When we hear the term “lifestyle diseases”, we tend to think about type 2 diabetes, obesity, high cholesterol or high blood pressure, even cancer and dementia. But rarely do we think of Poly Cystic Ovarian Syndrome (PCOS). But why so? Probably, because most of us attribute PCOS to our genes, or because most of us are oblivious to the complications that can arise due to PCOS.

Fact check

On an average PCOS affects 1 in every 10 women worldwide and if left untreated poses serious chronic health risks. There is no denying the fact that genes from both maternal and paternal pools play a role in PCOS. But genetics is not the only cause. PCOS can stem from a sedentary lifestyle coupled with a nutritionally imbalanced diet.

What is PCOS?

PCOS or Poly Cystic Ovarian Syndrome is a condition in which multiple cysts form inside the ovaries.

Our body secretes female hormones like luteinizing hormone (LH) and follicle-stimulating hormone (FSH) that regulate the monthly menstrual cycle. Ovaries contain many immature eggs inside the fluid-filled sacs called follicles.

FSH and LH help to release the most mature egg through a process calledovulation. This free egg awaits fertilization in the fallopian tube for about 12 – 24 hours and is ejected through menstruation, in case the fertilization does not occur. The remaining immature follicles degenerate.

In the case of PCOS, an abnormally high amount of LH is released that disrupts the normal menstrual cycle. As a result, some of the immature follicles end up as cysts in the ovaries, instead of getting dissolved.

In addition, blood insulin levels could also stay elevated. High insulin together with high LH, can result in excess production of a male hormone called testosterone. Abnormally high levels of testosterone prevent ovulation and lead to infertility. Testosterone is also responsible for causing many of the male pattern physical features associated with PCOS.

Signs and Symptoms of PCOS

Because of hormonal imbalance, PCOS patients showall orafew of thefollowing symptoms –

1. Menstrual cycle disruption with irregular or no periods

The healthy rangefor the menstrual cycle varies anywhere between 21 to 28 days. If the cycle is completed earlier than 21 days or later than 28 days, then a doctor’s visit would be appropriate.

2. Weight gain

If you notice unexplained weight gain, with no thyroid malfunction, then keep observingfor other signs that may indicate PCOS.

3. Infertility

If youhave been trying to conceive,but haven’t been able to,even after asubstantial time(1 year for women under 35yearsof ageand 6 months for womenabove 35 years),pleasevisit agynaecologist.

4. Hirsutism (excessive hair growth)

Due toexcess male hormone production, women with PCOS may develop hair ontheface, side of jaws, or abdomen.

5. Hair fall

The surge of male hormones in PCOS may also lead to excess hair fall and male pattern baldness in women.

6. Fatigueand Nausea

Women mayexperiencefatigueevenafter small tasks and may find it difficult to concentrateon theirwork.If youfeel drained outor anxiousoften,it could be due to PCOS.

7. Acne and excess sebum production

Excess testosterone may alsolead toexcessivesweating, andthe resultantoily skin may lead to sudden outburstsof painful acne mostly on the face and sides of the jaw.

Althoughsome of the major symptomsare listedhere,they dovary fromperson to person.

Types of PCOS

Based on theprimarycause, PCOS can beclassified into five broad types:

1. Insulin Resistance linked PCOS

This is the leadingcauseofPCOSinwomen today.An unhealthydiet, physical inactivity, mental stress, etc.,over time,leadtothedevelopment ofa condition calledinsulinresistanceand eventually PCOS.

2. Pill induced PCOS

The secondmostcommoncauseof PCOS istheconsumption of certain birth control pills.These pillscancurb ovulation leading to the formation of cysts.

3. InflammatoryPCOS

Inflammation-induced by stress,excess weight, toxins intheenvironment,andinflammation-inducingfoodcan also lead toPCOS. Headaches, skin allergies,VitaminD deficiency, and thyroid disorder together may account for inflammatory PCOS.

4. Hidden PCOS

Sometimes,PCOS can be induced by dietary deficiencies alone. This takes time to develop and stays hidden or undiagnosed for some time, hence the name.Dietary deficiencyofIodine and Zinc (required forovarian functions)can beimportant inducers.

