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Thu, 21 Nov 2019

Northeast Today

Polycystic Ovarian Syndrome, What Lifestyle changes can do about it

Polycystic Ovarian Syndrome, What Lifestyle changes can do about it
October 13
12:42 2019

SEPTEMBER ISSUE, Health

Dr. Priyanka Roy, M.S (Obstetrics and Gynaecology)

 Polycystic Ovarian Syndrome, shortly known as PCOS is like the Present Cry Of the She population.

One of the most common complaint, a gynaecologist deals with on a daily basis in the OPD is about menstrual problems and lately enough or so, the scenario which tops the list is anovulatory bleeding, mostly due to PCOS. PCOS is one of the most common hormonal disorders among the women of reproductive age group. Its prevalence is highly variable, ranging from 2.2 to 26 percent globally. One in every ten women in India has PCOS and out of every ten women diagnosed with PCOS, six are teenage girls.

 

The clinical feature of PCOS can be different at different stages of the woman’s life, from adolescent to postmenopausal period. She can come as a young teenage girl with irregular menses (say menses occurring after an interval of one to two months) but with heavy and prolonged flow. Whenever it occurs; she can also come as a chubby fatty girl with acne or increased hair growth over the body along with irregular and scanty menses; she can also come with occasional lower abdominal pain or recurrent miscarriages or she might only turn up one day when she is unable to conceive even after a good conjugal life. Rest apart, polycystic ovaries can exist without any sign of the syndrome, which however may appear in later course of time.

 

What is Polycystic Ovarian Syndrome

By definition, it’s any two of the following three criteria-

  1. Oligo or anovulation (like the pattern of menses as mentioned in the above lines)
  2. Clinical or biochemical signs of hyperandrogenism (Androgen is a hormone present in both male and female, but present at a low level in females and its responsible for the male traits of reproductive activity)
  • Polycystic ovaries i.e multiple follicles arranged like a string of pearls around the ovaries.

 

It’s important to note that its consequences doesn’t only stay confined to menstrual disorder, but the metabolic derangements associated with this condition can predispose to a wide range of diseases with attendant morbidities and mortality risk- in due course of time it can lead to type 2 diabetes mellitus, dyslipidaemia, hypertension, heart diseases, endometrial cancer, ovarian cancer and infertility. Thus we see how serious is the consequences of this rampant problem.

 

Lifestyle changes can make a difference in controlling the health problem

Although PCOS has got a genetic inheritance and could be the interaction of several genes, still no single cause alone can account for the spectrum of abnormalities in PCOS. Lifestyle changes, diet, exercise, weight control can go a long way in nullifying the symptomatology of PCOS, all this by combating with Insulin resistance. Insulin is a hormone secreted by the beta cells of pancreas, that helps in the metabolism of carbohydrate, fats and protein. Insulin causes increase in the uptake of glucose by muscle and adipose tissues. This Insulin resistance and concomitant hyperinsulinaemia is one of the major culprits in aggravating the condition of PCOS. Insulin resistance decreases a substance called sex hormone binding globulin, which in turn causes increase in the amount of free testosterone in the body. Insulin resistance also alters the ovarian steroidogenesis, creating a hyperandrogenic environment, all these unfavourable for a normal menstrual or reproductive physiology in females.

 

Obesity resulting from excess nutrient intake can cause insulin resistance by an increase in the production of agents like Tumour Necrosis Factor α, that impair insulin action; and also a decrease in the production of insulin sensitizing compounds. Weight reduction decreases the level of circulating free androgen and insulin level and can also cause spontaneous resumption of menses. Regarding diet, there’s a term called “nutrient toxicity” which is an important cause of insulin resistance. Both excess glucose and excess fats can cause insulin resistance in the muscle,fatty tissues and liver; by causing impairment in glucose transport and/or impairment in beta cell function of the pancreas.

 

Role of Diet

High fibre diet and a low glycaemic index diet can combat insulin resistance by slowing down digestion, meaning they do not cause insulin level to rise as much or as quickly as other food;this is beneficial to the girl or woman with PCOS.

 

A healthy PCOS diet include foods like.. Natural unprocessed foods; high fibre foods; whole grains; nuts; legumes; leafy greens; dark red fruits such as blueberries, blackberries, cherries, red grapes; fatty fish; olive oil; broccoli, cauliflower; dried beans; spices such as turmeric.

PCOS diet should avoid- Refined carbohydrate such as pastries and white bread; Fried foods such as fast food; Sugary beverages such as sodas and energy drinks; Processed meats such as hot dogs; Solid fats; Excess red meat.

 

Obesity and the metabolic consequences of this disease are carried even to the next generation and in view of the present situation where this disease is engulfing more and more of woman each day; these present day dietary habits- the crave for fast foods, soft drinks, red meat like pork; sedentary lifestyle. All these have definitely contributed to the increase in the present scenario of this disease, keeping aside an only genetic etiology. Adequate knowledge about PCOS among the population, early diagnosis and lifestyle changes can definitely change the picture of this disease in the coming future and help us to combat this emerging health problem of the modern era.

 

(The author is a Consultant (OnG) at Swagat Hospital and Research Centre, Bongaigaon, Assam)

 

 

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