into this category of potential hidden stressors; however, I do believe we’ve all become a bit more clued up on this lately. Exercise could potentially be an added stressor on your body if you are already carrying a lot of hidden or obvious stress. If running a 10K five times a week is leaving you feeling exhausted and you’re still struggling to regulate your cycle or control your symptoms, it’s time to rethink.
How to manage your PCOS and stress through movement
– Opt for low and slow over high-intensity cardio exercise as a general rule of thumb for PCOS. It may be the case that you stop all forms of exercise with the acceptation of walking and yoga until your symptoms become more manageable, then slowly build back up.
– Prioritise weightlifting or resistance training over cardio as weightlifting can help to increase insulin sensitivity, therefore supporting the rest of your sex hormone homeostasis.
– Incorporate yoga and stretching into your routine as well as Pilates and barre. Swimming is another fabulous low-intensity exercise and walking every day is a wonderful mindful activity.
– Check-in regularly with how your exercise routine is making you feel. Do you feel exhausted when you wake up in the morning and after you exercise? Do you feel wired at night yet have a mid-afternoon slump around 4 pm? If this sounds like you, you may want to reassess your workout routine.
Stress and PCOS- Manager your PCOS
Self-care means different things for different people. If an activity or ritual makes you feel calm and supports your overall feeling of wellbeing, keep at it! Seeing an improvement in your symptoms when reducing stress can take some time, so keep putting in consistent, daily efforts and it will pay off.
Once your stress hormones become regulated and your body doesn’t feel under threat constantly, you create an environment in which your hormones can reach some form of harmony again. Here is a quick list of potential stressors to be on the lookout for. If you experience any of these, it’s time to start implementing some calming rituals or speak with a professional who can best advise on how to eliminate the more stubborn, hidden stressors.
The More Obvious Forms of Stress:
- Toxic relationships
- A career that you hate
- Bills, taxes and rent
- Family sickness or loss
- Grief or trauma
- Your PCOS symptoms themselves
The Less Obvious Forms of Stress
- Your commute
- Poor absorption/issues in the gut (SIBO, parasites, increased intestinal permeability)
- Mould toxicity
- Heavy metal toxicity
- Poor liver function
- Unruly Blood Sugar
- Alcohol consumption
- Sleep quality
- Infections or illness
- Blue light from tech
- Xenoestrogens from the environment
Megan Hallett is a women’s health expert and nutrition coach and cookbook author. Megan specialises in women’s hormone health. Her work ranges from endocrine conditions such as PCOS and Hypothalamic Amenorrhea to addressing the root cause of symptoms including acne, PMS, hair loss, low mood and fatigue, to name a few.