Polycystic ovarian syndrome (PCOS) is a diverse endocrine condition that affects 4-12 per cent of women of reproductive age. High androgen levels, irregular menstrual cycles, or small cysts on one or both ovaries can cause PCOS. About 60% of women with PCOS are obese and insulin resistant. Up to 40% of women with PCOS are at risk of developing diabetes by 50, and many are dyslipidemic. ( to link study)
According to a study by the National Institute of Health Office of Disease Prevention, PCOS affects approximately 5 million women of reproductive age in the US. Also, PCOS leads to an increase in male hormones than average. This hormonal imbalance causes them to miss menstrual periods, making it difficult to conceive. It can also lead to long-term health issues like diabetes and heart disease. Postmenopausal women with PCOS, especially those with diabetes, are at a high risk of developing a clinical cardiac disease.
The new diagnosis of PCOS has sparked a surge in scholarly interest in the condition, which Scientists should channel into bettering customised clinical methods and, as a result, therapeutic solutions. Unfortunately, there is no cure for PCOS, but you can control and prevent it with exercise and a diet plan.
PCOS: How Does it Affect Your Body?
PCOS is a condition that affects a woman’s ovaries, which are the reproductive organs that generate oestrogen and progesterone. They regulate the menstrual cycle. An individual who has a lot of cysts is named “polycystic.” The ovaries also develop androgens, male hormones produced at negligible levels. The ovaries create eggs, fertilised by a man’s sperm. The monthly release of an egg is called ovulation. The pituitary gland produces follicle-stimulating hormone (FSH) and luteinising hormone (LH), which regulate ovulation.
The sac-like follicles contain immature eggs to trigger ovulation. Research states that lack of ovulation reduces the levels of female reproductive hormones like estrogen, which causes irregular periods.
PCOS is a “syndrome,” or a group of symptoms that affects ovulation and the ovaries. It has three primary characteristics:
- First, ovarian cysts are cysts that develop in the ovaries.
- Male hormones in excessive concentrations
- Periods that are irregular or missing
Although cysts are not hazardous, they can cause a hormonal imbalance. For example, PCOS can cause irregular menstrual cycles, elevated androgen (sex hormone) levels, excessive hair growth, acne, and obesity.
According to the studies, psychological issues like depression and other mood disorders and metabolic problems like insulin resistance and compensatory hyperinsulinemia significantly influence androgen production and metabolism. In addition, most women with PCOS are overweight or obese, which increases androgen secretion while compromising metabolic and reproductive capabilities, potentially encouraging the development of the phenotype.
Primary Causes of PCOS
The actual cause of PCOS is uncertain. However, several factors can lead to PCOS. For example, a study suggests that genes can also be responsible for PCOS. In addition, various other factors can be responsible.
- High level of androgens (male hormones)
- The ovaries cannot release eggs (ovulation) due to increased testosterone levels, resulting in irregular menstruation periods.
- A lack of ovulation causes relative deficiencies in progesterone production by the ovary, which frequently results in the absence of monthly cycles.
PCOS: Common Symptoms
- Missed Periods, irregular or very mild
- ovaries with a lot of cysts
- Excessive body hair, particularly on the chest, stomach, and back (hirsutism)
- Weight gain, particularly around the belly (abdomen)
- Acne or acne-prone skin
- Hair thinning or male-pattern baldness
- Excess skin in small pieces on the neck or armpits (skin tags)
- There are dark or thick skin patches on the neck, armpits, and breasts.
- Headaches are also common.
- Dark patches of skin can appear in bodily creases such as the neck, pelvis, and under the breasts.
PCOS and Exercise
Studies prove that PCOS individuals can benefit from weight loss in multiple ways. For example, reduced androgen, luteinising hormone (LH), and insulin levels are beneficial to weight loss by seeking to ease its clinical manifestations and minimise the associated risk of T2DM and cardiovascular disease through regular exercise and nutrition (CVD). Weight gain and PCOS have both direct and inverse relationships.
Changing your lifestyle is the most favoured and successful treatment for PCOS. Insulin resistance is more common in women with PCOS than in women who do not have the condition. It is a condition that impairs your body’s capacity to use blood sugar for energy. Not all PCOS patients are overweight. The good news is that, regardless of your weight, you can benefit from a physical activity if you have PCOS.
The Research compared aerobic exercise with resistance training, treadmill walking or jogging at a moderate intensity against high intensity, and riding a stationary bicycle versus riding a bike outside. The researchers discovered that moderate exercise benefits women with PCOS. For example, walking 30 minutes 3 days a week can help you lose weight and manage your insulin level.
