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Role of lifestyle modifications in Polycystic ovarian Syndrome

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By Sufora Yaseen 

Polycystic ovary syndrome is the commonest endocrine disorder in women which was first described in 1935 by American gynecologists Irving F. Stein, Sr. and Michael L. Leventhal, from whom its original name of Stein–Leventhalsyndrome is taken. Polycystic ovarian syndrome (PCOS) is a problem with hormones that affects a woman during their child bearing years (ages 15 to 44) and typically presents during adolescence. Between 2.2 and 26.7 percent of women in this age group have PCOS.

PCOS affects a women’s ovaries, the reproductive organs that produce estrogen and progesterone- hormones that regulate the menstrual cycle. In PCOS, many small, fluid filled sacs grow inside ovaries. Hence the word “Polycystic” means “many cysts”. The sacs are actually follicles, each one containing immature egg. The egg never matures enough to trigger ovulation. The lack of ovulation alters levels of estrogen, progesterone, FSH, and LH. Estrogen and progesterone levels are lower than usual, while androgen levels are higher than usual.A study conducted by the department of endocrinology and metabolism, AIIMS, shows that about 20-25 per cent of Indian women of childbearing age are suffering from PCOS. While 60 per cent of women with PCOS are obese, 35-50 per cent have a fatty liver. About 70 per cent have insulin resistance, 60-70 per cent have high level of androgen and 40-60 per cent have glucose intolerance.

 

PCOS is due to a combination of genetic and environmental factors. Risk factors include obesity, not enough physical exercise, and a family history of someone with the condition.

Signs and symptoms of PCOS include irregular or no menstrual periodsheavy periodsexcess body and facial hairacne, pelvic pain, difficulty getting pregnant, and patches of thick, darker, velvety skin. Many women with PCOS also have insulin resistance and hyperinsulinemia, which may contribute to the clinical and endocrine abnormalities.Ifnot treated, overtime it may lead  to serious health problems like  type 2 diabetesobesityobstructive sleep apneaheart diseasemood disorders, and cancer. Diagnosis is based on two of the following three findings: no ovulation, high androgen levels, and ovarian cysts. Cysts may be detectable by ultrasound

Lifestyle modification is the first line of treatment for PCOS patients because weight loss, and the prevention of weight gain, are vital to the improvement of PCOS symptoms, and a better quality of life. Lifestyle modification should take precedence regardless of whether a patient is lean, obese, taking medications, or not.

VARIOUS LIFESTYLE MODIFICATIONS INCLUDES:

1. Balance Your Daily Intake of Protein & Carbohydrates

Eating equal amounts of protein and carbohydrates assists in keeping your insulin levels even, therefore maintaining a healthy balance of hormones.

 DO’S:

  • Try to consume only wholegrain or sprouted grain products as they naturally contain more protein and fiber than their processed equivalents.
  • Fiber is another important element that assists in managing PCOS, as it slows the digestion of sugars within the body. This reduces the severity of a spike in insulin and promotes healthy estrogen metabolism, which assists in lowering androgen levels.
  • Some of the best sources of fiber include broccoli, celery, leafy greens, apples, and whole grains.

DONT’S:

  • Avoid heavily processed carbohydrates such as white flour and white rice as these causes a spike in insulin levels, while providing almost no nutrient value.

2. Eat and Drink Wisely

  • In balancing your protein and carbohydrate intake, it’s also important to consume only organic animal proteins whenever possible, as commercial products are high in added growth hormones (estrogens).
  •  This can be very damaging if you’re suffering from PCOS as it will disrupt the balance between estrogen and progesterone in your body.
  • Another thing to be mindful of is the potential presence of endocrine-disrupting chemicals such as BPA in your food and water.
  •  Endocrine-disrupting chemicals (EDCs) describe a combination of widespread pollutants often found in food products that have been transported in plastic containers or wraps.
  •  EDC’s are currently being investigated as possible contributors to PCOS after strong evidence from in vitro and animal studies showed them to be capable of causing ovarian symptoms similar to those that occur with PCOS.

3. Eat Low-GI Foods

  • Low glycemic index (GI) foods are carbohydrates that are absorbed into the body slowly and therefore don’t result in such a dramatic spike and subsequent drop in insulin levels.
  • By decreasing the amounts of high-GI foods that cause sugar spikes, such as refined sugars, white bread, simple starches and processed foods, your blood sugars will be kept in balance which will result in less extreme cravings and mood swings.
  •  Furthermore, androgens are stimulated by high blood sugar, so a low-GI diet will help to keep them in check.

4. Stay Active & Fit

  • Exercise is an important component in treating PCOS as it improves insulin sensitivity, enhances metabolism and helps to shed any excess weight which might come about as a result of hormone imbalances.
  • DO’S:
  • Try brisk walks, gentle weight lifting, yoga, or Pilates. The optimal amount of exercise to aim for is 30 minutes per day for 5 days each week.
  • DONT’S:
  • Be sure to avoid overdoing the intensity of your workouts, as too much exercise can overload the adrenal glands which may increase inflammation and irritate your PCOS further.

5. Take It Easy On The Coffee

  • Some health experts believe that caffeine can intensify PCOS.
  •  A study reported in Journal Fertility and Sterility (Mar 29 2016) shows that drinking two cups of coffee a day increases levels of estradiol, a natural estrogen, while drinking 4 – 5 cups of coffee a day produces 70% more estrogen in the follicular phase of a woman’s menstrual cycle.
  • This has the potential to substantially affect hormonal balance.

Polycystic ovarian syndrome can be a painful and discouraging condition to deal with, but with the right attitude, an active lifestyle and a wholesome diet, you can minimize its severity and continue to live a vibrant, happy life!

(The author is Tutor (Obstetrics & Gynaecological Nursing) at Government College of Nursing GMC Srinagar. Feeback at [email protected])