PCOS and Weight Management

What Is Polycystic Ovarian Syndrome?

Polycystic means many cysts. Polycystic ovarian syndrome (PCOS) often causes small clusters of pearl-sized cysts in the ovaries. These cysts are fluid-filled, and they contain immature eggs. Women with PCOS usually produce slightly higher amounts of male hormones like androgens, contributing to some of the condition's symptoms.

PCOS is a hormonal disorder in women. Studies and observations have shown that proper weight management has resolved many issues associated with PCOS.

PCOS is characterized by:

• Menstrual irregularities.

• Excess androgen.

• Ultrasound features of multiple small follicles arranged in the periphery of the ovary.

Women with PCOS can develop many problems related to weight gain and insulin resistance, including:

• Type 2 diabetes.

• High cholesterol.

• High blood pressure.

• Sleep apnea.

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PCOS is a commonly occurring hormonal disorder in women of childbearing age. It can lead to issues with fertility. Women with PCOS will have a slightly small amount of male hormones and are also less sensitive to insulin or become "insulin-resistant." Many women with PCOS are overweight or obese. As a result, they are more prone to heart disease, diabetes, sleep apnea, and uterine cancer.

It causes symptoms such as:

1. Heavy menses.

2. Infertility.

3. Miscarriages.

4. Abnormal uterine bleeding.

5. Anxiety.

6. Stress.

7. Depression.

8. Acne.

9. Excessive facial hair growth.

10. Weight gain.

What Are The Tests Used To Diagnose PCOS?

• Pelvic Examination: Examination of the reproductive organs for masses, growths, or other abnormalities.

• Hormone Test: A blood test is done to detect the level of testosterone, thyroid-stimulating hormone (TSH), prolactin, and adrenal gland hormones.

• Ultrasound: Physician checks the appearance of ovaries and the thickness of the lining of the uterus.

Polycystic Ovarian Syndrome And Obesity:

Polycystic ovary syndrome is a condition that has a strong connection with obesity. It has been proposed that women with PCOS are affected by inherent insulin resistance with additional obesity and lifestyle-related extrinsic insulin resistance. Obesity, particularly abdominal obesity, can further increase insulin resistance, strongly associated with an increased risk of type 2 diabetes mellitus and CVD (cardiovascular disease) in the general population and women with PCOS. Obesity or insulin resistance exacerbates the reproductive, metabolic, and psychological features of PCOS. According to a survey, only a lower proportion of women with PCOS had a BMI of less than 25, but the majority proportion of women with PCOS had a BMI of more than 30.

PCOS can cause severe physiological and psychological health consequences. It can affect women across their reproductive lifespan and lead to pregnancy complications, like preeclampsia, gestational diabetes, and large gestational-age babies. PCOS is usually associated with excess weight gain, which, in turn, increases the health burden of PCOS.

Therefore, weight management, including natural weight loss, prevention of weight gain, maintenance of weight loss, and prevention of excess gestational weight gain, is the first-line treatment for women with PCOS.

Long studies and cumulative data reflect two kinds of PCOS: central obesity (fat accumulation in the abdomen) and peripheral obesity (fat accumulation in the hips, buttocks, and thighs). Obesity has been directly and indirectly linked to the cholesterol levels in the human body. Hormones are the derivatives of cholesterol, and therefore any changes in cholesterol levels reflect on the hormones.

Excessive obesity can cause an imbalance in the FSH (follicle-stimulating hormone) and LH (luteinizing hormone) levels, leading to menstrual irregularities. This is seen most commonly in the case of central obesity. Weight reduction has shown promising results on the regularization of menses in central obesity patients.

What Are the Ways To Manage Weight With PCOS?

The main goal of weight management in overweight or obese women with PCOS is to prevent further weight gain and, if possible, lose weight. These women should monitor their weight regularly.

A combination of calorie-burning exercises and a balanced low cholesterol diet helps in weight management.

1. Doing yoga, aerobics, cardio exercises, brisk walking, and healthy food intake help reduce weight.

2. Taking medication for weight reduction is not a great idea as the weight rebounds once the medication is stopped.

3. Nutrients can help balance hormones like lowering testosterone and raising progesterone and nutrients to support healthy adrenal function and detoxification. All these stressors can make you fat and tired. Replacing missing nutrients can help your cells become more insulin sensitive and lower the stress hormones like cortisol, so stop storing fat and start burning it, which will also help to increase your energy.

4. Use food as medicine to avoid hormonal imbalances in your life.

5. Heavy calorie-burning exercises like skipping, swimming, and cycling are good options.

6. Avoid food and sugar cravings to reach your health goals.

7. Cutting down on oily food is a must.

8. Avoid taking cheesy food, junk food, and oily stuff. Instead, take more juices and fruits.

9. Increase consumption of green leafy vegetables.

10. Try to take more steamed, boiled, and baked vegetables and meat instead of fried versions.

11. Be part of a support community because when we surround ourselves with like-minded individuals, we can very easily reach our health goals and live longer and healthier.

12. Around 250 minutes of moderate or 150 minutes of vigorous exercise are recommended each week to promote weight loss.

Very Low Energy Diet:

VLEDs (very low-energy diet) are considered an initial weight loss strategy when rapid weight loss is needed. VLEDs are low in carbohydrates, causing mild ketosis after 2 to 3 days, and have an anorexic effect. Before starting the VLED, a baseline evaluation of weight and waist circumference and blood tests should be done, and an assessment should be made every 4 to 6 weeks.

This diet is not suitable for pregnant or lactating women or those with severe psychological disturbance, recent acute cardiovascular events, substance abuse issues, porphyria, or women over 65.

Conclusion:

I strongly suggest the strategy of strict weight management in case of PCOS and resolving the issues by the methods mentioned above. Women who are having PCOS become obese because of complex endocrine changes. In this case, a 5 to 10% loss of body weight can improve symptoms, metabolic and CV (cardiovascular) outcomes and may improve anovulation.