6 Things You Should Know About PCOS

It's September, which means it's PCOS Awareness Month - so let's get aware, shall we? Here's 5 things you should know about PCOS, right off the bat (and here's a good overview article on PCOS if you're looking to brush up on the basics!).

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1 | The name "PCOS" is misleading

PCOS, or Polycystic Ovary Syndrome, is poorly named - not only does it affect more areas of health than your ovaries, but it also doesn't even require ovarian cysts for diagnosis. PCOS gets diagnosed using something called the Rotterdam Criteria, meaning you have to have at least two of the following:

  1. Oligo- or anovulation | I.e., you either don't ovulate, or you go a long time between each ovulation. A cycle length (from Day 1 of your period to the day before your next period) of 21-35 days is considered "normal", and if you consistently have cycles shorter than 21 days or longer than 35 days, your provider may look into this.
  2. Hyperandrogenism | Or rather, high androgens (male sex hormones, like testosterone). Clinical (visible) signs of hyperandrogenism may look like facial or body hair, or acne. To check for this, your provider may order a blood test to check testosterone levels.
  3. Ovarian cysts | These are confirmed via ultrasound, and the provider reading your ultrasound is looking at things like how many cysts you may have - because...

2 | Having ovarian cysts and PCOS are different

Ovarian cysts are actually pretty common and can be a normal part of a cycle. A cyst is essentially a fluid-filled sac, and during your follicular phase, which is the first half of your cycle during which your body selects 15-20 eggs, matures them into follicles (a fluid-filled sac, or functional cyst), and then releases the egg from the biggest/most promising follicle - aka, ovulates.

PCOS may come with ovarian cysts, but is overall a metabolic & hormonal condition, and affects more than just your ovaries. It can manifest in several ways - through hair & skin changes (see above), insulin resistance, and changes in your blood lipids (fats). 

3 | PCOS doesn't have a "look"

PCOS may be stereotyped as only existing in women in larger bodies - and that's weight stigma. I'll spare you the language used around weight in articles, but they've found that maybe half of women with PCOS live in a larger body, meaning that women with PCOS live in a large range of body sizes - you know, like normal humans.

Not all women have signs of hyperandrogenism (like acne and facial/body hair growth or hair thinning on the head), and it's not required for diagnosis. So while checking for those signs may be part of the exam, you cannot diagnose based on appearance alone. There's no "look" to PCOS, and to make assumptions based on physical appearance is to compromise patient care.

4 | Getting diagnosed can be really frustrating

Over one third of women diagnosed with PCOS wait >2 years for a diagnosis. They also usually see ≥3 health professionals to get diagnosed, and are generally unsatisfied with the amount of information they receive. To quote Julie Duffy Dillon, "PCOS is not a pamphlet disease."

PCOS is not a pamphlet disease. -Julie Duffy Dillon 

If you're struggling with a new PCOS diagnosis, in the process of learning about your body, or have been living with PCOS for some time now (or none or all of the above - we're all friends here): please know that there is healing for you, and I see you.

5 | Dieting shouldn't be part of your treatment

Dieting is often touted as the "cure-all" for PCOS while glossing over the damage it causes, such as a disordered relationship with food, weight cycling, and inflammation. So while it may seem like there's an initial improvement in symptoms, we know the vast majority of dieters regain the weight - and PCOS changes how your body's metabolism runs, making diets even more harmful. 

That being said, there's still ways to support your body with PCOS (or without!) with food - and we'll cover that in another post this month!

6 | PCOS is not your fault

You didn't do anything to cause your PCOS. While scientists are unsure about what exactly does cause PCOS, the one thing that's clear is that it's likely caused by a variety of factors, including genetics and environment. PCOS is not your fault, and there is hope and healing for all bodies.


If you've been diagnosed with PCOS and feel comfortable sharing - what was the process of getting diagnosed like for you? Do you feel your provider gave you enough information, or sent you to someone who did?

How Working At A Cupcake Shop Changed My Relationship with Food

My friend Hannah wrote the best post about eating ice cream for 60 days straight and I loved every word, then immediately texted her to ask if I could jump on the bandwagon and write about working in a cupcake shop. During the very last portion of my internship, I did a quick business rotation with The Cakery Bakery in St. Louis, MO, then got hired at their sister shop, The Cup, to do some baking.

I took on the gluten-free baking which tends to have a smaller demand than gluten-full cupcakes, so I would come in twice a week to bake and frost, take a menu item as I left (#jobperks), and head back home happy and covered in sugar.

A common and powerful tool in dieting recovery is food exposure - trying previously forbidden foods. Sometimes this gets done with a dietitian, sometimes no - please know that you deserve help if you need, and the path to dieting and ED recovery is different for each person.

A type of food exposure may look like picking one forbidden food and stocking up on it/scheduling it into your eating. So if dieting created anxiety around X food, you'd eat it daily (hopefully with the support of a counselor, friend, dietitian, or loved one). The idea is not to "get sick of" that food, but to decrease your emotional response to the food so you can approach it more calmly.

All that to say - working in a cupcake shop was basically a very structured version of a food exposure. I felt like a pretty normal eater by the time I worked at The Cup, but there is always room to grow and learn from food and experiences.

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Here's how that job taught me about my eating habits:

1 | The more freedom you give yourself, the more you learn.

