PCOs – Polycystic Ovarian Syndrome (also known as Polycystic Ovarian Disease) is spreading like a volcanic eruption in the young generation. In the developed world (western countries) its prevalence is 5- 10 %.
In Pakistan, about 33% of women diagnosed with Polycystic Ovarian Syndrome. You would see that every third person is suffering from PCOs in Pakistan now. 50% of women are suffering from PCOs all over the world, and this 50% of women are fertile, i.e. they belong to reproductive age.
What is PCOs :
As the name shows, PCOs means “Polycystic Ovarian Syndrome“. “Poly” means “Many” and “Cystic” means “Cyst” (small water packets inside ovaries). It seems as if it affects only the Ovary, but actually, it affects other organs of the body too.
Difference between PCOs and PCOD:
Polycystic Ovarian Disease (PCOD) affects only the Ovaries. It seems as if it affects only the ovaries, but actually, it affects other organs of the body too. So, it is called Polycystic Ovarian Syndrome (PCOs).
Reason For PCOs:
PCOD is an epigenetic disease. In this disease, the balance of hormones distorts causing an Imbalance Of Hormones. Levels of a hormone called LH hormone, released from the Pituitary gland, becomes very high. FSH (follicle-stimulating hormone) levels decrease.
Insulin levels secreted from the pancreas also increase. Level of estrogen increases, and the level of Progesterone increases.
In PCOs, one hormone increases, and the other one decreases i.e. when the egg is released it releases a hormone called Progesterone, which affects the second cycle of the uterus (womb) which causes periods.
If the egg does not release, the lining of the uterus will go on increasing, which causes fluffiness of the womb. There will be no periods.As a result, small cysts develop in ovaries.
Polycystic Ovarian Disease is like a vicious cycle, i.e. hormonal imbalance in a girl / lady leads to anovulation, which leads to generation of a hormone in the body which increases fat. That fat release another hormone which acts on ovary and prevents ovulation.
Testosterone levels (a male hormone), which is usually at very low levels in females, increases too in this disease.
What are the Symptoms Of PCOs?
Because of the increase in testosterone levels, symptoms like Oily skin, unwanted hairs on the face (hirsutism), skin conditions like acne appear too. Weight gain, thinning of hairs, male type baldness, problems in conception, infertility are among the major symptoms of PCOs.
More severe forms are infertility, anovulation, development of Insulin resistance, diabetes.
PCOD problem symptoms:
Signs and symptoms of PCOs range from mild to severe. In about 25% of women, PCOs remain undetected, as it’s not necessary that symptoms of PCOs are seen in every patient.
About 75% of patients show signs of menstrual irregularity, infrequent period, no menstrual cycle, the occurrence of mensturation after 3-4 months, spotting in periods, etc.
In 40% of cases, a lady suffering from PCOs suffers from Obesity too. Normally we do not measure obesity by weight only. The tool we used to measure obesity is called BMI.
To measure BMI, you have to take weight in kgs and height in m2 and divide both of them. Normal range of BMI is 18-25. If value is high than 25, it means you are among obese persons.
In PCOs, there is Hirsutism too i.e. appearance of a male kind of thick hairs specifically on the face, abdomen, around nipples, and chest. These symptoms are because of an increase in testosterone.
How do diagnose PCOs:
To diagnose PCOs, a clinical history of the patient, PCOs tests, and ultrasound are necessary. There is not any single test based on which we can diagnose PCOs.
In the patient’s history, a doctor will ask the patient about menstrual irregularities, skin condition, weight gain, unwanted hairs, etc.
Hormonal tests include;
-Levels of androgens
-Level of progesterone
– TSH levels
– and any cyst on pelvic ultrasound.
In diagnosing PCOs, we should meet 2 out of 3 criteria i.e. appearance of symptoms, ultrasound findings, menstrual problems. No single test is there to diagnose PCOs.
Does PCOs put you at risk of other serious health complications:
PCOs do not affect only ovaries, but it affects other organs too. If PCOs left untreated, many serious lifetime complications can take place i.e. Diabetes, Heart disease, Blood pressure, Uterine cancer.
In Polycystic ovarian syndrome/polycystic ovarian disease, Insulin production takes place but cell receptors on which insulin acts, do not act properly. In 70% of cases, Insulin resistance takes place.
Insulin is a hormone which is produced from Pancreas. When we eat food, it changes to glucose after digestion. Glucose absorbs in blood. Insulin helps to make energy from this glucose in the cells.
With Insulin Resistance, blood sugar level increases, so diabetes prevalence is high in PCOs. Chance of heart disease, increase in the level of cholesterol, chances of increased B. P is also there.
In Polycystic ovarian syndrome, Estrogen levels increase, and Progesterone levels decrease. Because of an imbalance in these hormones, eggs do not release in the first stage of the cycle. Menstrual irregularities take place, which leads to Endometrial Hyperplasia, which can be a cause of Endometrial Uterine Cancer in a later part of life.