Practising moderate exercise routines gets your heart pumping at around 50 to 70% of your maximal heart rate. Walking, riding a bicycle, dancing, or taking an aerobics class would be best. If you are short on time, investing in a mat and a pair of well-cushioned shoes will help you engage in spot jogging in the comfort of your home. Do not forget stretching exercises before that. One can look at a home trampoline workout too.
Pool workouts like swimming or aqua aerobics are great for women with PCOS. Try to increase the number of laps. Increase the distance and speed. Apart from using all muscle groups, swimming leads to less injury as it is easy on the joints. It is also calming on a hot summer day and improves sleep quality.
Exercises to Calm The Mind
Yoga, Pilates, and tai chi are mind-body workouts that can help you burn calories and reduce stress levels, exacerbating your PCOS symptoms.
Studies have found that yoga lowered testosterone levels and depression and anxiety in women with PCOS. As per the same study, one hour of yoga three days a week helped reduce free testosterone levels (from 5.96 vs 4.24 pg/ml; P<0.5). Measurements included dehydroepiandrosterone, androstenedione, body mass index and waist to hip ratio. It also included fasting blood sugar and insulin levels and anxiety and depression score.
High-intensity interval training (HIIT) includes alternating periods of intensive exercise with periods of relaxation. For example, burpees, tuck leaps, and mountain climbers are all joint exercises in a HIIT workout. It improves women’s insulin resistance and muscle strength, altering overall body fat composition.
Exercising at different intensity levels with variations in exercises can keep the heart rate high. Even though the heart rate you achieve is less than HIIT, depending on the regularity and duration of interval training can make a lot of difference to your condition.
If you have PCOS and trying to conceive, try improving your lower back strength and posture. In addition, it would help you if you engaged in pelvic floor strengthening exercises. It prevents incontinence and enhances libido and pelvic stability to support a healthy pregnancy.
Bodyweight exercises improve muscle mass and boost metabolism. As a result, it improves insulin resistance. Squats, push-ups, and tricep dips are excellent for women with PCOS.
It helps keep excess weight at bay by burning more calories during exercise and even at rest.
Playing a Sport
Playing badminton, table tennis, or outdoor tennis can help you break the monotony. The curious learner in us can pick up skills at any age. Do not delay. Sign up for new sports activities.
Lifestyle Modifications to Help Combat PCOS
Studies show that behavioural techniques can assist women in achieving their weight-loss goals, which can help control PCOS symptoms. Incorporating behavioural and psychological methods, such as goal-setting self-monitoring, cognitive restructuring, problem-solving, and relapse avoidance, in weight control programmes for women with PCOS will likely enhance outcomes. Improved motivation, social support, and psychological well-being strategies are also vital. These can be used in the clinical therapy of women with PCOS at various times of their reproductive lives.
Self-care habits such as avoiding over-commitment, getting enough sleep, and scheduling time to relax can also aid in the management of PCOS. As a result, one would be more committed to exercising and fall off the bandwagon.
PCOS and Diet
No exercise plan is effective unless supported by a regulated diet plan. According to several studies, food can help minimise the effects of PCOS. Weight control and insulin production and resistance are two critical ways nutrition impacts PCOS. On the other hand, insulin plays a big part in controlling insulin levels with a PCOS diet is one of the best ways to manage the condition.
People with PCOS may feel better if they eat a diet that fits their nutritional needs, keeps them at a moderate weight, and encourages optimal insulin levels. Unfortunately, although diet plays a vital role in PCOS, there happens to be no standard diet to follow. But there is discussion and agreement over which food proves beneficial to managing PCOS conditions and which ones to avoid.
A diet with a low glycemic index (GI)
Your body digests foods with a low GI more slowly, causing insulin levels not to rise as quickly or as quickly as foods with a higher GI, such as certain carbs. Therefore, whole grains, legumes, nuts, seeds, fruits, starchy vegetables, and other unprocessed, low-carbohydrate foods constitute a low GI diet.
The DASH Diet
To lower the risk or impact of heart disease, doctors frequently recommend the Dietary Approaches to Stop Hypertension (DASH) diet. It may also help with PCOS symptoms treatment. A DASH diet is rich in fish, poultry, fruits, vegetables, whole grains, and low-fat dairy products.
Other Healthy Diets:
Foods that are unrefined and natural, high in fibre, salmon, tuna, sardines, and mackerel are examples of fatty fish. Dark leafy greens such as kale, spinach, and others are dark red fruits. Cauliflower and broccoli are good healthy fats sources. Pine nuts, walnuts, almonds, and pistachios are examples of nuts.
A study shows that losing weight improved the appearance of PCOS irrespective of dietary content. Therefore, weight loss should be a goal for all overweight women with PCOS, regardless of diet composition, by reducing caloric intake while maintaining optimal nutritional information and making intelligent food choices.
