Polycystic Ovarian Syndrome-PCOS is manifested by 1 in 5 women in India. Women with PCOS may have enlarged ovaries that contain immature follicles located in single or both ovaries as seen during an ultrasound exam whilst in normal women these follicles mature for ovulation. It is characterized with symptoms- oligomenorrhea (irregular menstrual periods), hirsutism (excessive body hair), thinning of hair, acne.
Androgen excess: Ovaries, adrenal glands produce androgens (male hormones) along with estrogens. In healthy women, 80% of testosterone is bound to a protein called sex hormone binding globulin (SHBG) made by liver. SHBG binds tightly to sex hormones found in both men and women namely estrogen, dihydrotestosterone (DHT), and testosterone. SHBG carries these three hormones throughout the blood and it controls the amount of testosterone that body tissues can use. PCOS patients show significantly higher levels of free testosterone and this free testosterone (unbound fraction) is responsible for the anovulation, hirsutism, thinning of hair, acne, menstrual irregularities and other symptoms related to PCOS.
PCOS and metabolic syndrome: Metabolic syndrome is much more common in women with PCOS than in the general female population. It is a collection of risk factors namely obesity, insulin resistance, hypertension, and dyslipidemia which are associated with the development of cardio vascular disease and type-2 diabetes. Hence, obesity is considered as one of the factors for PCOS but statistics says it occur both in obese and non-obese women with the former group at larger risk. Non-obese women with PCOS are at higher risk of having metabolic syndrome compared to women free of PCOS.
However, not all women with cysts in their ovaries exhibit same symptoms. Ethic differences, genetic factors and lifestyle, influence the symptoms greatly. Based on Rotterdam criteria PCOS is broadly classified into three groups:
- Classic PCOS: This is the most prevalent PCOS where women exhibit oligo/anovulation (irregular or no ovulation), hyperandrogenism and polycystic ovaries on ultrasound. Metabolic syndromes are present but largely influenced by body weight. Obese women at are larger risk of having this type of PCOS
- Ovulatory PCOS: Women with ovulatory PCOS have their normal menstrual cycles but exhibit polycystic ovaries and hyperandrogenism with the latter manifests itself with acne and other hair thinning problems. These groups of women have less severe insulin resistance and are at low risk at CV and diabetes compared to women with classic PCOS. Women with ovulatory pcos have normal weight or slightly increased weight but it is advisable to maintain normal body-mass index or lose extra pounds for alleviating the symptoms.
- Normoandrogenic PCOS: This is very uncommon. Women under this type exhibit anovulation and polycystic ovaries with normal androgen levels.
Lifestyle Changes: Irrespective of the type of PCOS a woman has, strict lifestyle changes are to be incorporated, as it remains the first line of therapy. Weight management has to be a priority as weight gain worsens pretty much all aspects of the syndrome and weight loss improves most aspects. A sedentary lifestyle worsens metabolic parameters and an active lifestyle improves them. Losing weight with crash diet is not advisable instead following a regulated diet plan with daily exercise routine not only improves the symptoms related to PCOS but also reduces the risk of diabetes and CV diseases.
Omega fatty acids:
Omega fatty acids are the polyunsaturated fatty acids (PUFA). The omega-6 series of fatty acids are found in higher value compared to omega 3 in vegetable oils (mainly safflower, soya bean and corn oil), margarines, and peanut and other nut butters. These series of fatty acids are known for increasing the risk of obesity. Our usual diets have higher ratio of omega-6: omega-3 fatty acids. Several sources of information suggest that man evolved on a diet with a ratio of omega 6 to omega 3 fatty acids (ω6: ω 3) of approximately 1 whereas today this ratio is approximately 10:1 to 25:1 with obvious consequences of higher incidences of metabolic and other syndromes.
Foods rich in omega-3 fatty acids: Flaxseed oil, fish oil, chia seeds, walnuts, fish roe (eggs), fatty fish, seafood and spinach.
Omega-3 fatty acid foods for PCOS: It has been reported that foods rich in omega-3 fatty acids or intake of omega-3 supplements could regulate menstrual cycles and also reduce the free testosterone levels and increase sensitivity to insulin. Walnuts among all nuts have high PUFA content, known for increasing SHBG. They also decrease LDL cholesterol, improve lipid profile.
Best quality walnuts : Borges California Walnuts
Fitness routine with omega-3 rich diets are the known so-far best and safe natural therapies for PCOS.
You can check these links. These products have maximum positive reviews:
Variations in the Expression of the Polycystic Ovary Syndrome Phenotype by Enrico Carmina
European journal of clinical nutrition
Disclaimer: The purpose of this article is for education. The information presented is not a substitute for professional medical advice, examination, diagnosis or treatment.