POLYCYSTIC OVARIAN SYNDROME (PCOS)

PCOS is a common endocrine disorder that affects women who are in their reproductive age. There is an imbalance of reproductive hormones resulting in symptoms like infertility, altered menstrual cycle, unwanted facial hair, weight gain, excess level of male hormones, acne and hair fall. Hormones which regulate the female menstrual cycle are progesterone and oestrogen. Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) are the other two hormones which are categorised under Gonadotropins. This is because they stimulate the gonads (testes in males and ovaries in females). Production of follicle which is a sac-like structure containing eggs is stimulated by FSH leading to LH triggering the ovary to release an egg. This release of an egg per month by the ovaries is termed as ovulation. PCOS affects both ovulation and menstrual cycle.

Studies have shown that PCOS affects approx. 5-10% of women under the reproductive age in the United States. Another study conducted by Choudhary et al.(2017) to check the prevalence of PCOS among Indian women revealed that out of 170 women participants with altered menstrual cycles, 70 women were diagnosed with PCOS. Experts say that there is no exact cause of PCOS but it is rising and urban lifestyle has been linked as one of the contributing aspects. There are certain other factors which might play role in causing PCOS like hereditary, excess production of androgens (hormones that play role in male traits), high insulin levels, obesity and excess inflammation.

PCOS AND ITS EFFECTS

  1. Women with PCOS are more likely to suffer from insulin resistance. They usually have a high Body Mass Index (BMI) and higher weight. PCOS results in a reduced metabolic rate due to which the tendency of gaining weight increases.
  2. Another significant effect and symptom of PCOS is a demonstration of insulin resistance. Insulin hormone is required for regulating the uptake of glucose by our tissues which maintains blood sugar levels. It also suppresses lipolysis (breakdown of lipids) preventing free fatty acid circulation in our blood. PCOS leads to insulin resistance which is characterised by the decreased ability of insulin to metabolise glucose. This altered mechanism increases the chances of developing type II diabetes.
  3. Women suffering from PCOS are also prone to develop cardiovascular diseases. This association has been shown in many studies where researchers found elevated levels of homocysteine in the blood of women suffering from PCOS. Homocysteine is an amino acid found in our blood and if the levels of this amino are too high then it might result in blood clots, damage our arteries and cause stroke.
  4. In addition, this disorder might increase the susceptibility to develop hypertension in women with PCOS. Among causes, insulin resistance, obesity, hyperandrogenism, dyslipidemia are believed to be the main ones.
  5. Studies have shown that approx. 90-95% of women getting treated for anovulatory infertility have PCOS. The most common effect of this disorder is infertility with prevalence varying between 70-80%. Alteration in the secretion of reproductive hormones leads to the formation of ovarian cysts which further disturbs the menstrual cycle and hence fertility. When a woman with PCOS conceives she is at a greater risk of developing gestational diabetes than a non-PCOS pregnant woman.
  6. Women with PCOS also exhibit clinical symptoms like acne vulgaris, alopecia (hair loss), hirsutism (excessive hair on chin, face, etc.), seborrhoea (dry itchy scalp) and dark skin patches on the body.

DIETARY MANAGEMENT OF PCOS

Multiple medical treatments are available for PCOS. But looking at the effects, diet is another crucial domain which should not be overlooked. In fact, dietary changes make PCOS less challenging to manage. Weight gain and insulin resistance are most common manifestations of PCOS hence following a diet which manages insulin levels and aids in maintaining a healthy weight might reduce the risk of developing metabolic and chronic degenerative diseases like diabetes, CVD and cancer.

HERE ARE SOME POINTS TO PONDER:

  • Avoid refined-based and processed foods.
  • Include plenty of fibre, both soluble and insoluble in your diet.
  • Refrain from consuming fried and fatty foods.
  • Avoid the intake of sugar and sugary beverages and desserts.
  • Avoid skipping meals.
  • Avoid overeating.
  • Manage your carbohydrate intake with more of complex carbs than simple carbs.
  • Emphasize on lean proteins.
  • Include healthy fats in the diet.
  • Consume probiotic rich foods.
  • Ensure that saturated fats make only 10% or less of the daily dietary fat needs.
  • Consume antioxidants and phytonutrients rich foods.
  • Have low-fat dairy products to manage excess saturated fat intake.
  • Avoid foods that can cause inflammation.
  • Read Nutrition Label carefully before purchasing any food item.
  • Avoid smoking and alcohol consumption.
  • Have a regular exercise schedule, involve yourself in any sport or activity you like. This will help in boosting metabolic rate, manage insulin levels and burn more calories.

To sum this up it is not impossible to manage PCOS. It is very much possible to reduce its effects by maintaining a healthy lifestyle and consuming a well-balanced diet. As soon as the symptoms appear, consult a physician or an expert and make the much needed alterations in your lifestyle.

REFERENCES

  • Choudhary, A., Jain, S., & Chaudhari, P.(2017). Prevalence and symptomatology of polycystic ovarian syndrome in Indian women: is there a rising incidence?.International Journal of Reproduction, Contraception, Obstetrics and Gynaecology,6(11),4971-4975
  • Bremer A. A. (2010). Polycystic ovary syndrome in the pediatric population. Metabolic syndrome and related disorders, 8(5), 375-94.
  • Georgopoulos, N.A., et al.(2009).Basal metabolic rate is decreased in women with polycystic ovary syndrome and biochemical hyperandrogenemia and is associated with insulin resistance.Fertility and Sterility. 92(1), 250–255
  • Diamanti-Kandarakis, E., & Dunaif, A. (2012). Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocrine reviews, 33(6), 981-1030.
  • Guzick, D.S.(2004).Cardiovascular Risk in PCOS.The Journal of Clinical Endocrinology & Metabolism, 89(8), 3694–3695
  • Bentley-Lewis, R., Seely, E., & Dunaif, A. (2011). Ovarian hypertension: polycystic ovary syndrome. Endocrinology and metabolism clinics of North America, 40(2), 433-49, ix-x.
  • Melo, A. S., Ferriani, R. A., & Navarro, P. A. (2015). Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice. Clinics (Sao Paulo, Brazil), 70(11), 765-9.
  • Hachmi L, B. S., et al.(2006).Hypertension in polycystic ovary syndrome.99(7-8):68
  • Ramani, B.V. et al.(2015).Fertility problems in women with polycystic ovary syndrome. International Journal of Reproduction, Contraception, Obstetrics and Gynecology.4(3),560-565
  • Dennett, C. C., & Simon, Judy.(2015).The Role of Polycystic Ovary Syndrome in Reproductive and Metabolic Health: Overview and Approaches for Treatment.28(2): 116-120
  • The Role of Insulin Resistance in PCOS.(2005).Retrieved from https://clinicaltrials.gov/ct2/show/NCT00173043

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