Polycystic Ovarian Disease /Polycystic ovarian Syndrome

What is Polycystic Ovarian Disease?

Polycystic Ovarian Disease (PCOD), also known as Polycystic Ovary syndrome (PCOS) is a very common condition affecting 5% to 10% of women in the age group 12–45 years.

It is a problem in which there is a hormonal imbalance

It can cause problems with menstrual periods and make it difficult for a women to conceive.

The principal features include no ovulation, irregular periods, acne and hirsutism.

If not treated it can cause insulin resistant diabetes, obesity and high cholesterol leading to heart disease.

What causes Polycystic Ovarian Disease (PCOD)?

• Normally, the ovaries make female sex menhormones and a tiny amount of male sex hormones (androgens). These help regulate the normal development of eggs in the ovaries during each menstrual cycle.
• Polycystic ovary syndrome is related to an imbalance in these sex hormones. In PCOS, they start making slightly more androgens. This causes patients to stop ovulating, get pimples and grow extra facial and body hair.
• Follicles are sacs within the ovaries that contain eggs. Normally, one or more eggs are released during each menstrual cycle. This is called ovulation.
• In polycystic ovary syndrome, the eggs in these follicles do not mature and are not released from the ovaries. Instead, they can form very small cysts in the ovary, hence the name polycystic ovaries.
• PCOS seems to run in families, so the chance of having it is higher if other women in the family have PCOS, irregular periods, or diabetes

Common symptoms of PCOD/PCOS include:

• Acne
• Weight gain and trouble losing weight
• Extra hair on the face and body. Often women get thicker, darker facial hair and more hair on the chest, belly, and back.
• Thinning hair on the scalp
• Irregular periods. Often women with PCOS have fewer than nine periods a year. Some women have no periods others have very heavy bleeding
• Fertility problems. Many women who have PCOS have trouble getting pregnant (infertility)
• Depression
• In addition, 80 percent of PCOS patients tend to be overweight and have excess belly fat.Because of their weight, PCOS patients often have higher rates of sleep apnea, joint pain, and infertility as well

Investigation

Blood sugar estimation,

Thyroid hormone tests,

Ultrasound of the abdomen and pelvis are done.

pcos as in USG pelvis investigation

Sometimes serum androgens, luteinising hormone and other hormone estimations may be ordered

Treatment

The medical treatment of PCOD/PCOS focuses on managing individual concerns, such as infertility, hirsutism, acne or obesity.

• Lowering of blood glucose levels
• Restoration of fertility
• Treatment of hirsutism or acne
• Restoration of regular menstruation, and prevention of endometrial hyperplasia and endometrial cancer

Losing weight (which can be difficult) has been shown to help with diabetes, high blood pressure, and high cholesterol. Even a weight loss of 5% of total body weight has been shown to help with the imbalance of hormones and also with infertility.

Medications used to treat the abnormal hormones and menstrual cycles of polycystic ovary syndrome include:

• Birth control pills or progesterone pills help to make menstrual cycles more regular
• Metformin, a medication that increases the body’s sensitivity to insulin, can improve the symptoms of PCOS and sometimes will cause the menstrual cycles to normalize. For some women, it can also help with weight loss.
• LH-releasing hormone (LHRH) analogs
• Treatment with clomiphene citrate causes the egg to mature and be released. Sometimes women need this or other fertility drugs to get pregnant.

Medications or other treatments for abnormal hair growth include:

• Birth control pills. It may take several months to begin noticing a difference.
• Anti-androgen medications, such as spironolactone and flutamide may be tried if birth control pills do not work.
• Eflornithine cream may slow the growth of unwanted facial hair in women.
• Hair removal using laser and nonlaser light sources damages individual hair follicles so they do not grow back. This can be expensive and multiple treatments are needed. Laser removal can be combined with other medicines and hormones.
• Pelvic laparoscopy to remove a section of the ovary or drill holes in the ovaries is sometimes done to treat the absence of ovulation (anovulation) and infertility. The effects are temporary.

