Polycystic Ovary Syndrome (PCOS) is a common hormonal condition in women that can cause hormonal imbalances, ovarian cysts, irregular periods & excess androgen levels. Irregular periods, usually with a lack of ovulation can make it difficult to conceive.
It affects 5 – 10% women of reproductive age between 15-44. It usually starts during puberty, but symptoms may fluctuate over time.
Causes of PCOS
The four main causes of the PCOS include:
1. Disorders of Gonadotropin Hormone Synthesis:
– In PCOS, there can be problems with the production and regulation of certain hormones, particularly gonadotropins. The human gonadotropins include the follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones which control the reproductive system. When these hormones are not produced or regulated correctly, it can lead to irregular menstrual cycles and the development of cysts in the ovaries if remain untreated.
2. Insulin Resistance:
– Insulin is a hormone that helps in regulating blood sugar levels. In PCOS, the body may become resistant to the effects of insulin. This means that even though the body is producing insulin, it doesn’t work as effectively as it should. Insulin resistance can lead to higher levels of insulin in the blood, which in turn can affect hormone production and lead to symptoms like irregular periods and excessive hair growth.
3. Excessive Body Fat:
– Having too much body fat, especially around the abdomen, can contribute to PCOS. Excessive body fat can worsen insulin resistance, leading to higher insulin levels in the blood. Additionally, fat cells can produce certain hormones that disrupt the balance of reproductive hormones in the body, further exacerbating PCOS symptoms.
4. Metabolic and Hormonal Pathways Involved in PCOS:
– PCOS involves complex interactions between various hormones and metabolic pathways in the body. One key factor is the secretion and activity of insulin, which affects the balance of other hormones. Problems in the encoding for steroidogenesis, the process of producing steroids, can also disrupt hormonal balance. These disruptions can lead to the characteristic symptoms of PCOS, such as irregular periods, ovarian cysts, and hormonal imbalances.
Risks related to PCOS
– Insulin Resistance in Women with PCOS:
Women with Polycystic Ovary Syndrome (PCOS) tend to develop Insulin resistance, it is a condition where the hormone insulin, produced by the pancreas, does not get utilized effectively by the body. Women with PCOS cannot use it efficiently, despite the fact that their bodies are producing insulin. This inefficiency causes an increased risk of developing type 2 diabetes. Normally, insulin helps regulate blood sugar levels by enabling cells to absorb glucose for energy. However, in women with PCOS, this process is compromised, causing elevated levels of glucose in the bloodstream, which can gradually result in diabetes.
– Health Risks for Overweight Women with PCOS:
Obese women with PCOS are primarily at risk of developing a range of health issues. They have a greater risk of developing type 2 diabetes. Additionally, these women may also face an increased threat of developing gestational diabetes, a condition that can complicate both the mother’s and child’s health during pregnancy. Furthermore, they are at a higher risk of having heart disease due to various factors like elevated blood pressure, high LDL-cholesterol levels (also known as “bad” cholesterol), and low levels of HDL-cholesterol (often known as “good” cholesterol). Such imbalances in levels of cholesterol can contribute to the buildup of plaque in the arteries, leading to cardiovascular problems.
Apart from concerns related to physical health, women with PCOS and obesity commonly experience sleep issues. These issues can range from insomnia to sleep apnea, impacting the overall quality of their rest. Sleep disorders not only affect their daily functioning but also contribute to a cycle of stress and fatigue, further exacerbating their health challenges.
It has been observed that by the age of 40, more than half of women diagnosed with PCOS end up developing type 2 diabetes. This highlights the urgency for effective management and preventive measures in this population.
– Mental Health Issues:
In addition to the physical challenges, PCOS is associated with various mental health problems, notably depression and anxiety. Dealing with the complexities of managing a chronic health condition, coupled with concerns about fertility and body image, can take a toll on a woman’s mental well-being. The hormonal imbalances inherent in PCOS may also contribute to mood swings and emotional distress. These mental health issues not only impact their overall quality of life but can also interfere with their ability to manage their physical health effectively.
Addressing the mental health aspect of PCOS is crucial. Providing emotional support, counseling, and access to mental health services are essential components of a comprehensive care plan for women affected by this syndrome. By recognizing and addressing both the physical and mental health aspects, healthcare providers can significantly improve the lives of women living with PCOS.