5. Inherited PCOS

PCOS can also be genetic.InheritedPCOS canmanifestfrom as early as 13-15 years of age.Infrequent Periods, PCOSamongstimmediate relatives, excessive hairiness in males in the family, etc. are generally associated with genetics of the disorder.

PCOS and Insulin Resistance

PCOS is known to stem fromasedentary lifestyle, stress, andunhealthy food choices, whichincidentallyalso lead to insulin resistance in the body.So,although there is a correlationbetween the two conditions,a causality, if any, is yet to be proven.However,insulin resistancedoes elevate the severity of PCOSin the body.

Insulin resistanceisacondition whereinitseffectivenesstoregulateblood sugar has been impaired.So,to compensate,the body ends up producing excess insulin.This excess insulin in the bloodis known toworsen the pathology of PCOS. Therefore, to help patients with PCOS, it is vital toreverse theinsulinresistance, to the extent possible.

Health Check

If untreated, PCOS aggravates and could lead to complications like obesity, type 2 diabetes, and cardiovascular diseases- a vicious spiral.

Diagnosis of PCOS

There is no one single test forPCOS,asits symptoms are common to other diseases as well.Hence, adifferential diagnosis is generally used to eliminate other possible conditions &identify PCOS as thecause of the symptoms. Aphysical exam, endocrine blood tests, ultrasound, and metabolic blood testscan beprescribed toconfirmthe diagnosis,along withmeasurement of hormoneslike FSH, LH, and testosterone.

PCOS patients are also tested for fasting bloodglucose andinsulin to ascertain whether the patient is insulin resistant. The medications andlifestyle interventionsare thenadvised accordingly.

Beating PCOS

Though medications like Metformin are prescribed to women with PCOS,it only ends up managing the symptoms, while the underlying condition worsens.PCOS, along with its clinical and physical symptoms, canhave a lasting effectona woman’s quality of life,her overall health, and psychological well-being.Hence it is essential totake along termholisticapproach whiletreating PCOS, insteadof relying on antiandrogendrugs and other medication.

The root cause for PCOS can be addressedmostly throughcorrecting the diet,including physical activity in the daily routine, ensuring adequatesleep,reducingweight to improvetheBMI,andtaking nutritional supplements, as required.

Acompilation of basic hacks that canhelp beat PCOS:

1. Moderate Physical Activity

Physical exercises to reduce weight can not only help improve insulin sensitivity and lipid profile but also helpprevent complicationsliketype 2diabetes and cardiovascular diseases. Recommended exercise includes moderate physical activity like brisk walking, resistance training, and enduranceroutines.

2. Healthybalanced diet

Choosing and managing what to eat, when to eat & how much to eatisof utmost importancefor PCOS patients. The focusshould beonthequantumand qualityof carbohydrates, proteins, and fats, instead of blindly following any faddiet. Some dietary interventions that can helpimprove the condition:

Choosing complex carbsover“refined”–Improvesbeta-cell responsiveness& reducesfasting insulin.

Choosing foods with low GI and more fibre content–Improvesinsulinsensitivity.

Adequate intake of proteins and omega-3 fatty acids–Though there is less evidence on the effect of proteins on PCOS, a healthy intake can helpregulateyour ghrelinand leptinsecretion. This promotessatiety and fullness and thereby helpswith mood fluctuationsas well as weight reduction.

Intake of antioxidants and supplements–PCOS often leads to a decrease in the concentration of antioxidants in the body, further leading to mitochondrial dysfunction, inflammation, oxidative stress, and insulin resistance. Recommended antioxidants include superoxide dismutase (SOD) and α-lipoic acid (ALA). Along with antioxidants, supplements like inositol can help women with PCOS. They arealsofoundnaturally inabundancein foods like peas, nuts, and grains.

Key Takeaway

The root cause for PCOS can be addressedmostly throughcorrecting the diet,including physical activity in the daily routine, ensuring adequatesleep,reducingweight to improvetheBMI,andtaking nutritional supplements, as required.

Disclaimer: The information provided in this blog, or any linked materials, are not intended & should not be construed as medical advice. Please consult a certified healthcare professional in case of a medical concern.