New Delhi, March 5, 2021: Ever since Lata entered puberty, she has had difficulty in managing her weight. She craved carbohydrates and even skipped dinner, but her weight increased at a faster rate month over months. Apart from her weight problem, she faced acne and Hirsutism issues (male-pattern facial hair growth). She also has visited her primary care physician on several occasions, complaining of dizziness, feeling shaky, and irregular menses. Her doctor started her on birth control pills to regulate her periods but in vain. Later, she was detected with Hypoglycemia; her physician and her family encouraged her to follow a strict diet and exercise regimen.
Lata is now married for two years and plans to begin a family but cannot conceive. She continues to struggle with severe Hypoglycemia, has elevated serum triglyceride levels and feels miserable. However, recently when Lata visited a reproductive Endocrinologist, she was diagnosed with Polycystic Ovarian Syndrome (PCOS).
Like Lata, many young women suffer from Polycystic Ovarian Syndrome (PCOS) or Polycystic Ovarian Disease (PCOD) and cannot live a healthy life. These conditions bring along complications that deteriorate the quality of life among young women. Statistics state that one in every five women in India suffers from PCOS.
DIFFERENCE BETWEEN PCOS AND PCOD: In women with PCOS, their ovaries produce higher levels of androgen than usual, which interferes with the development and release of the eggs. Some of the eggs develop into cysts – which are the little sacs filled with liquid. Instead of being released during ovulation, these cysts build up in the ovaries and even get enlarged. PCOD (Polycystic Ovarian Disease) is a condition where the ovaries release many immature or partially mature eggs, which eventually turn into cysts. Some common symptoms are abdominal weight gain, irregular periods, male pattern hair loss, and infertility. In this condition, the ovaries usually become enlarged and secrete large amounts of androgens that can cause havoc with a woman’s fertility & her body.
EFFECTIVE WAYS TO MANAGE PCOD AND PCOS: Obesity is recognized as an important contributory factor in these conditions. So, diet control, exercise, and monitored weight loss are the first line of treatment. Even 10% weight loss helps quite a lot for hormone imbalance management and in bringing body mass index <25. This also improves menstrual disorders, infertility, insulin resistance, Hirsutism, and acne.
Hormonal management with combined Oral Contraceptive Pills (OCP) is effective in reducing Luteinizing Hormone and Testosterone Hormone. PCOD/ PCOS is not a disease; it is a hormonal imbalance where male hormones increase, so we can control these hormonal changes with OCPs. Insulin resistance is associated with Diabetes Mellitus, central obesity, Dyslipidemia and Hypertension, which can be managed.
Hormonal changes cause abnormal uterine bleeding, prolonged menses, and anovulation (absence of ovulation), for Endometrial Hyperplasia, sometimes endometrial biopsy has to be done. For young females presented with infertility, ovulation induction is done with hormones. Sometimes if the person is not responding to medicine, then Laparoscopic Ovarian Drilling is done. There are rare cases where if weight loss is not possible with diet and exercise, then bariatric surgery is prescribed. Anti-androgen medicines are used for cosmetic purposes in Hirsutism patients. Laser is also used for hair removal.
So, eating the right foods and avoiding certain carbohydrates & fat helps manage the symptoms. Try to consume whole foods which are free from sugar, hormones and preservatives; fruits, vegetables whole grains and legumes should be preferred. Moreover, plant-based proteins and unprocessed high carbohydrates can improve insulin sensitivity. Try to consume more fibre in your diet, reduce the consumption of coffee. Soy, Turmeric, Cinnamon, Vitamin-D3, Calcium, Zinc, Primosa oil, and Cod liver oil should be added to your diet.
(Text by Dr Sushma Tomar, Consultant Obstetrics and Gynecology Fortis Hospital, Kalyan; Images by Soleha Shaikh, Mumbai-based nutritionist and certified diabetes educator, and calligraphy artist.)