Polycystic Ovarian Syndrome is one of the most common gynaecological conditions women are affected by, and it can be extremely frustrating to deal with. Not only does it have a marked impact on your fertility, but it could also lead to a number of secondary symptoms and metabolic issues that may be uncomfortable or embarrassing to deal with. 1. How do I know if I have PCOS? To be given a diagnosis, you need to present with at least two of the following ‘Rotterdam’ criteria: 2. Ovulatory dysfunction  This can manifest as irregular menstrual cycles with the absence of ovulation, which would be confirmed via blood work to assess your female hormone levels. 3. Raised androgen hormones Like Testosterone and Androstenedione, checked via blood testing. 4. Evidence of cystic ovaries Assessed via an ultrasound scan. But there are also numerous other signs and symptoms associated with PCOS:

• Hair loss from the scalp
• Hair growth on the face/body
• Acne
• Mood disturbance
• Low or high libido
• Weight gain
• Mood disturbance
• Sleep disturbance
• Recurrent miscarriage or problems conceiving
• Hypothyroidism (underactive thyroid gland)
• Hyperprolactinemia (declining levels of Prolactin hormone)
• Imbalance withe the adrenal hormones (DHEA/Cortisol)

PCOS is not a ‘black or white’ condition. For years, the scientific community have been debating the specific criteria that would give a woman a definitive diagnosis of PCOS. Even now, having decided upon the Rotterdam criteria as the best diagnostic method, there are still women who fall outside this definition, yet who still display clear signs of hormonal disturbance. For example, a typical PCOS patient would have tendency towards being over-weight, but there is another type of PCOS patient who may actually be quite slim, often of athletic build and yet still have elevated testosterone and or insulin resistance. It is important if you suspect you may have PCOS to get checked out sooner rather than later as it could have long-term implications for your health. 5. Are there health risks associated with PCOS? Unfortunately, yes. Apart from fertility issues there are numerous secondary health conditions that are linked to PCOS, which could affect you well beyond your reproductive years. Cardiovascular disease, obesity and type 2 diabetes are common while there may also be increased risk of endometriosis or future diagnosis of breast cancer. 6. What can I do about it? If you have been given a diagnosis of PCOS, or if you are displaying one or two symptoms and are worried that you may have a tendency towards PCOS, then improving your diet and lifestyle could make a huge difference to your health. The drug of choice for most women with PCOS is Metformin, which is typically used for patients who have type 2 diabetes, that results in elevated blood sugar levels. However, depending on medication for long-term management of your blood sugar levels is not ideal, especially when there are so many natural methods that have clinical evidence supporting their use for PCOS symptoms. 7. Diet There are currently over 400 studies on pubmed.com relating to PCOS and diet, so this should be one of the first areas to look at when trying to improve your symptoms. For a detailed analysis of what to include or avoid on a PCOS diet, you might want to check out this comprehensive article I wrote on this topic last year here. The bottom line is that avoiding sugar and processed carbohydrates is vital. Eating protein at regular intervals is also helpful as it curbs appetite and keeps your blood sugar levels on an even keel. Don’t drink your calories. Stick to water and herbal teas and leave the fizzy drinks and coffee to one side. Here are some meal swaps you may wish to try: 8. Breakfast Instead of orange juice and cereal with cow’s milk, try porridge made with almond milk with nuts, seeds and an organic boiled egg. 9. Lunch Substitute a ham sandwich and diet coke for a wholegrain wrap with roasted Mediterranean veg, hummus and turkey with a pelligrino. 10. Dinner Alternate the saturated fat-laden lasagna for teriyaki-seasoned wild salmon, stir-fried vegetables and brown rice. 11. Myo-inositol This has been the cause of understandable excitement amongst the PCOS community in recent years. This isn’t another drug, but a supplement that is part of the B complex vitamin family and is naturally occurring within the human body. It is a vital component of the body’s insulin receptors, which would explain it’s efficacy for women with PCOS. It has no known side-effects, yet has a number of proven benefits such as regulating erratic menstrual cycles, reduction of acne symptoms, assisting with weight loss and managing insulin levels. Research has found myo-inositol to be on a par with Clomid, due to its ability to induce ovulation, and there is also evidence that higher levels of myo-inositol within the body, could be a marker for improved egg quality, which is encouraging news for PCOS patients who are dealing with fertility issues. There's also evidence that cinnamon, vitamin D, omega 3 supplementation and folate have a positive impact on PCOS, so there's plenty reason to be optimistic. With a little groundwork your health symptoms could substantially improve, it only takes a few simple changes to make a difference. With almost a decade of experience in the field, Jessica Bourke has gained a reputation for helping women conceive where everything else has failed. For more from Jessica, visit jessicabourke.com.