The human body is an intricate machine with many organ systems working together to maintain synergy. However, when one of the organ systems gets affected by an ailment or condition, it can also change and affect the functions of the other systems in the body. For instance, PCOS (Polycystic ovarian syndrome), a disorder common in women of reproductive age, occurs because of hormonal imbalance. It in turn causes fertility issues, sudden weight gain and many other problems all of which have a bearing on the physical and mental well-being of a person.
Managing PCOS should begin with and hinge on lifestyle changes, say experts. Exercise has a key role to play too.
How lifestyle changes help manage PCOS
In women with PCOS, there is an elevated level of luteinizing hormone, which stimulates the overproduction of androgens (male sex hormones) by the ovaries. This results in high levels of androgens in women with PCOS. Hyperandrogenism results in insulin resistance leading to weight gain and obesity. PCOS increases the risk of heart-related issues.
“There is excess estrogen and testosterone in women with PCOS along with other hormonal imbalances,” says Dr SB Shafalika, consultant gynaecologist, Manipal Hospitals, Bangalore. “The hormonal imbalances cause a lot of short-term and long-term physical and psychological changes. It includes menstrual irregularities, obesity, growth of facial hair and hair loss. The long-term side-effects are lifestyle-related diseases like early onset of diabetes, hypertension, and so on.”
According to a research review, women with PCOS have a higher risk of developing type 2 diabetes, cardiovascular diseases, anxiety, depression and other mood disorders. Lifestyle changes that involve exercise and diet are the first-line intervention for these conditions.
Exercises for PCOS
Staying physically active and doing exercises like walking, jogging, running, swimming, gym workouts and yoga, will have a positive impact on the body weight and improve hormonal balance and fertility outcomes.
“In PCOS treatment, we have to address treating the associated conditions, which might occur like obesity, diabetes, cardiovascular diseases so on,” says Bhavik Tari, physiotherapist, SL Raheja Hospital – A Fortis Associate, Mumbai. “An exercise routine that involves cardiovascular training, resistance strength training or HIIT training, will improve your cardiovascular health and show results in weight loss. On weight reduction, there is improved hormone regulation.”
Women with PCOS have disturbed sleep and also experience lower back pain, lower abdominal pain and discomfort, which exercises alleviate.
“It is generally advised to lose at least 5% of the body weight. It will help reduce insulin resistance and increase the chances of regulating periods,” says Dr Soumya Mahesh Koregol, infertility gynecologist at Shreshtha Womens Clinic, Bangalore. “In women with PCOS, who have a low body weight, we ask them to stay active, which will help them reduce insulin resistance.”
How exercises control hormonal imbalance
Reduce luteinizing hormone: Luteinizing hormone stimulates the ovary to produce androgens. “Excess LH levels inhibit the ovulation (release of egg). Exercising brings down the LH levels and promotes egg release,” says Dr SB Shafalika. The androgen levels can be controlled with resistance strength training.
Reduce estrogen: Peripheral fat is one of the sources of estrogen. Exercises help reduce fat and there by estrogen levels. “When estrogen is high, the endometrium (uterus wall lining) continues to grow thicker resulting in delayed periods or irregular periods. So, when estrogen levels are reduced, the periods will start becoming regular,” says Dr Koregal.
Improve insulin sensitivity: Consistent vigorous aerobic exercises in the long run help improve insulin sensitivity. “High insulin levels will lead to excess estrogen and testosterone in the body. Doing high-intensity exercises for at least 45 to 50 minutes, five to six days a week, helps to bring down insulin levels to a great extent and indirectly reduce the estrogen and testosterone levels,” says Dr SB Shafalika.
Reduce stress: Stress is another factor that throws the hormones out of balance in women with PCOS. Exercises and yoga are good ways to reduce stress levels. “Exercise helps trigger the brain to release endorphins which improves the mental state of well-being and reduces stress,” says Tari.
Role of diet in managing PCOS
There are many diet regimens in vogue these days – from keto and fruit diets to liquid diets. All of them can give short-term weight loss. To permanently drop some pounds, it’s necessary to choose a diet that can be followed consistently for a longer period.
“I encourage women with PCOS to eat home-cooked food that is less of carbohydrates and rich in proteins and fibers, along with fruits and vegetables, nuts and seeds,” says Dr SB Shafalika. “It is extremely healthy and helps in weight loss. Reduce the intake of dairy products and non-vegetarian food. Avoid consuming junk food and frozen food, as they are rich in preservatives and endocrine disrupting chemicals (EDCs) which will worsen the hormonal imbalance.”
- Polycystic ovarian syndrome (PCOS) is an endocrine disorder that is very common in women of reproductive age.
- It is characterized by obesity, insulin resistance and higher levels of estrogen and androgen which lead to irregular menstrual cycles and fertility issues.
- Diet and lifestyle changes are the first line of treatments for PCOS.
- Exercises for PCOS help improve insulin sensitivity, reduce testosterone and estrogen levels, to manage weight and hormonal imbalance.