I didn’t know this about myself until this job, but I don’t actually like all cake. And I don’t actually like cake all the time. I got to take something home off the menu every time I worked - so I was guaranteed a gourmet cupcake twice per week. Sometimes that felt like the right amount, sometimes I needed more and different desserts throughout the week, and sometimes I split my items with my family or friends.

I also learned that, while I like cake, I only feel strongly about a few kinds and flavors of cake. I could take or leave chocolate cake and I'm not huge on red velvet, but if chocolate chip cake or gooey butter cake popped up - I'm happily all over it. Without rules to dictate what and when you eat, there's so much more room to be discerning about what you actually like.

2 | Dessert does not ruin your day.

This is such a common component of a diet mindset - that eating something off-plan "ruins" your day - so you may as well eat more of it later since the day doesn't count. And then the week doesn't count. And you end up eating all of these off-plan foods "while you can" without regard to if you want them.

I don't mean to imply that normal eating never includes dessert or whatever else was "off-limits" for you - because it absolutely does! But it changes the mindset around these foods entirely - you can eat for reasons other than it being a good or bad dieting day. You can choose what you want freely and know that your body can handle it, and you can eat the food and be done with it instead of keeping it on your mind far past the actual eating experience.

3 | There are a million more ways to talk about food than nutrition facts.

I spent way too long referring to foods as a "good protein source" or "low calorie option", etc. It was like learning a whole new language to talk about how a cake paired with its buttercream flavor or toppings, which cakes went best with an icy cold brew, or which flavors pair together to create a cohesive looking and tasting wedding cake.

To be fully honest, I still have no idea what it means for something to taste fruit-forward, or for wine to have "good legs." But I do know that we should be talking about the textures and tastes of food just as much, if not more, than we talk about nutritional content.

Note: there is a way to do both, and it's called gentle nutrition - read more here.

4 | No food rules = more room to be picky

More than a year later, I still have found a happier rhythm and less anxiety around dessert after working at a cupcake shop. When I was in a diet mindset, I would say "yes" to every dessert, let it "ruin" my day, and not even stop to consider if it had been satisfying. But that satisfaction is so key to normal eating - so I've found I typically pass on certain kinds or flavors of cake just because I know what I like. 

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Have you had an experience with food exposures you'd like to share? I'd love to hear from you in the comments!


4 Ways to Learn About Yourself

September is PCOS (Polycystic Ovary Syndrome) Awareness Month, so we're diving into content about hormone health, periods, PCOS, and more - and kicking things off with a post about how you can learn more about yourself (periods included).

Read all the way through or just skip to the bottom if you like discounts like me!

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1| Learn about your cycle - because it's not just about your period

High school health class would have us believe that all of womanhood is summed up in the few days you actually get a period per cycle, but the star of the show is actually ovulation - when your body releases an egg. Having a working understanding of the two phases of the cycle (the follicular and luteal phases) as well as some of the hormones at plan can be super empowering and give you more insight into conversations with your OB/GYN.

Resources

2 | Track your cycle with an app or calendar

Periods are one of the best indicators of women's health there is - so keeping tabs on yours can be a great way to learn about your body plus bring data into a conversation with a healthcare provider.

Note: if you're on hormonal birth control, you don't get a "true" period - your body is preventing ovulation so any bleeding you have is breakthrough bleeding or withdrawal bleeding (if you take birth control pills and have placebo days).

Resources

3 | Use journal prompts to reflect & grow

Cheesy title, powerful practice. I'm not a huge one for journaling, but I've found with very specific prompts it's easy for me to jot something down about my thoughts, feelings, or day.

Resources

  • Reflectly App - free journaling with prompts that take <5 minutes out of your day.
  • The Intuitive Eating Workbook - highly, highly recommend this for all people. It guides you through the 10 principles of intuitive eating and encourages self-reflection to help you move out of the diet mindset.
  • "Rose & thorn" - I love this practice of writing down/typing out/thinking about the best part of your day (rose) and some pain points from your day (thorn). It's a great way to cultivate gratitude as well as provide some insight into what may improve your day tomorrow, knowing that some things are out of your grasp and some you can influence.
  • List-making - This is my favorite practice as a Type-A ENFJ because it's quick and to-the-point. List out things you find refreshing, things that would be included in your perfect day, a bucket list - this is a fab way to get journaling if you're not into writing full sentences/paragraphs or getting too introspective right off the bat.

4 | Try something new

You know that well-meaning but annoying phrase, "You'll never know until you try?" Well... it works well for this post. Try a new form of movement, a new food, a new activity - shaking up your routine and doing something unexpected is a great way to not only provide some variety but to learn about yourself. If you like it - great! If you don't - also great! Either way, you have new information to work with and you know one more thing. 

BONUS | Learn about your reproductive health with Modern Fertility

In honor of PCOS Awareness Month, I've partnered with Modern Fertility, a company that offers at-home fertility hormone testing, to give away discounts for THREE test kits. With a simple finger stick (or blood draw you can do in a lab!), you can do things like gain insight into your ovarian reserve, get access to free webinars to learn what your results mean, and spend 1:1 time chatting with a fertility nurse.

I'm giving away these exclusive discounts on my Instagram page so pop over there to see how to enter!