Irregular periods, unexplained weight gain, excessive facial hair can all be symptoms of PCOS. Surprisingly, most women with PCOS don’t even know they have it. Several Indian women put their own health on the back burner and menstruation problems are often hailed as part and parcel of being a woman. Most women are never officially diagnosed until they begin struggling with infertility and seek help in getting pregnant. Lack of knowledge and awareness combined with a casual attitude towards their own health leads to a delayed diagnosis of PCOS among women. It’s time to change that and make women take their well-being up as a priority. Here is the ultimate guide to navigating PCOS with expert advice, tips and everything you need to know.
What Exactly Is PCOS Or PCOD?
Polycystic Ovary Syndrome (PCOS) or Disease (PCOD) is a hormonal disorder common among women of reproductive age. Since this is a chronic condition that affects a woman’s hormone levels, it causes you to skip periods or not get any periods at all. This condition further makes it difficult for women to get pregnant.
Did You Know?
According to the PCOS Society of India, 1 in 10 Indian women suffer from the condition. What’s more shocking is that a large percentage of these females are teenagers. Poor lifestyle habits are to be blamed for this surge as 80% of PCOS patients are obese.
Watch this video to understand the daily struggles that women with PCOS have to go through.
8 Common Symptoms Of Polycystic Ovary Syndrome (PCOS)
- Irregular periods
- Excessive facial hair
- Heavy menstrual flow
- Pelvic pain
- Fluctuations in weight
- Mood swings
Do you have any of these symptoms? Here is a quick quiz that can help you determine whether you have PCOS or not. If you suffer from heavy bleeding during your periods, using the right menstrual hygiene products might help a lot. Buy Evolve Essentials sanitary pads from the Red Dot Shop here.
Major Causes Of PCOS In Women
Research has proven that PCOS can be carried forward in a family through genes. If there is a history of PCOS in your family, you are at a higher risk of getting it.
Women with insulin resistance are more prone to having PCOS. Insulin is the hormone that causes the body to use the energy obtained from the consumption of sugar. When a body cannot break down the sugar, the pancreas is forced to produce higher levels of insulin, which is a cause for the ovaries to produce more male hormones (androgens).
PCOS is more common among overweight women. Excessive weight could be a result of insulin resistance or an unhealthy lifestyle. The excessive consumption of simple sugars can hamper effective insulin management in the body, leading to PCOS.
Types Of PCOS
It’s vital to know about the types of PCOS for effective management of the condition.
1. Insulin Resistant PCOS
Insulin-resistant PCOS is caused by sugar, smoking and trans-fat. The high levels of insulin prevent ovulation, triggering the ovaries to create more testosterone. The best way to control this is by quitting sugar.
2. Inflammatory PCOS
Inflammatory PCOS is when ovulation is prevented, the hormones are imbalanced, and androgens are produced. This is caused by stress, toxins in the environment and gluten. Avoiding stress and trying to calm down is the best way to control this type of PCOS.
3. Hidden Cause PCOS
The hidden PCOS is a simpler form of PCOS which can be resolved in 3-4 months. The causes for this are Thyroid disease, iodine deficiency, a vegetarian diet and artificial sweeteners.
4. Pill Induced PCOS
Pill-induced PCOS is developed due to birth control pills that suppress ovulation. This is not long-term and the results wear off after the effects of the pill get over.
Medication For PCOS
Although there is no medical cure for PCOS, there are ways in which women can control and even reverse the effects of the condition. Using birth control pills helps women regulate their menstrual cycles to quite an extent and doctors also prescribe some supplements to some women in an attempt to regulate their hormones. However, these measures only help in dealing with the effects of PCOS. Reversing PCOS can happen through weight management and adopting a healthy lifestyle. Since PCOS is so closely related to insulin management, following a PCOS diet plan that regulates the insulin in the body is a primary step in the treatment.
The Correlation Between Food & PCOS
The PCOS diet mainly aims at the consumption of foods that prevent a sudden spike in blood sugar levels. Along with eating the right food, women with PCOS are also advised to exercise regularly in order to shed the extra weight. The first step towards battling PCOS through a diet is to be able to differentiate between the best foods for PCOS and the foods to avoid with PCOS.
There are also some ground rules that one needs to keep in mind while adopting the polycystic ovary syndrome diet. They need to understand that following a PCOS diet plan is a lifestyle change and not just an alteration in the food one chooses to eat. Everything that goes into the body can either help it reverse the effects of PCOS or aggravate them. Consistency in following the PCOS diet plan to lose weight will gradually help the woman completely get rid of PCOS.
Doctors advise that eating foods with a low glycemic index (GI) can work wonders in improving the effects of PCOS. Such foods take time to get absorbed in the body and do not shoot up the insulin levels like many of the simple carbohydrates do. A PCOS diet does not forbid the individual from eating all carbohydrates. It is crucial to eat the correct carbohydrates in the correct proportion.