Foods to Avoid
Refined carbohydrates should be avoided, such as mass-produced pastries, white bread, and fried and fast foods. Likewise, carbonated drinks like soda and energy drinks are high in sugar, which you should avoid. Steak, hamburger and pork are other meat varieties that women with PCOS should not consume.
Tips to Plan an Eating and Workout Plan for PCOS
Exercise doesn’t have to take hours each week to improve your PCOS. Exercise sessions range from 30 minutes to 60 minutes a day, three times a week, to three hours per week to ease metabolic and reproductive symptoms linked with PCOS in studies.
A regular exercise plan for PCOD can involve brisk walking, cycling, jogging, swimming, and a sample Indian diet. These exercises aid in weight loss, insulin resistance reduction, reproductive enhancement, and alleviating sadness and anxiety symptoms.
- You can do strength training and core strength exercises at least twice a week to enhance metabolism, build body mass, and relieve symptoms like lower back discomfort. Yoga is a complementary practice used to maintain hormonal balance along with activities.
- Pilates or tai chi in a studio, gym, or online would be the best option for PCOS. If this is your first time practising, you may want to seek the advice of a trainer to assess your form and safety.
- Brisk walking or jogging for 30 to 45 minutes is beneficial.
- Physical activity like aerobics is beneficial. Several youtube videos offer easy, moderate and difficult exercises at your convenience.
Sometimes the nature of the PCOS treatment makes one hesitant to use over-the-counter or prescription medications to address their illness. In addition, one is concerned that some standard PCOS therapies have adverse side effects. Therefore, sometimes doctors encourage home treatments for women with mild symptoms to control the illness.
You may want to include the following habits for healthy meals:
Consume a Well-Balanced Diet
A well-balanced PCOS diet will aid in maintaining your body’s neutral, homeostatic state. In addition, insulin can work effectively by transporting glucose to your cells for energy when eating a well-balanced PCOS diet.
Maintain a Consistent Routine and Meal Times
People should not skip meals. Skipping meals can cause blood sugar levels to drop, resulting in food cravings and overeating. However, it will regulate your blood sugar levels if you stick to a regimen.
Choose Healthy Foods
Choose foods that are nutrient-dense and high in vitamins and minerals. According to studies, eating foods high in Vitamin D, Vitamin B, Iodine, Selenium, and Magnesium can help improve insulin resistance and reduce the severity of PCOS symptoms.
Exercise and, ideally, a weight loss of at least 5 to 10 % of a woman’s body weight can aid in the restoration of ovulation cycles and the improvement of cycle regularity. Therefore, combining diet and exercise can effectively control PCOS and infertility.
Healthy Meal Planning
A PCOD weight-reduction plan will follow identical parameters but based on your BMI and BMR measurements at a calorie deficit.
- Breakfast: Poha with vegetables and a glass of buttermilk with flaxseed powder. Wheat dosa with roasted chana dal chutney, vegetable oats, ragi Rava dosa with mint chutney, vegetable upma, brown rice idlis with coconut chutney, and ragi pancakes.
- Lunch: Brown rice with rasam, dal and curd, brown rice pulao with raita, brown rice, sprouts curry, rasam and curd.
- Snacks: Low glycemic fruits like apples, roasted chana, whole wheat bread with almond butter, peanuts or walnuts, and any seasonal fruit like banana.
- Dinner: Take chapati or roti with vegetable churma, besan chilla, chana masala with chapati or roti, low-fat paneer, salad and roti, Baajra, moong and peas khichdi.
PCOS: The Impact
Most PCOS symptoms result in high levels of specific hormones known as androgens. The hormones in women with PCOS are out of balance, with higher-than-normal amounts of androgens and possibly lower-than-normal oestrogen levels. High androgen levels can lead to the following.
- Interfere with brain impulses that ordinarily lead to ovulation, preventing ovulation from occurring regularly.
- Cause cysts to form by causing the follicles—small, fluid-filled cysts within the ovaries (where eggs grow and mature) to increase.
- Other prominent PCOS symptoms are excessive hair growth and acne.
- Several genetic investigations on PCOS observed genes that impact hormone levels and insulin resistance. PCOS may run in families as well.
- Women with polycystic ovarian syndrome gain weight in most cases. Insulin resistance worsens with obesity and being overweight.
- Hair development on the face, neck, chest, arms, and legs (hirsutism)
- According to studies, women with PCOS have increased levels of inflammation. Excessive inflammation can increase androgen levels.