Expectations (prognosis)

Women who have this condition can get pregnant with the right surgical or medical treatments. Pregnancies are usually normal.

PCOD/PCOS Complications

• Increased risk of endometrial cancer
• Infertility (early treatment of polycystic ovary disease can help prevent infertility or increase the chance of having a healthy pregnancy)
• Obesity-related (BMI over 30 and waist circumference greater than 35) conditions, such as high blood pressure, heart problems, and diabetes
• Possible increased risk of breast cancer

Diet plan for pcod/pcos

Maintaining a balanced diet and therefore a healthy weight can be key in managing PCOS symptoms, by improving the way the body processes glucose, and potentially improving fertility.

Here are some food groups you should increase and limit, respectively, to manage PCOS symptoms and maintain or reach a healthy weight.

FOODS YOU SHOULD EAT ON A PCOS DIET

The following healthy foods can lower inflammation, keep blood sugar levels in check, and help you maintain a healthy weight to mitigate the side effects of gut issues and other uncomfortable manifestations of PCOS.

FIBER:-

A high fiber diet offers many benefits to women with PCOS, such as lower insulin levels, and antioxidants which fight to lower inflammation, and better gut bacteria. (Many high-fiber foods contain prebiotics, which feed probiotics and help to nourish your gut microbiome.)

 High fiber food for a PCOS diet include:

Seeds (chia, flax, sunflower seeds)

Legumes (black beans, lentils, chickpeas)

Berries (raspberries, blackberries, blueberries)

Whole Grains (bulgur, quinoa, brown rice, whole oats)

LEAN PROTEIN:-

Eating more lean protein (as opposed to meat that’s higher in saturated fat, like red meat and cured meats) may help weight loss, as well askeeping you fuller for longer.

When it comes to protein sources, I recommend include 2 to 3 servings of fish per week (avoiding fish with high amounts of mercury), chicken (grilled or baked), and plant based sources of protien.

High in lean protein food for a PCOS diet include:

• Fish (salmon, shrimp, tuna, cod)
• Lean poultry (skinless chicken and turkey)
• Plant protein sources (beans, peas, tofu, tempeh)

ANTIOXIDANT-HEAVY FOODS

Women with PCOS have been shown to have low-grade inflammation, elevated inflammatory signals can raise insulin, contributing to worsening of PCOS symptoms.The best antioxidant filled food include fruits, vegetables, whole grains, and unsaturated fats,

Antioxidant-rich foods for a PCOS diet include:

• Fruits (strawberries, blueberries, raspberries )
• Vegetables (spinach, artichokes, kale)
• Whole Grains (whole oats, whole wheat, quinoa, brown rice)
• Unsaturated fats (nuts like pecans, nut butters, olive oil, avocado)

FOODS WITH ORGANIC WHOLE SOY

The isoflavones in soy may increase the chances of getting pregnant. Organic whole soy has been shown to improves fertility in PCOS women. But it must be organically produced and not highly processed.

Organic whole soy food for a PCOS diet include:

• Miso
• Edamame
• Tempeh

FOODS COMPLIANT WITH THE MEDITERRANEAN DIET

Mediterranean Diet foods for a PCOS diet include:

• All fruits and vegetables
• Seafood (shrimp, salmon, tuna, sea bass)
• Whole Grains (brown rice, quinoa, couscous)
• Healthy Fats (olive oil, plain, unsalted nuts, avocado)

The DASH diet, originally designed for controlling high blood pressure, can also be beneficial to patients with PCOS in managing lower levels of insulin. It mainly focuses on healthy carbs, like fruits, vegetables, and whole grains. Due to the presence of fiber, whole grains minimize spikes in your blood sugar and insulin levels. Individuals who are insulin sensitive are able to better manage their weight and experience a reduced risk of diabetes, heart disease, and stroke. Lower levels of insulin are also consistent with menstrual regularity .

