Polycystic ovarian syndrome and lifestyle interventions

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder among women in their childbearing age around 18 -25% of women all over the world suffering from this syndrome.

PCOS SYMPTOMS

Women with this PCOS can represent different symptoms, most common are following;

  • Irregular periods
  • Excess facial hair growth (HIRSUTISM)
  • Infertility or difficulty getting pregnant ( because of irregular ovulation or failure to ovulate)
  • Obesity
  • Acne and skin problems like Dermatitis.
  • Depression, anxiety, bipolar disorders and eating disorders.
  • Metabolic syndrome; hypertension, diabetes and coronary artery diseases

How to diagnose PCOS??

This condition should invite early diagnosis and intervention because there is considerable evidence that women with PCOS are at increased risk of
infertility, dysfunctional uterine bleeding, metabolic syndrome, type II diabetes, and cardiovascular disease. A Rotterdam criterion is widely used as a diagnostic assessment for PCOS. It requires two of the following three features;

  • Irregular or skipped periods
  • Anovulation
  • Multiple cysts in ovaries on ultrasound
  • Higher levels of Androgens; either manifested by symptoms like Hirsuitism, Acne or balding or biological evidence like raised levels of Testosterone in their blood tests.

Causes and risk factors;

The exact cause of this syndrome remains elusive however excess androgens production and insulin resistance may cause this syndrome. A Genetic factor is also important as several studies reported an increase incidence among first degree relatives. It is reported by studies that around 50-70% of women with PCOS have insulin resistance meaning their cells are not able to use insulin effectively. To keep body glucose normal, the body tries to pump out the high level of insulin. This hyperinsulinemia is associated with weight gain and increase production of androgen hormone testosterone. Insulin resistance makes it harder to lose weight, that’s why women with PCOS experience this issue.

lifestyle interventions for PCOS management;

According to international PCOS guideline 2018, lifestyle interventions like diet, exercise, behaviour or combined are recommended as first line management for PCOS. Several studies reported the higher prevalence of obesity and overweight in women with PCOS as compared to the general population so these prevention opportunities are particularly relevant for the management of PCOS symptoms.

How the intervention might work

Lifestyle intervention is therefore anticipated to work because a reduction in the Body Mass Index (BMI) will be associated with a reduction in insulin resistance, which will, in turn, lead to an improvement in the reproductive and metabolic features of PCOS. Weight loss of as little as 5-10% has been demonstrated to correct oligo anovulation and improve the ability of women with PCOS to conceive.

PCOS nutrition ;

its is frequently asked by women with PCOS that which diet is best for curing their symptoms but unfortunately there is no such miracle diet. Research shows that diet which reduces insulin resistance like some carbs, proteins and healthy fats may help in improving menstrual irregularities and obesity.

➡️choose your carbs wisely as all carbs are not bad… carbohydrates with high fibre content like whole grains, lentils, legume and beans are helpful in reducing weight and risk of type 2 diabetes in women with PCOS.

➡️ Food with a low glycemic index (a ranking system indicate how rapidly blood sugar level rises after eating carbohydrates) may reduce insulin resistance as reported by several studies.

➡️ Protein may helps in cravings, balance hormones levels and aid in weight reduction, examples are lean meat, egg, seafood and plant based proteins. some evidence has suggested the beneficial effect of a diet with higher ratio of protein to carbohydrates.

➡️ Food that reduces inflammation as; tomato, spinach, olive oil, walnuts, almonds, blueberries and strawberries.

Food to avoid;

  • Food high in refined carbs like white bread, Muffins, white pasta
  • sugary drinks like soda and juices as they increase blood sugar levels, which can lead to weight gain and worsen the symptoms of PCOS.
  • Processed food and red meat.

Review the stress in your life;

stress increases cortisol level and this high level is linked with insulin resistance and weight gain. yoga and meditation can reduce stress as reported by studies.

Make sure you are getting enough sleep:

Several studies observed that short sleep duration is significantly associated with metabolic abnormalities, including higher BMI, raised fasting insulin levels, and increased risk of insulin resistance. Make sure you are getting enough and good quality sleep.

Get active;

Regular physical activity may help in reducing insulin resistance. studies have shown that low intensity exercise like walking or cycling reduces levels of cortisol and helps in reducing insulin resistance.

Consider supplements;

certain supplements like vitamin D, Myo inositol may help manage weight and other symptoms of PCOS though there is very little research is available to recommend these supplements for PCOS.

Take-home message;

PCOS is distressing for most of the women due to its symptoms and it is suggested by clinicians and dietitians that life style modification is the first line treatment for overweight and obese women.However due to diversity of symptoms one size does no fit for all. Make healthy food choices and create workout plan that suits your body and your PCOS….

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s