As soon as a girl reaches puberty, till the time she reaches menopause, she may be afflicted by Polycystic Ovary Syndrome (PCOS). A hormonal disorder, it is caused by an imbalance of reproductive hormones. It is characterised by multiple cysts on ovaries, hence the name; but not all women with PCOS will have cysts. PCOS can be physically and emotionally draining, and given the lack of awareness about the condition, many women continue to suffer without a diagnosis.
What causes PCOS?
Insulin and Cortisol are two hormones that fluctuate and cause PCOS, and can cause an existing condition to flare up. While there isn’t much clarity about why this happens, it is believed that insulin resistance may be the root cause. The other hormone, cortisol, reduces greatly due to problems in pituitary or adrenal glands (Addison’s disease). The onset of symptoms is very gradual and includes fatigue, dizziness, weight loss, muscle weakness, mood changes, and darkening of patches of skin.
Types of PCOS
Blood hormone levels need to be checked to make the correct diagnosis as the course of treatment depends on the cause.
Depending on the cause, PCOS is of four types:
Insulin Resistance PCOS:
The most common type of PCOS, it affects around 70% of women. The body is affected by hyperinsulinemia in this condition.
Post-pill PCOS:
This type of PCOS presents itself only after women stop taking oral contraceptive pills. If you had irregular periods before you started the pill, you likely had PCOS the entire time and did not realize it as the pill masked the symptoms. It becomes important to investigate insulin resistance as the pill can cause or worsen insulin resistance. If insulin resistance is there, then you have insulin resistance PCOS. Otherwise, your hormones will return to normal with time and patience.
Adrenal PCOS:
This type of PCOS develops as an abnormal response in the body. Normal hormone and insulin resistance levels, elevated levels of DHEAS, high-stress levels, irregular periods, and polycystic ovaries on an ultrasound scan, all indicate adrenal PCOS.
Inflammatory PCOS:
Chronic inflammation leads to hormonal disturbance which causes ovulation issues. Symptoms include unexplained fatigue, joint pains, digestive issues, recurring infections(cold, cough, sinus), inflammation of systems related to the respiratory tract, and skin infections or inflammations(Eczema, redness, patches). Elevated levels of CRP (C-reactive protein), ESR (erythrocyte sedimentation rate) and DHEA, and Vitamin D3 deficiency are its prominent blood markers.
Managing PCOS
Diet plays a big role in PCOS management. It can flare up if you under-eat and over-exercise or eat more of inflammatory foods such as dairy and processed foods. Lifestyle changes such as meditation, breathing exercises, and yoga can help in easing hormonal fluctuations. Adding plant foods rich in nutrients such as avocados, olives, and seed oils (mustard, sesame, and flaxseed), increasing intake of fiber to manage cravings and adding protein to manage blood sugar and add satiety value, go a long way in managing PCOS.
While these are general guidelines for managing all kinds of PCOS, specific types of PCOS require further management.
Managing Insulin Resistance PCOS
This requires lifestyle modifications and treatment with medication to prevent complications.
Managing Inflammatory PCOS
As it is caused by inflammation, decreasing the intake of inflammatory foods is the first step in managing it. Reduce or eliminate the intake of gluten (replace with ragi, besan, Samak, etc), dairy, processed sugar and packaged foods (chips, biscuits, frozen foods, etc). Once you eliminate these from the diet, give your body at least 90 days to heal. Reduce your exposure to environmental toxins like plastics and pesticides by opting for metal containers and growing at least one seasonal green vegetable (spinach, rocket leaves, methi) in a kitchen garden.
Managing Adrenal PCOS
Apart from managing your stress levels, focus on reducing the intake of processed foods, caffeine and dairy, and eat within an hour of waking up. Supplements like magnesium, vitamin B5 and vitamin D are beneficial as well. Do not over-exercise, stay hydrated and include pre-probiotics in your diet. Use of herbs like Ashwagandha and Rhodiola is also recommended.
Role of suppléments
Supplements such as Inositol, Shatavari and Cinnamon have proven to be helpful.
Inositol
18 mg per day is a safe dose but if you want to start, take minimum 4 mg per day that can be taken as a single dose after breakfast or lunch, or it can be divided into 2 mg doses of one each post breakfast and post lunch.
Shatavari
A dose of 10mg per day is recommended and you can take it during first half of the day, even after fruits.
Cinnamon
It is best to take a quarter of a teaspoon at bedtime or right after dinner in powder form as a herbal concoction.
You can mix cinnamon and Ashwagandha and make a herbal tea that helps insomnia.
After taking these for three months, you will see a notice able difference in your PCOS. For further evaluation and guidance, consult a certified nutritionist.
