PCOS/PCOD – an essential guide

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A study conducted by Department of Endocrinology and Metabolism, AIIMS shows that about 20-25% of Indian women of childbearing age are suffering from PCOS. While 60% of women with PCOS are obese, 35-50% have fatty liver, 70% have insulin resistance and 60-70% have high level of androgen and 40- 60% have glucose intolerance. Polycystic ovary syndrome (PCOS) or Polycystic ovary disorder (PCOD) is generally a lifestyle disorder due to improper living style habits and has no cure. However you can manage it by making lifestyle changes.

Causes

PCOS is a common health problem caused by an imbalance of reproductive hormones and affects women between 15 to 44 years. The etiology or the causes of PCOS are largely unknown.  PCOS affects about 11 – 22% of adolescent girls in India and the urban/rural ratio is 25%/11%. “It is known to run in families, so your risk of being affected by PCOS is higher if you have a mother or sister who is affected. It appears to be having an autosomal dominant mode of inheritance. A genetic predisposition is difficult prove as there is not enough evidence to this end. Women with PCOS have abnormalities in the metabolism and production of certain hormones example androgens, estrogens, luteinizing hormone. Obesity is also associated with PCOS and there is some evidence that women who are obese are at a higher risk of PCOS,” says Dr. Prathima Reddy, Director & Senior Consultant Obstetrics & Gynaecology, Fortis La Femme, Bangalore. Dr. Sunita P Shekokar, Consultant, Obstetrics and Gynecology, Motherhood Hospitals adds, “if you are insulin resistant, your body may try to pump out high levels of insulin in an effort to keep your blood sugar levels normal. Too-high levels of insulin can cause your ovaries to produce more androgens, such as testosterone. Insulin resistance may also be caused by having a body mass index above the normal range. Insulin resistance can make it harder to lose weight, which is why women with PCOD often struggle with this issue.”

Symptoms

Most women present with menstrual irregularities (80%) and cosmetic problems.  Menstrual cycles can be irregular example occurring once in 2 to 6 months as opposed to a regular cycle of 28 – 30 days. A small percentage may have no periods at all and will need medication to induce periods.  They may have prolonged heavy periods, scanty flow or irregular flow. Cosmetic problems are when girls have acne (20%), hirsutism or increased hair growth (45 – 70%) and more rarely male pattern hair loss. Women can present with difficulty in conceiving and an increase risk of miscarriages. Apart from this, women are also at risk of Obesity (31 – 38%), Early Diabetes (Insulin Resistance), High Blood Pressure, Fatty Liver, Increased risk for cerebrovascular disease (strokes etc).The lesser known associations are eating disorders, depression, endometrial cancer and sleep disorders.

Treatment

Despite several advances in the world of medicine the treatment of PCOS remains the same. This is around weight loss and lifestyle modifications. A reduction in weight helps balance out the abnormal levels of hormones and reduces the symptoms to some extent, although a complete cure may not be entirely possible. “Metformin is a drug given to diabetics.  In PCOS it reduces insulin and luteinizing hormone levels and contributes to weight loss if taken regularly for 6 months. However it must be emphasized that the long term management of PCOS is weight loss and lifestyle modifications,” says Dr. Prathima. Dr Manoj Kutteri, Wellness Director, Atmantan Wellness Centre adds, “although there are many conventional modes of treating this disease by taking hormone pills or hypoglycemic agents, the best approach to manage this disease is by changing the lifestyle and adopting more positive habits. This would include Breathing exercises, Yoga practices, Meditation, Dietary intervention and Herbal remedies. Acupuncture, Magneto therapy and Pranic healing are also found to be helpful in treating PCOS.”

Women Issue

The biggest problem in India is the lack of awareness about the syndrome. Unfortunately, the exact cause of it remains unknown. “Most researchers say that PCOS results from a combination of factors, among which genetics plays a big role. Women who suffer from obesity are also very likely to suffer from PCOS. Women, who are obese, do not exercise regularly or have a family history of diabetes. Other problems that arise from PCOS include high blood pressure, depression, and anxiety. Perhaps the most serious of these is endometrial cancer, which women suffering from ovulation problems, obesity or diabetes (all symptoms of PCOS) are particularly at risk for,” says Dr Manoj.

Take Care

Luke Coutinho, Holistic Nutritionist opines, “nutrition has a vital role to play in PCOD. Avoid junk and processed food, avoid fried food, excess sugar intake in the form of soft drinks, sweets cakes chocolates etc. (as they all cause obesity which may lead to hormonal imbalance and hence PCOS). Food should not be stored in plastic containers as plastic mimics testosterone (male sex hormone). Vitamin D supplementation, consumption of whole grains, fruits and vegetables, intake of nuts and oilseeds (MUFA and PUFA rich fats) in right quantity helps. Sound sleep for 7-8 hours helps. Avoid stress, practice meditation, yoga to reduce stress and make walk or exercise as an integral part of life.”  High-fiber foods can help combat insulin resistance by slowing down digestion and reducing the impact of sugar on the blood. This may be beneficial to women with PCOS. “Great options for high-fiber foods include broccoli, cauliflower, and sprouts, red leaf lettuce , green and red peppers, beans and lentils, tomatoes, spinach, almonds and walnuts, olive oil, fruits, such as blueberries and strawberries, fatty fish high in omega-3 fatty acids, such as salmon. Lean protein sources like tofu, chicken, and fish don’t provide fiber but are very filling and a healthy dietary option for women with PCOS. Instead of 3 big meals they should have 5 small meals, which helps in metabolism and in maintaining weight,” opines Dr. Sunita. So take charge of yourself and beat PCOS.

Did You Know?

  • It was first described by Stein and Leventhal in 1935 and was known as Stein Leventhal Syndrome until the name was changed to PCOS.
  • One in every 10 women in India have Polycystic Ovary Syndrome (PCOS), a common endocrinal system disorder among women of reproductive age, according to study by PCOS Society.
  • Castor oil packs is an age-old remedy for ovarian cysts. Castor oil clears the body of excess tissues and toxins. It also stimulates the lymphatic and circulatory systems, which helps reduce and dissolve ovarian cysts.
  • The myth is that once the women get PCOD, she cannot conceive and this is not true. PCOD are easily manageable.
  • Flax seeds help in decreasing the androgen level in the body.
  • Fenugreek helps in the insulin resistance in the body which in turn balance your hormones.
  • Tulsi hast anti androgenic properties which helps in managing insulin levels.

This story appeared in the May 2017 issue of New Woman here: Healthfile – PCOS

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