PCOS in Adolescents
Diagnosing PCOS in teenagers is hard because they’re still growing. Some signs of PCOS during puberty include having pimples (acne), periods that aren’t regular, and having too much insulin in the blood. Doctors can’t easily find PCOS using ultrasound in teenagers because their ovaries often look big and have many small sacs filled with fluid. So, finding PCOS in young people can be tricky.
Common signs of PCOS
PCOS can cause various signs and symptoms in women. These are as follows:
– Irregular Menstrual Periods: Women with PCOS often experience irregular menstrual cycles, meaning their periods might come too frequently or be unusually spaced apart. Sometimes, they might even skip periods, making it challenging to predict when the next one will occur.
– Infertility: PCOS can cause difficulties in conceiving. The hormonal imbalances and irregular ovulation patterns associated with PCOS can lead to infertility, making it harder for women with PCOS to become pregnant.
– Obesity: Research indicates that a significant number of women with PCOS are overweight or obese. The hormonal imbalances in PCOS can contribute to weight gain, especially around the abdomen.
– Excess Hair Growth (Hirsutism): One of the visible signs of PCOS is hirsutism, which refers to the excessive growth of hair in areas where men typically grow hair, such as the face, abdomen, chest, and upper thighs. This occurs due to elevated levels of male hormones called androgens in women with PCOS.
– Skin Changes: PCOS can cause skin changes, including the development of patches of thickened, velvety, and darkened skin, a condition known as acanthosis nigricans. These skin changes are often seen in body folds like the neck, groin, and under the breasts.
– Acne: Women with PCOS frequently experience severe acne. Hormonal imbalances in PCOS can stimulate the sebaceous glands in the skin, leading to increased oil production and the development of acne.
– Oily Skin: PCOS can result in oily skin due to the excess production of sebum, an oily substance that lubricates the skin. This can contribute to the development of acne and make the skin appear shiny.
– Multiple Small Fluid-Filled Sac in Ovaries: PCOS gets its name from the appearance of the ovaries in affected individuals. Inside the ovaries, multiple small fluid-filled sacs, known as cysts, develop. These cysts are actually immature eggs that haven’t matured properly due to hormonal imbalances.
These symptoms can vary in severity among individuals with PCOS, and it’s important for women experiencing these signs to seek medical attention for proper diagnosis and management.
Food to avoid during PCOS
PCOS women can benefit from avoiding some foods that increase the risk of diabetes, cardiovascular disease, obesity, and other common health issues. the foods that must be avoided are as follows:
• Refined carbohydrates like white bread
• Fried foods
• Fast foods
• sugary beverages like sodas, energy drinks etc
• processed meats
• solid fats, including margarine
• high levels of added salt or sugar & highly processed foods
It is a chronic condition that is the leading cause of infertility and cannot be cured. However, some symptoms can be improved through changing lifestyle which includes diet, physical exercise, sleep, supplementation & fertility treatments. Let us discuss these in detail.
Change your lifestyle:
Change your lifestyle to manage PCOS because it is the first step for the treatment but is not an alternative to its pharmacological treatment.
Maintain appropriate body weight, do regular physical exercise following healthy dietary patterns, and avoid tobacco & alcohol consumption. Here are some tips that will help you in changing your lifestyle.
1. Healthy Eating: Focus on eating nutritious foods like fruits, vegetables, whole grains, and lean proteins. Avoid too much sugar, processed foods, and unhealthy fats.
2. Exercise Regularly: Try to move your body every day, even if it’s just a short walk. Regular physical activity helps your body stay healthy and can improve PCOS symptoms.
3. Maintain a Healthy Weight: Being overweight can make PCOS symptoms worse. By eating well and staying active, you can work towards achieving and maintaining a healthy weight.
4. No Smoking or Alcohol: Avoid smoking and limit alcohol. Both can affect your overall health and worsen PCOS symptoms.
5. Regular Check-ups: Visit your healthcare provider regularly. They can monitor your progress, adjust your treatment plan, and provide support.
6. Manage Stress: Find ways to relax and manage stress, like deep breathing, yoga, or spending time with loved ones. Stress can worsen PCOS symptoms, so it’s important to take care of your mental well-being too.
Eating certain foods can really help women with PCOS. These include fruits and vegetables with low sugar levels, so they don’t cause quick spikes in blood sugar. It’s also good to eat smaller portions and choose foods that have low calories and a low glycemic index (GI). These foods help balance hormones in the body, making a hormone called glucagon go up and another one called ghrelin go down, which is good for women with PCOS.
