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October 21 2021 8:42 PM ˚

Lifestyle changes ease symptoms of Polycystic Ovary Syndrome — gynecologist

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(Photo: Jordan News)
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AMMAN — Studies have shown that one in five women suffers from Polycystic Ovary Syndrome (PCOS), a hormonal condition increasingly affecting women of reproductive age. Although it is a chronic illness, it can be easily managed through adherence to a healthy diet and lifestyle.اضافة اعلان

“PCOS is a syndrome of ovarian dysfunction associated with complex endocrine and metabolic dysfunction. It is a lifelong syndrome,” Khalil Barham, an obstetrician-gynecologist, said in an interview with Jordan News.

PCOS is a heterogeneous condition that is associated with an endocrine reproductive disorder in females, according to Barham. There is no one cause for it, although evidence implies a complex interplay between hereditary and environmental variables. It affects women between the ages of 18 and 44.

“The persistent hormonal disbalance leads to complexities such as numerous cysts, an irregular menstrual cycle that ultimately leads to infertility among females. Many candidate genes have been identified to be one of the causes of PCOS,” he said. 

Barham added that for women with PCOS, changes in ovarian follicle form and function have been widely documented.

Symptoms of PCOS, such as ovulatory dysfunction and hyperandrogenism, most commonly appear during adolescence. Other symptoms include cutaneous signs of hyperandrogenism, polycystic ovaries (one or both), obesity, and insulin resistance.

Barham mentioned that obesity is more common in PCOS patients. Obesity is also linked to PCOS infertility and raises the risk of metabolic syndrome and its constellation of cardiovascular risk factors, according to Barham.

“The prevalence of anxiety or depression for females with PCOS living in Jordan is high and calls for special attention by healthcare specialists and policymakers in our country. Females who received the PCOS pharmaceutical care service showed significant improvements in depression scores,” he said.

A thorough physical examination, as well as an assessment for the presence of hirsutism, ovarian ultrasonography, and hormonal testing to confirm hyperandrogenism and oligo-anovulation as needed, are all part of the evaluation of patients prone to PCOS.

Treatment for PCOS varies and can include both nonpharmacologic and pharmaceutical therapies. Weight loss is the most common treatment for PCOS — even a five percent loss in weight can restore regular menses and increase response to ovulation-inducing and reproductive medications. Metformin has been linked to a reduction in metabolic syndrome symptoms in premenopausal PCOS patients.

Barham said that “clamp studies using Ethinyl estradiol/drospirenone combination failed to reveal evidence of an increase in either peripheral or hepatic insulin resistance. Subjects with PCOS have a 1.5-times higher baseline risk of venous thromboembolic disease and a 3.7-fold greater effect with OCP use compared with non-PCOS subjects.”

The gynecologist added that there is presently no genetic test to diagnose PCOS or aid in treatment strategy selection.

The evaluation of a woman with PCOS for infertility entails looking for pre-conceptional issues that could affect response to therapy or lead to poor pregnancy outcomes, as well as looking at the couple for other common infertility issues that could influence therapy selection, such as conducting a semen analysis. A high incidence of impaired glucose tolerance — a known risk factor for gestational diabetes — and metabolic syndrome with hypertension are among the factors that may increase the risk of pregnancy in women with PCOS.

“Before attempting conception, women should be tested for hypertension and diabetes and treated if necessary. Although limited clinical trial data is proving a benefit to this approach, women should be counseled about weight loss before trying conception,” he said. 

Even without significant weight loss, effective nutrition and exercise strategies can improve endocrine characteristics, reproductive function, and cardiometabolic risk profile. Recent research has enabled experts to create micronutrient intake recommendations. Fat should account for no more than 30 percent of total calories, with a minimal percentage of saturated fat. Large consumption of low-GI carbs may lead to dyslipidemia and weight gain, as well as increased hunger and carbohydrate cravings. Studies suggest that diet and exercise must be adapted to the demands and tastes of the individual, and calorie intake should be divided across several meals per day.

“The use of drugs to either improve insulin sensitivity or to promote weight loss is justified as a short-term measure and is most likely to be beneficial when used early in combination with diet and exercise,” said Barham.

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