Best Foods For PCOS
- Fresh fruits like apples, pears, kiwi, orange and bananas (especially berries).
- Vegetables like cauliflower, broccoli and green leafy vegetables.
- Good fats in the form of avocados, coconut oil, olive oil and dark chocolate.
- High protein foods like beans, lean meat, fish and eggs.
- Spices such as cinnamon, ginger, garlic and turmeric.
- Herbal teas like green tea and spearmint tea.
Watch this video to learn 5 food items that can help manage PCOS.
Foods To Avoid With PCOS
- Processed foods that make use of refined flour (maida). This includes almost all the bakery items such as bread, pastries, doughnuts, mithai and cookies.
- High-calorie foods like fried food and fast food.
- Sugary and aerated drinks.
- Red meat and processed meat like sausages, hot dogs and cold cuts.
- Vegetables that are high on starch like potatoes, corn and peas.
- Cornflour and corn syrup.
PCOS Diet Chart
|Early Morning||Breakfast||Lunch||Evening Snack||Dinner||Bedtime|
|8-10 almonds/walnuts OR1 fruit (of your choice) OR10 ml amla or wheatgrass juice with 4-6 almonds/walnuts OR1 cup cinnamon (dalchini) tea with 4-6 almonds/walnuts OR1 glass green juice made with bottle gourd (dudhi), lemon, ginger, cucumber and mint (pudina) OR100 ml of low-fat milk||2 Idlis with chutney and sambar OR1 paneer sandwich OR1 paratha with low-fat yoghurt OR1 bowl of poha OR1 bowl of rawa upma or oats upma OR1 bowl of oats porridge (made with low-fat milk)||2 small rotis with dal and vegetable OR1 cup brown rice vegetable pulao with raita OR1 cup brown rice with chicken/egg curry OR2 jowar rotis with vegetable OR1 bowl chicken soup with a vegetable salad||1 glass buttermilk made with low-fat yoghurt OR1 small bowl of bhel OR1 bowl of mixed fruits OR2 egg whites OR 1 bowl of sprouts salad||1 roti with vegetable and yoghurt OR1 bowl vegetable soup OR1 bowl of brown rice with chicken/fish (50 gms) and vegetable salad OR100 gms grilled chicken/fish with sauteed vegetables OR1 roti with fish/ chicken curry or dal OR2 whole egg omelette with vegetables||1 cup of green tea/cinnamon (dalchini) tea|
5 PCOS Questions Answered By Gynaecologist Dr Sushma Tomar
While it may look scary, PCOS is pretty manageable. Regular exercise, customised diet and meal plans and medication prescribed by your doctor can help in major ways. Team TC46 spoke to Dr Sushma Tomar, Infertility Specialist & Endoscopic Surgeon at Fortis Hospital (Mumbai), to answer some burning questions about the relation between PCOS and infertility and pregnancy.
1. Can I get pregnant with PCOS naturally?
Dr Sushma: “Having Polycystic Ovary Syndrome (PCOS) does not mean you will not be able to get pregnant; however, it is one of the common causes of infertility. PCOS is not a disease, it is a hormonal imbalance and can be successfully treated with medicine. It can be diagnosed with astute history taking, ultrasonography and hormone tests at the time of menses. Hormonal imbalance interferes with the growth and release of an egg from the ovaries; if you do not ovulate, you cannot get pregnant.”
2. What is the best age to get pregnant with PCOS?
Dr Sushma: “You should try to get pregnant within one year of your marriage. Do not use contraception and delay the pregnancy; it is best to have a pregnancy before 35 years of age, primarily because fertility levels decrease after that.”
3. How do I know if I’m ovulating if I have an irregular cycle because of PCOS? Do ovulation tests work with PCOS?
Dr Sushma: “To know if you are ovulating or not, it is always better to go for a Follicular Study that can be done at a nearby sonography centre or be prescribed by a gynaecologist. In PCOS, irregular menses are common, so you have to use more than 5 strips, and still, if you are not sure if you are experiencing late ovulation or no ovulation, it is advisable that one goes for a Follicular Study.”
4. How does delivery change if I have a PCOS pregnancy? Is a C-section mandatory?
Dr Sushma: “The mode of delivery is not going to change depending on whether the mother-to-be has PCOS/PCOD or not. There is no specific indicator for the C-section because of Polycystic Ovary Disease (PCOD), but patients with Polycystic Ovary Disease (PCOD) are prone to have high blood pressure, diabetes, and risk of preterm delivery, and that could impact the mode of delivery. In such cases, the babies can be underweight, premature, and need neonate care.”
5. Does PCOS affect your health postpartum?
Dr Sushma: “Patients with long term Polycystic Ovary Syndrome (PCOS) are prone to have high blood pressure, diabetes and cardiac problems.”