Avoiding too much high fructose (a type of sugar) is important because it can make PCOS symptoms worse. On the other hand, a special diet called the ketogenic diet can be beneficial for women with PCOS who are overweight and have liver problems. This diet helps improve the menstrual cycle, lower blood sugar levels and body weight, and treat liver issues.
It’s also a good idea to include certain foods in your diet, like low-fat dairy products, fish rich in omega-3 fatty acids, small amounts of lean red meat and poultry, healthy fats, beans, and whole grain products. These choices can make a positive difference for women dealing with PCOS.
Foods to eat
Foods that can be included in a PCOS diet:-
• unprocessed & high fiber-rich foods
• fatty fish like salmon, mackerel, tuna & sardines
• dark, leafy green vegetables like Spinach & kale
• take dark red fruits, such as blueberries,cherries, red berries & blackberries
• broccoli, cauliflower, dried beans, lentils, and other legumes
• include healthy fats like olive oil
• Take nuts in your diet like walnuts, , pistachios & almonds
• dark chocolate in moderation
• spices, such as turmeric and cinnamon
Physical Exercise is really good for managing PCOS. It makes your body more sensitive to insulin, which is helpful. Insulin is like a key that helps your body use sugar properly. When you exercise, especially with energetic activities like jogging or dancing, it helps your body handle insulin better. Scientists have found that doing these kinds of exercises can improve how sensitive your body is to insulin and also help with hormones like androgens, which can be problematic for women with PCOS. So, being active is a great way to support your health if you have PCOS.
Having trouble sleeping can affect how anxiety and depression develop in PCOS. In fact, sleep issues can be one of the first signs that something might be wrong. When you don’t sleep well, it can weaken your body’s natural defenses and the pathways that help your body handle insulin. So, getting good sleep is really important for your overall health, especially if you have PCOS.
Women with PCOS may be treated with metformin, which normalizes glycemia, but its chronic intake is additionally associated with deficiencies in thiamine and cobalamin. Therefore, it is a good idea to supplement with thiamine to inhibit the mechanisms of damaging blood vessels, reducing the risk of cardiovascular diseases.
When analyzing the available literature on supplementation in PCOS, attention should be paid to vitamin D, which increases insulin synthesis and release, increases insulin receptor to expression, and increases insulin response to glucose transport.
Through studies, it has been seen that combining magnesium, zinc, calcium, and vitamin D supplementation leads to a significant reduction in hirsutism.
Treatment with Herbs
Managing insulin is crucial in treating PCOS. Using herbal infusions like Aloe vera, cinnamon, green tea, and white mulberry can be a good addition to the treatment. These herbs can help regulate blood sugar, lipids, and insulin resistance (IR).
Here are some other herbs and their benefits:
1. Aloe Vera: Aloe vera is known for its anti-inflammatory properties and can help in reducing inflammation in the body. It also supports digestion and overall gut health.
2. Cinnamon: Cinnamon helps regulate blood sugar levels, which is crucial in managing insulin resistance associated with PCOS. It also has antioxidant properties.
3. Green Tea: Green tea is rich in antioxidants and has been found to improve insulin sensitivity. It can also aid in weight management, a common concern for women with PCOS.
4. White Mulberry: White mulberry leaves contain compounds that can help lower blood sugar levels. It also has anti-inflammatory effects and supports heart health.
5. Green Mint: Green mint possesses anti-androgenic effects, meaning it can reduce the levels of male hormones (androgens) in the body. This helps in restoring normal ovarian function and hormone balance.
6. Licorice Root: Licorice root has anti-androgen and estrogen-like properties. It helps in reducing excessive androgens in the body, balancing hormone levels, and supporting menstrual regularity.
7. Turmeric: Curcumin, the active compound in turmeric, acts as a powerful antioxidant and anti-inflammatory agent. It helps in reducing oxidative stress and inflammation associated with PCOS.
8. Marjoram: Marjoram has been shown to improve hormonal levels, enhance ovarian function, increase insulin sensitivity, and reduce inflammation. These effects contribute to better overall PCOS management.
9. Vitex Agnus-Castus: Also known as chasteberry, this herb is a natural regulator of the menstrual cycle. It balances hormones, particularly the hormones involved in menstrual regularity.
10. Flax Seeds: Flax seeds contain lignans, which have estrogenic properties. They can modulate the levels of circulating sex hormones, potentially balancing hormone levels in women with PCOS.
Counseling from the Nutritionist or Dietitian in Noida at FitandCure should be taken for getting the right guidance about food to take or avoid. Some people restrict their calorie but it does not produce the expected long term effects. So, the right guidance about diet is important to improve PCOS.