What is Polycystic Ovarian Syndrome?
Polycystic Ovarian Syndrome, or more properly known as PCOS, affects nearly 10% of the women ages 18-44 and is one of the most common female disorders of the endocrine system2. It is also often overlooked and can lead to elevated risk for several medical issues including infertility and metabolic syndromes such as hypertension, diabetes and cardiovascular disease2. Additionally, the continued hormonal imbalance caused by PCOS can cause numerous ovarian cysts, acne and irregularities of the menstrual cycle1. The direct cause of PCOS is still continued to be studied, however there are theories regarding the pathogenesis. One theory states that PCOS is caused by the dysfunction within the Hypothalamic-pituitary gland causing disruptions in the lutenizing hormone and gonad-otropin-releasing formones, then resulting in dysfunction within the ovarian hormones2. Another is that there is a presence of an ovarian defect which then results in an overproduction of androgens (hyperandrogenism)2. Lastly, the pathogenesis is believed to be caused by a metabolic disorder, such as insulin resistance, having a negative impact on the hypothalamus, ovaries, pituitary and even the adrenal glands2. Risk factors often include genetics (i.e. CAPN10, Isulin gene, AR and Cytochrome family p4501) and lifestyle factors (i.e. obesity). PCOS patients usually present with numerous ovarian cysts over 8mm in size1. Additionally, medical professionals do an evaluation to focus on symptoms (such as visceral obesity, acne and ogliomenorrhea) and count out any other hormonal conditions through lab work and a physical exam2. Where Nutrition Comes in Believe it or not, nutrition plays an integral role in the management of PCOS. Due to the connections between insulin resistance, metabolic syndrome and PCOS, food and nutritional lifestyle changes can make a real difference for patients. In fact, obesity has been known to worsen the symptoms of PCOS, making weight loss a primary goal for several patients and healthcare practitioners3. While there is little debate on whether or not weight loss and diet can benefit PCOS, there is debate over which dietary pattern is best suited for the job. As the most common and arguably most balanced dietary pattern, we will look at the Mediterranean Diet today. The Mediterranean Diet The Mediterranean diet is a way of eating that consists of consuming whole grains, legumes fruits, veggies and high quality proteins and fats, such as omega-3 fatty acids (olive oil, fish). There have been studies conducted on the therapeutic use of the Mediterranean diet for treatment of PCOS, often tracking body composition3 and CRP levels (inflammation markers). In one study, high adherence to the Mediterranean diet with a focus on MUFA and PUFA (monounsaturated and polyunsaturated fatty acid) intake, led to significant decreases in BMI and inflammatory CRP levels4. The Role of Resveratrol One of the key beneficial elements, not often discussed, within the Mediterranean diet is “resveratrol.” Resveratrol is found within food sources such as red wine, grapes, grape seed, pistachios, and dark colored berries (blueberries, cranberries, raspberries, blackberries, etc.). It has been found that consuming these foods have the ability to appease the hyperandrogenic affects of PCOS, lowering androgens and reducing hyperinsulinemia6. In on study, treatment with resveratrol over 3 months reduced testosterone and dehydroepiandrosterone sulfate excess by 23% in PCOS patients6. Something to note, however, is that many of these studies are conducted with high concentrated amounts of resveratrol (ex: 1500m), which would be better consumed via supplement than food form. Dietary Supplements While we are on the subject of supplements, it is important to note other supplements that can be beneficial for and supportive of PCOS management. Omega-3s While the Mediterranean diet is a great way to get healthy omega-3s, PCOS patients often find benefit from additional supplementation with higher doses. In one study, patients were given 2mg of omega-3 capsules per day for 6 months, resulting in significant decreases in waist and hip circumferences, fasting blood sugar, and size and number of ovarian cysts7. Research has also shown an increase of high-density lipoprotien7 and overall reduction in CRP levels when supplementing with omega-3s2. Chromium An essential trace mineral, chromium has been found to reduce hyperinsulinemia and increase the action of insulin2. One study, specifically focused on PCOS patients, showed that daily supplementation with 1000 mcg of chromium for 2 months could result in improving insulin sensitivity by 38%2. Chromium supplements are often found to be combined with Picolinate (an amino acid) to support absorption2. Supportive Treatments Generally, the doctor that treats patients with PCOS in a traditional medical setting is an Endocrinologist. There are, however, supportive therapies that can help manage symptoms and support medical treatment. One such treatment is acupuncture, which gained more popularity over the past few years for benefiting endocrine issues. The reason for this is because studies have shown acupuncture to have a positive impact on reproductive hormone5. In one study on PCOS patients, acupuncture treatment for 12 weeks showed reduction in LH/FSH ratio, LH, BMI and beneficial results on testosterone, menstrual frequency and PCOS symptoms5. Moving Forward PCOS can be a challenging condition to manage with many uncomfortable symptoms, however, quality of life can be improved with proper nutrition and supporting therapies. In addition to health practitioners, many PCOS patients from comfort and support in connecting with others who have the condition, a well as finding resources for management tips within the PCOS community often found on social media. Instagram pages, such as ours (@novamammawellness) can be a great place to learn more and connect with others! RESOURCES: 1. Ajmal N, Khan SZ, Shaikh R. Polycystic ovary syndrome (PCOS) and genetic predisposition: A review article. Eur J Obstet Gynecol Reprod Biol X. 2019;3:100060. Published 2019 Jun 8. doi:10.1016/j.eurox.2019.100060 2. Rakel D. Integrative Medicine: Expert Consult Premium Edition - Enhanced Online Features and Print. 3rd ed. W B Saunders; 2012 3. Barrea L, Arnone A, Annunziata G, et al. Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS). Nutrients. 2019;11(10):2278. Published 2019 Sep 23. doi:10.3390/nu11102278 4. Szczuko M, Kikut J, Szczuko U, et al. Nutrition Strategy and Life Style in Polycystic Ovary Syndrome-Narrative Review. Nutrients. 2021;13(7):2452. Published 2021 Jul 18. doi:10.3390/nu13072452 5. Cao Y, Chen H, Zhao D, et al. The efficacy of Tung's acupuncture for sex hormones in polycystic ovary syndrome: A randomized controlled trial. Complement Ther Med. 2019;44:182-188. doi:10.1016/j.ctim.2019.04.016 6. Mirabelli M, Chiefari E, Arcidiacono B, et al. Mediterranean Diet Nutrients to Turn the Tide against Insulin Resistance and Related Diseases. Nutrients. 2020;12(4):1066. Published 2020 Apr 12. doi:10.3390/nu12041066 7. Khani B, Mardanian F, Fesharaki SJ. Omega-3 supplementation effects on polycystic ovary syndrome symptoms and metabolic syndrome. J Res Med Sci. 2017;22:64. Published 2017 May 30. doi:10.4103/jrms.JRMS_644_16
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Amanda Nova, MSCN, HHPArchivesCategories |