Polycystic ovarian syndrome, or PCOS, is a condition in which an imbalance in the reproductive hormones leads to ovarian cysts and irregular menstrual cycles and also impacts one’s fertility. It is not just a gynecological issue but can lead to a host of metabolic diseases as well. Experts who spoke at ‘Happiest Her,’ the women’s wellness summit organized by Happiest Health in Bangalore, held in March 2024, focused on the different aspects of a woman’s life — health, career, and mental well-being.
While PCOS is mainly linked with hormonal imbalance, it also shares a connection with several metabolic conditions, stated Dr Aruna Muralidhar, senior consultant obstetrician and gynecologist at Cloudnine Hospital, Bangalore, and the author of the book Nine Months.
What is PCOS?
While delivering the keynote on ‘Weight loss, lifestyle, PCOS and childbirth concerns (20s to mid-30s)’ at the summit, Dr Muralidhar said, “PCOS is a complex hormonal, metabolic, and reproductive disorder and the leading cause of infertility.”
Dr Muralidhar, who is currently conducting studies on the prevalence of PCOS and its symptomatology, added that almost one in ten women suffer from PCOS.
PCOS and metabolic diseases
Dr Muralidhar said, “It’s a syndrome rather than a disease, so calling it a disease is a misnomer.” Essentially, it is the hormonal imbalance, but it also comes with a whole lot of metabolic problems, she said.
“It can lead to other serious conditions in the long term, such as severe anxiety, depression, and obesity,” she added.
While stressing the fact that the actual cause of PCOS is unknown, Dr Muralidhar says that insulin resistance is the primary pathology of PCOS.
“Insulin resistance means the pancreas is producing insulin, but the insulin is not able to do its job — it cannot metabolize the sugars at a set level. This insulin resistance drives everything. It is the fundamental pathology in PCOS,” she said.
Research has linked PCOS to several metabolic conditions, including type 2 diabetes, hypertension and cardiovascular diseases. Dr Muralidhar adds that PCOS is also linked to endometrial cancer.
Dr Muralidhar says that since PCOS is linked to so many complications, its management and treatment is also a multi-disciplinary affair.
Myths about PCOS
Dr Muralidhar says that one of the most common myths is that women with PCOS cannot have children.
“PCOS is the most easily treatable fertility issue,” she said, adding, “70% of women may experience problems getting pregnant and 30% get pregnant. But PCOS is easily treatable, and the chances of pregnancy are much higher.”
Dr Muralidhar says other common myths include that diet alone can cure PCOS, menopause, or having a hysterectomy or taking oral contraceptive pills can cure PCOS.
Management and treatment of PCOS
Dr Muralidhar says that treatment of PCOS is often symptomatic and may involve the use of insulin sensitizers to help insulin work better, correcting hormone imbalances, dermatological treatment for symptoms like excess hair growth and acne, or fertility treatment for egg release.
According to the doctor, lifestyle changes play a crucial role in PCOS management. “Genetics load the gun, but the lifestyle is the trigger,” she said.
She recommends leading an active lifestyle, even engaging in activities like going up and down the stairs, not sitting for long periods, doing a few burpees in between meetings, and so on.
Speaking about the importance of weight management in PCOS, Dr Muralidhar pointed out that one donut contains 242 calories which would require 88 minutes of crunches to burn. “Similarly, a heavy milkshake, made of dry fruits, contains 780 calories, which would take 72 minutes of skipping to burn.”
According to Dr Muralidhar, a waist circumference of less than 85 centimeters is what everyone must achieve. “We have to monitor our weight regularly,” she said.
Dr Muralidhar said it is essential for those with PCOS to not engage in high-intensity training.
“You must reach 60-70% of your maximum heart rate. High-intensity strenuous and prolonged exercise increases cortisol levels, a stress hormone that lowers thyroid levels and metabolism,” she explained.
Dr Muralidhar recommends choosing locally-grown foods, foods lower in fat and sugars, avoiding maida products completely, and adding plenty of veggies, fibrous fruits, whole grains, and probiotic-rich foods like curd and buttermilk in your diet.
Takeaways
While it is primarily a hormonal disorder, polycystic ovarian syndrome (PCOS), which causes irregular menstrual cycles, ovarian cysts, or unusual hair growth in women, is also linked to several serious metabolic conditions, including diabetes and cardiovascular diseases, say experts.
