Perhaps among the biggest gynaecological disorders to have affected urban women in India today, Polycystic Ovarian Syndrome really comes with no cure. However, making the right lifestyle choices can go a long way in dealing with the condition, finds out Bindu Gopal Rao.
It is unlikely that if you are a woman in India today, you would not know at least one person without the dreaded Polycystic Ovarian Syndrome (PCOS), or not be the one to be affected by it yourself. A study conducted by the Department of Endocrinology and Metabolism, AIIMS, New Delhi shows that about 20-25 per cent of Indian women of childbearing age suffer from the Polycystic Ovary Syndrome (PCOS). While 60 per cent of women with PCOS are obese, 35-50 per cent have fatty liver, 70 per cent have insulin resistance, 60-70 per cent have high levels of androgen, and 40-60 per cent have glucose intolerance. Also known as Polycystic Ovary Disorder (PCOD), PCOS is generally a lifestyle disorder and does not have a cure really. However, you can manage it by making some lifestyle changes.
What is causing this rampant increase?
PCOS is a common health problem caused by an imbalance of the reproductive hormones and affects women between 15 and 44 years of age. The causes of PCOS are largely unknown. PCOS affects about 11–22 per cent of adolescent girls in India and the urban/rural ratio is 25 per cent to 11 per cent. “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 have an autosomal dominant mode of inheritance. A genetic predisposition is difficult to prove as there is not enough evidence to this end. Women with PCOS have abnormalities in metabolism and production of certain hormones like androgens, oestrogens, luteinizing hormone (a pituitiary glycoprotein hormone that stimulates ovulation in females and the synthesis of androgen in males). 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, Bengaluru. Dr Sunita P Shekokar, Consultant, Obstetrics and Gynecology, Motherhood Hospitals, Bengaluru, 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. 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.”
How do I know if I have PCOS?
Most women suffering from PCOS, experience menstrual irregularities (80 per cent) 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 per cent), hirsutism or increased hair growth (45-70 per cent) and more rarely male pattern hair loss. They face difficulty in conceiving and an increased risk of miscarriage. Apart from this, women are also at risk of obesity (31-38 per cent), early diabetes (insulin resistance), high blood pressure, fatty liver, and increased risk of cerebrovascular disease (strokes etc). The lesser known associations are eating disorders, depression, endometrial cancer (related to the mucous membrane lining the womb) and sleep disorders.
The biggest problem in India is the lack of awareness about the syndrome. 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 along with women who 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.
What’s the treatment?
Despite several advances in the world of medicine, there are little improvements in the treatment of PCOS. 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 luteinising hormone levels and contributes to weight loss, if taken regularly for six months. However, it must be emphasised that the long term management of PCOS is all about 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 such as by taking hormone pills or hypoglycaemic agents (rectifying deficiency of glucose in the bloodstream), the best approach to manage this disease is by changing the lifestyle and adopting more active habits. This would include breathing exercises, yoga, meditation, dietary intervention, and herbal remedies. Acupuncture, magneto therapy, and pranic healing are also found to be helpful in treating PCOS.”
Tweak your lifestyle
Luke Coutinho, holistic nutritionist opines, “Apart from regular exercise, nutrition has a vital role to play in PCOS. Avoid junk, fried and processed food, avoid 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). Foods 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 help. Getting sound sleep for 7-8 hours is also important. Avoid stress, practice meditation, yoga to reduce stress and make walking or exercise an integral part of your life.”
High-fibre 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-fibre food include broccoli, cauliflower, sprouts, red leaf lettuce, green and red peppers, beans and lentils, tomatoes, spinach, almonds, walnuts, olive oil, fruits, such as blueberries and strawberries, and fatty fish high in omega-3 fatty acids, such as salmon. Lean protein sources like tofu, chicken, and fish don’t provide fibre, but are very filling and a healthy dietary option for women with PCOS. Instead of three big meals they should have five small meals, which helps in metabolism and in maintaining weight,” opines Dr Sunita.
So, in case, you happen to be among that percentage of women suffering from PCOS, take charge now!
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.
• According to a study by PCOS Society, one in every 10 women in India have Polycystic Ovary Syndrome (PCOS), a common endocrinal system disorder among women of reproductive age.
• Castor oil pack 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 help reduce and dissolve ovarian cysts.
• The myth that once a woman suffers from PCOD, she cannot conceive, is not true. PCOD are easily manageable.
• Flax seeds help in decreasing the androgen level in the body.
• Fenugreek helps in insulin resistance in the body, which in turn balance your hormones.
• Tulsi has anti androgenic properties which helps in managing insulin levels.