Pharmacological Treatment for PCOS
Treatments for the polycystic ovarian syndrome (PCOS) can help you control your symptoms and reduce your risk of long-term health issues like diabetes and heart disease. You should consult a gynaecologist to assess the severity of the condition.
- Menstrual abnormalities in PCOS get treated with two types of oral medications.
- Birth control pills suppress ovulation and thereby overcome the monthly cycle.
- Provera (medroxyprogesterone) is oral progesterone used to treat secondary amenorrhea in women.
- Healthcare specialists treat insulin resistance in women with PCOS with diabetes medications, including Glucophage (metformin), the first-line oral diabetic drug that also helps with weight loss. In addition, Actos (pioglitazone) is an oral glucose-lowering medication.
- Avandia (rosiglitazone) is an oral medication of the same class as pioglitazone. Doctors use it to regulate diabetes symptoms.
- Weight loss aids in pharmacological therapy in addition to exercise and food. For example, Contrave (naltrexone/bupropion) is a drug that reduces food cravings by stimulating the brain’s reward and hunger regions. Qsymia (phentermine/topiramate) is a similar appetite suppressant to Contrave.
Treatment of PCOS
Since there is no specific underlying cause for PCOS, treatment focuses on symptoms. Despite the prevalence of symptoms, few treatment techniques alleviate all components of the illness. Correcting anovulation, limiting androgen impact on target tissues, and reducing insulin resistance should be part of the treatment plan. Lifestyle modifications include adapting physical exercise, a healthy diet, and medical treatment.
Although there’s presently no cure for PCOS, you can reduce PCOS symptoms. Your quality of life is improved by following a healthy diet and incorporating physical activity. Exercising can help you control your PCOS symptoms. It can also help you manage your stress levels and improve your physical health.
Health practitioners generally recommend lifestyle changes as the first treatment for PCOS, and they often work. However, if lifestyle modifications don’t work, medications are an alternative. For example, birth control pills and metformin can help PCOS symptoms by restoring regular menstrual cycles.
Frequently Asked Questions (FAQs)
Q. Does PCOS go away with exercise?
A. There is no cure for PCOS yet, and exercise will not cure it completely. But doing physical activity daily or three times a day can improve your PCOS symptoms.
Q. Can exercise make PCOS worse?
A. According to a few studies, women with PCOS can reduce weight by doing 30 minutes of moderate-intensity exercise at least three times a week. On the other hand, intense exercise can worsen PCOS symptoms, and persistent physical stress can cause the body to store fat and prevent muscle growth because it can’t tell the difference between self-imposed stress and an actual threat.
Q. Which exercise is best for PCOS?
A. Moderate exercises like brisk walking, running, cycling, or swimming improves PCOS symptoms. In addition, this exercise improves your body’s insulin sensitivity, lowering your heart disease and type 2 diabetes risk.
Q. What is the best time to exercise?
A. The best time to exercise is in the morning. Working out at 7 in the morning will help improve your overall health. In addition, exercising on an empty stomach in the morning will help you lose more fat and be more effective than exercising in the afternoon or evening.
Q. Can exercise reduce ovarian cysts?
A. Running and light exercises like yoga and stretching help women with ovarian cyst discomfort. But avoid doing extreme exercises.
Q. Is HIIT okay for PCOS?
A. HIIT improves insulin resistance and body composition in women with PCOS, even if they don’t lose weight. However, there’s no need to go overboard. While you’re working out, pay attention to how you’re feeling. Don’t overwork yourself to the point of injury, tension, or suffering.
Q. Can PCOS go away with weight loss?
A. Unfortunately, there is no cure for PCOS. However, reducing weight can assist in normalising hormone levels in overweight and obese women. Aside from that, treatment focuses on symptom management. A variety of therapy alternatives are available to help prevent any potential issues.
Q. How many times a week should you work out with PCOS?
A. Exercise doesn’t have to take hours each week to improve your PCOS. Exercise sessions range from 30 minutes three times a week to three hours per week report to alleviate metabolic and reproductive symptoms linked with PCOS in studies.
Q. How much should I walk with PCOS?
A. Walk for 30 min daily. In these 30 minutes, try and alternate your speed by walking at a moderate pace for 5 minutes and then increasing to a brisk pace for the next 5 minutes. It proves to be beneficial for PCOS.
Q. How can you get rid of belly fat with PCOS?
A. Fortunately, a better diet combined with lifestyle modifications can help correct hormonal imbalances caused by PCOS, allowing you to stop and reverse your belly growth.
- Consume the appropriate diet for your body type
- Each day, aim for 3-4 large servings of colourful veggies.
- Stay away from alcohol, processed foods, and packaged foods for at least two weeks.
- 39-60 minutes of exercise every day, 4-6 times per week