Dr Sushma Lists Treatment Options For Infertility Caused By PCOS
1. Weight Loss to Restart Ovulation
Women with PCOS who are overweight are more likely to experience more severe anovulation, going months between periods. Regular exercise and a special PCOS diet can help. Research has found that women who have lost weight have a great chance of having fertility treatment success. Losing weight isn’t easy for anybody, and it may be even more difficult for those with PCOS. Also, not all women with PCOS are overweight.
Some women with PCOS need medications to help them conceive. If you’re insulin-resistant, taking the diabetes drug metformin can treat insulin resistance and may help you lose weight. Clomid is the most commonly used fertility drug overall, and also the most commonly used treatment for women with PCOS. Gonadotropins, an injectable fertility drug, is also used as a treatment option.
3. Fertility Treatments
IVF (in vitro fertilisation) or IVM (in vitro maturation) are the commonly used fertility treatments for women with PCOS.
IVF: This involves using injectable fertility drugs to stimulate the ovaries so that they will provide a good number of mature eggs. The eggs are retrieved from the ovaries during a procedure known as egg retrieval. Those eggs are then placed together with sperm into Petri dishes. If all goes well, the sperm will fertilise some of the eggs. After the fertilised eggs have had between three and five days to divide and grow, one or two are transferred into the uterus. This procedure is known as an embryo transfer. The desired result is a positive pregnancy test after two weeks.
IVM: It stands for in vitro maturation. Instead of giving you high doses of fertility drugs to force your ovaries to mature many eggs, with IVM you receive either no fertility drugs or very low doses. The doctor retrieves immature eggs from the ovaries and then matures these eggs in the lab. IVM is not offered at all fertility clinics. This is something to consider when choosing a fertility clinic.
5 Breastfeeding With PCOS Facts You Should Know
Here is some expert advice from Lactation Consultant Arushi Agrawal along with 5 must-know facts about breastfeeding for moms with PCOS.
1. PCOS does affect breastfeeding
PCOS – Polycystic ovary syndrome is associated with hormonal imbalance in a woman’s body who has attained reproductive age and is thought to affect between 10 and 15% of women. . The women’s body produces higher than normal levels of male hormones that cause them to skip menstrual periods and makes it harder for them to get pregnant. Features of PCOS can include fertility problems, acne, obesity, excess hair growth on the body and an increased risk of developing type 2 diabetes. The range and severity of symptoms are so variable that there is no globally accepted clinical definition of PCOS. Rather, a diagnosis must be made from a combination of symptoms.
While PCOS symptoms usually start in adolescence, in some women they do not develop until their early to mid-twenties. While PCOS is treatable, and long term improvement is obtainable, there is not a cure.
2. PCOS can be a challenge for breastfeeding mothers
So, the good news is that a lot of mothers suffering from PCOS have not encountered anything unusual during their breastfeeding journey. However, some women with this underlying issue have complained about facing extra challenges with breastfeeding.
The biggest issue with PCOS and breastfeeding is a lack of milk supply. Unfortunately, the exact explanation of why women with PCOS may have a low milk supply is unclear. It’s more than likely related to the hormonal imbalances that come with PCOS.
Two main hormones that play an essential role in breastfeeding are prolactin and oxytocin. A lot of women suffering from PCOS have elevated levels of androgen hormones, such as testosterone. These androgen hormones may disrupt prolactin’s function in the body, resulting in decreased milk supply during breastfeeding. It’s also known that elevated levels of androgens in women with PCOS, can also interfere with and bind to prolactin (the primary hormone of lactation or milk production) receptors, further affecting the milk supply.
3. Insulin resistance affects breastfeeding
Insulin is a hormone that helps to keep blood sugar levels in check. Insulin resistance affects up to 70% of women with PCOS, meaning their cells are immune to insulin and do not consume glucose (sugar) from the bloodstream efficiently. As a result, an insulin-resistant individual generates more insulin to aid glucose processing.
Insulin resistance increases the risk of a low milk supply in women. When a mother is insulin resistant, one gene expresses itself more prominently than others. The presence of this gene in insulin-resistant women indicates that insulin resistance and inadequate milk supply are related.
4. The lack of glandular tissue can lead to breastfeeding trouble
In the 1940s, researchers observed that women with PCOS had a lower-than-normal amount of glandular tissue in their breasts, which affects both the appearance and functionality of the breasts. Because of the hormonal imbalances which occur, there is the development of poor breast tissue during puberty and pregnancy. Fewer menstrual cycles in early puberty can translate into less estrogen to develop mammary tissue.
Because of the lack of glandular tissue, the breasts of women with PCOS are often tiny (almost prepubescent in size) and cone-shaped, with a large gap between the breasts. Nonetheless, some affected women have very large breasts that are mainly made up of fatty tissue rather than glandular tissue.
