September is Poly Cystic Ovarian Syndrome (PCOS) Awareness month. It is a federally designed event which came into effect from 2017. A global event emphasizing the need for awareness around PCOS.
While there is ample information around available, it’s important to know all the aspects of PCOS.
PCOS is a hormonal disorder causing enlarged ovaries with small cysts on the outer edges. Three main features of PCOS are:
- Presence of cysts in ovaries
- Abnormally high level of male hormone – Androgen
- Irregularity in menstrual periods
PCOS prevalence in India in women of reproductive age (18-44 years) ranges between is 9.13% to 36%, roughly estimating to 1 in 5 Indian women.
With this prevalence, it’s important to educate ourselves about PCOS.
The cause for PCOS is relatively unknown. However following factors have been found to play a role:
Contributing factors: Early age of menarche, unhealthy lifestyle (inappropriate nutrition and lack of exercise) and pollution.
SIGNS AND SYMPTOMS:
Menstrual cycle: Heavy bleeding with irregular periods is often one of the main symptoms.
The doctor (Gynaecologist) performs the following examinations:
- Pelvic Exam: A physical examination to look for any problems with your ovaries or other parts of your reproductive tract.
- Diagnostic imaging: Ultrasound examination (pelvic and transvaginal), MRI to look for abnormal follicles and other problems with your ovaries and uterus.
- Blood tests: To check for higher-than-normal levels of male hormones. Lab tests will measure the levels of: Follicle stimulating hormone(FSH), Leutinizing hormone, Testosterone, Oestrogen etc.
WHEN TO SEE A DOCTOR?
Consult a doctor if:
- Absence of periods and you are not pregnant.
- Signs of PCOS are visible on your body such as hair growth on your face, headache, pelvic pain etc.
- Failure to become pregnant for more than 12 months.
- Symptoms of diabetes are present.
Treatment is symptomatic and a multidisciplinary approach is required to tackle it.
- MEDICAL TREATMENT:
It usually revolves around tackling the individual signs and symptoms.
Main concern includes:
- Lowering of blood glucose levels.
- Treatment of fertility.
- Dissolving issues like acne, hirsutism.
- Restoration of regular menstruation, and prevention of endometrial hyperplasia and endometrial cancer.
Common medical treatments include birth control, fertility drugs and metformin (to improve insulin levels).
- DIETARY CHANGES:
The best way to control and manage PCOS is through proper weight management.
American Association of Clinical Endocrinologists guidelines recommend a goal of achieving 5 to 15% weight loss or more, which improves insulin resistance and all hormonal disorders.
Diet should include:
- High protein intake
- High fibre intake
- Low on sugar
- Low carbohydrates
- ROLE OF PHYSIOTHERAPY:
The most annoying complication of PCOS is obesity. Women with PCOS may also experience low back pain, sacral pain and lower quadrant abdominal pain.
High insulin resistance often leads to diabetes – a potential complication of PCOS. Exercise can effectively help in decreasing this resistance to insulin and thus reducing blood sugar levels.
Exercise also helps in weight reduction-
A physiotherapist will devise a customized exercise regimen for you according to your specific needs.
From personal experience, I have found women with PCOS benefitted a lot from a tailor-made exercise program for them, showing visible benefits like –
- Increased strength in muscles
- Weight loss
- Increased Endurance (stamina)
- Reduction in fatigue
Two forms of exercises: Strength training and aerobic exercises.
A) Strength Training:
- Builds muscle
- Raises the BMR
- Reduces insulin resistance and inflammation
Strength training can be incorporated using body weight, external weights such as dumb bells, therabands, weight cuffs, etc.
B) AEROBIC EXERCISES:
- Increases stamina.
- Helps in weight loss due to increased calorie consumption.
- Reduces risk of cardiovascular disease.
Cycling, swimming and walking are some forms of aerobic exercises.
Yoga and Pilates has also shown to be beneficial in PCOS.
PCOS is an endocrine disorder affecting a lot of women. Women often have a severe impact of PCOS on their mental health. Change in body image – acne, weight problems, excess hair. All this causes them to develop anxiety and depression.
All this can be avoided with a right approach to PCOS.
If you are dealing with PCOS – the good news is that it is possible to live a comfortable life and manage it with a holistic approach.
Authored by- Dr. Mansi Babrekar Masters in Community Physiotherapy (Women's health & Geriatrics) Certified ANC PNC fitness trainer & K-taping therapist.
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