DASH Diet foods for a PCOS diet include:

• All fruits and vegetables
• Whole Grains (brown rice, quinoa, whole wheat)
• Poultry and fish (chicken, turkey, salmon)
• Legumes (peanuts, chickpeas, peas)
• Nuts and seeds (walnuts, pecans, flaxseeds, sunflower seeds)

FOODS TO AVOID ON A PCOS DIET

When you’re eating to alleviate PCOS symptoms, you’ll want to avoid the following foods that can spike blood sugar, increase inflammation, and cause weight gain.

REFINED CARBS

Women with PCOS do not typically process carbohydrates correctly (because of their high levels of insulin, in most cases), which is why refined carbs are on the list of foods to avoid with PCOS. “Limiting carbohydrates, especially refined nutrient – viod carbohydrates can lead to weight loss, which in turn decreases androgen levels responsible for acne, abnormal hair growth, and anovulation, or an irregular menstrual cycle,

Carbohydrates to avoid on a PCOS diet include:

• White bread
• Pizza dough
• Regular pasta
• White rice

SUGARY BEVERAGES

Though you may think juice and smoothies are healthy, some pre-bottled options can contain close to 30 grams of sugar and will spike your blood sugar, a problem if you have high insulin levels to begin with. It’s best to stay away from concentrated sweets and sugars, like fruit juice—instead, choose natural sugars like fruits . These are higher quality carbohydrates, and therefore are higher in fiber.”

Sugary beverages to avoid on a PCOS diet include:

• soda
• Fruit juice
• Bottled smoothies
• Cold-pressed juices

SUGARY, PROCESSED FOODS

Along with sugary beverages, sugary foods are not much better for the PCOS diet. “Really all processed foods, many containing harmful chemicals, not only are poor for weight loss but can also destroy the gut microbiome. Instead of packaged foods, choose farm-to-table, whole foods.

Processed foods to limit on a PCOS diet include:

• Cakes, candy, cookies, and other sweets
• sweetened cereals
• Yogurts with added sugar
• Ice cream with excess added sugar or sugar substitutes

SATURATED AND TRANS FATS

Saturated fats, found in foods like overly processed meats, aren’t beneficial for weight loss or a healthy balanced diet. Additionally, these high-fat foods can also be problematic for PCOS patients. It’s much better to focus on healthy fats, as in the Mediterranean diet (and you can have as much whole grain avocado toast as you want). “Women with PCOS should avoid saturated and trans fats which can be pro-inflammatory, especially in the gut.

Fats to avoid on a PCOS diet include:

• Saturated fats (red and processed meats like fast food hamburgers)
• Trans fats (doughnuts, French fries, frozen pizza)

DAIRY, IN SOME CASES

According to research published in the International Journal of Preventive Medicine, reducing dairy intake could potentially help certain women with PCOS lose weight and help some of their hormonal PCOS symptoms. Some patients (perhaps if they have gut issues linked to a dairy intolerance) can benefit from starting out with cutting back on dairy or even a vegan diet. But other patients, Plano explains, if they have no sensitivity or intolerance to dairy, have no reason to eliminate it from their diet—especially if they need the calcium and Vitamin D. Plano suggests sticking to healthy options like plain Greek yogurt as opposed to sugary options like a candy-topped yogurt.

Dairy products to limit on a PCOS diet include:

• Artificial or heavily processed cheeses
• Yogurts with added sugar
• Ice creams with sugar alcohols or tons of added sugar

ALCOHOL

Women with PCOS have high rates of fatty liver, which is only diagnosed with an ultrasound. Also, alcohol is a direct toxin to the liver and gut microbiome.

A European Journal of Endocrinology study states that lifestyle changes, particularly maintaining a balanced diet, is the best way to manage fatty liver in conjunction with PCOS.

Alcohol to avoid on a PCOS diet include:

• Cocktails made with sugary mixers like juice or bottled mixers
• Canned cocktails