An increase in Estrogen levels also increases the chances of Breast Cancer in females in the later stages of their life.
Does PCOs affect your chances of getting pregnant:
Because of obesity and menstrual irregularities, there can be problems in conception. In 75% of cases, patients suffering from PCOs can have infertility too.
Tips to get pregnant:
If a person tries to shed extra weight, and able to bring BMI in the range i.e. 18-25, chances are there that periods become regular. Insulin and Testosterone levels come to normal levels. Your unwanted hairs can disappear too. The patient will conceive as well.
How can a patient maintain a healthy lifestyle with PCOs:
Being a Doctor I want to tell you very clearly that, “You can get rid of PCOs permanently ” and “Pregnancy can cure PCOs” is a MYTH. We can control PCOs with treatment or we can minimize their effects.
The reason that PCOs are becoming common in our young generation is Environmental factors, our Sedentary lifestyle, processed food, Inorganic diet, i.e. intake of refined carbohydrates, sugary snacks, beverages, etc.
What modifications we should adopt to treat PCOs? How can we break the vicious cycle? Which modification we should do to treat PCOs naturally?
Modify your lifestyle, modify your diet, then go for the treatment. Lifestyle modification is necessary for treating PCOs/PCOD. The more you add antioxidants to your diet, the more you go towards ovulation, and PCO symptoms decrease.
Polycystic Ovarian Syndrome (PCOD) – Treatment:
Modification in dietary habits:
Modify your diet i.e. add spinach, broccoli, green leafy vegetables, nuts, legumes, mustard, sweet potato, pumpkin, blueberries, walnut, capsicum in your diet.
Decrease your caffeine consumption. Decrease consumption of skimmed dairy products. Use full-fat products. Use this high calorie in your calorie count. In this way, you will get good fats and proteins and not gain weight.
The Insulin resistance you were developing because of an increase in Insulin levels was compromising your pancreas too. Because of modification in dietary habits, chances of the development of Diabetes mellitus in later stages of life also decrease.
If you make use of turmeric and cinnamon as part of your routine, it is very beneficial too. Use of Evening Prim Rose Oil is very beneficial too.
Modification in Lifestyle:
Make Exercise and Yoga a part of your routine. Keep in mind the Exercise should be moderate. Loss your weight gradually by modifying your diet.
Increase your physical activity. You can do aerobic dances, swimming, yoga, walking, running, cycling, etc. Your physical activity should be 150-200 minutes/week, which means 35-45minutes of physical activity 5 days a week.
Modification in eating habits:
Make 3 portions of your meal, i.e. one portion should be of green leafy vegetables (salad), one portion should be of Protein(lentils, legumes, chicken, beef, mutton), and the third portion of carbohydrates. (brown rice, full grains).
Take natural organic food in your diet. Avoid processed food like junk food, tinned / canned food, deep fried food. Avoid chicken, as chicken is now being matured in short cycle, i.e. <20 days.
For this purpose many hormones and feeds (which have anabolic steroids) are being used, so that more muscle fat formed in chicken. These steroids produce a negative impact on the ovary.
PCOs treatment medication:
Medical treatment of PCOs depends upon the symptoms of the patient i.e.
If a person has menstrual irregularities, to balance I recommend the hormones Birth control pills. Estrogen and Progesterone hormones are present in balanced amount in birth control pills.
Benefits of Birth Control Pills includes regularizing of menstrual cycle., helps in conception and infertility.
We can give infertility drugs like clomifine citrate for Ovulation Induction, along with lifestyle modification. It helps the monthly release of the egg from the ovaries.
If clomifine is unsuccessful, we use Metformin. Insulin resistance is quite common in PCOs patients. Metformin helps to cure Insulin resistance, lower the insulin and blood sugar levels.
Metformin for PCOs weight loss showing excellent results. Does metformin helps you to lose weight? Lose 10kg in a month diet plan Metformin increase efficiency of pancreas by correcting Insulin sensitivity.
As discussed above, increased testosterone levels cause Acne and Hirsutism (increased male type hair growth). This excessive hair growth can be stopped too by treating hormonal imbalance. Remove the old hairs with the help of Laser or Wax, but new hair growth stops with the help of proper treatment of PCOs.
Best supplements for PCOs includes Inositol. It improves your Insulin resistance. You can take VitB. Chromium and Zinc are very good as well. Cod Liver Oil is very good to have for PCOD patients.
I would like to recommend that if Ur child has acne, irregular periods, unexplained weight gain, instead of hiding it, better consult a Doctor/Physician and go for proper treatment.
As we can control this disease and decrease its effects(keeping in mind it can never be cured completely). Otherwise, it can create serious complications in her later life.
Your comments and Queries are highly welcomed. Ask anything.
Will share proper diet plan for PCOs patients in my next article, so keep your fingers crossed. 🙂