Insufficient breast milk production may be caused by a lack of glandular tissue, and as a result, some women with PCOS have trouble starting and/or maintaining breastfeeding.
5. The need to manage your PCOS symptoms persists
Breastfeeding performance can be improved by monitoring your PCOS symptoms before, during, and after pregnancy. When hormones are not in balance in PCOS, problems with breast milk supply are more likely to occur. You will help your body maintain hormone balance and do the work required to produce breast milk by sticking to the lifestyle and food choices that help you control your PCOS symptoms.
Many of the symptoms of PCOS are caused by abnormally high levels of androgens, as well as other hormone deficiencies that affect breast production and milk synthesis. Metformin is often used by doctors to help patients with insulin resistance. Alternatively, a mother can take all the possible steps to maximize her potential to breastfeed. These steps include the use of non-medical options for pain relief during labour, practising lots of skin to skin contact with your newborn without delay after birth, followed by 24 hour rooming in with your baby, feeding the baby on demand, ensuring optimal positioning and latching and avoiding artificial nipples and teats.
Taking care to drink adequate fluids and eat ample calories is vital for adequate milk. Make sure you provide additional stimulation to the breast by frequent nursing or pumping after feedings for boosting your supply to meet the needs of your baby.
Regulate Your Periods With These 8 Yoga Asanas
Trying yoga for an irregular period can yield great results and there are almost zero side effects. Apart from yoga asanas, even meditation can help resolve menstrual issues. Meditation has been demonstrated to improve physical and emotional symptoms of PMS, especially in people with severe PMS. So, try pranayama for irregular periods and see the difference. Begin your yoga journey with this video of 3 yoga asanas to practice if you have PCOS.
1. Adho Mukha Svanasana (Downward-Facing Dog Pose)
This asana has numerous amazing benefits that make it extremely essential for you to practice it every day. The best part is, even a beginner can get the hang of this asana with great ease.
How To Do It:
- Place your palms and feet flat on the ground.
- Lift your body to form a 90-degree angle while facing down.
- Hold this pose for one minute.
2. Viparita Karani (Legs-Up-The-Wall Pose)
Known for relieving headaches and migraines, this is one of the best yoga poses for irregular periods. It helps get rid of menstrual cramps, PMS and helps manage menopause symptoms.
How To Do It:
- Start with your support about 5 to 6 inches away from the wall. Sit sideways on the right end of the support, with your right side against the wall.
- Exhale and, with one smooth movement, swing your legs up onto the wall and your shoulders and head gently down onto the floor.
- Take a small roll made from a towel for example under your neck if the cervical spine feels flat. Open your shoulder blades away from the spine and release your hands and arms out to your sides, palms up.
- Stay in this pose anywhere from 5 to 15 minutes. Be sure not to twist off the support when coming out. Instead, slide off the support onto the floor before turning to the side.
3. Ustrasana (Camel Pose)
The camel pose causes stretching in your abdominal region. The pull in your stomach signals your uterine muscles which ease your menstrual cramps. This asana also stretches the spine which relieves mild lower back pain.
How To Do It:
- Kneel on the floor.
- Arch your back slowly.
- Touch your heels with your hands.
- Hold this for 30 to 60 seconds.
4. Dhanurasana (Bow Pose)
Dhanurasana is one of the best poses for your reproductive system. It is a basic yoga posture that not only relieves menstrual pain but also reduces the severity of the symptoms of your next menses.
How To Do It:
- Lie face down.
- Lift up your hands and feet.
- Join hands and feet above your body and hold them.
- Continue holding for 30 seconds and repeat.
5. Paschimottanasana (Seated Forward Bend Pose)
This asana calms the brain and helps relieve stress and mild depression that can be common while PMSing. It also helps relieve the symptoms of menopause and menstrual discomfort.
How To Do It:
- Sit with your feet straight in front of you.
- Exhale as you stretch your body towards your feet.
- Hug your feet with your hands and hold for one minute.
6. Ardha Pincha Mayurasana (Dolphin Pose)
The dolphin pose relieves menstrual discomfort and headaches. It stretches the shoulders, hamstrings, calves, and arches. Make sure to support your head to get better results.
How To Do It:
- From all fours, come down onto your forearms. Spread your fingers wide and keep elbows shoulder-width apart.
- On an inhale, tuck your toes and lift your hips up and back like you’re in Downward-Facing Dog. Allow your head to hang above the floor.
- Ground down into your forearms and lift your upper body away from the floor. Press your heels down toward the mat for a nice hamstring stretch.
- Stay between 30 seconds to one minute. Then release your knees to the floor with an exhale.
7. Setu Bandha Sarvangasana (Bridge Pose)
Bridges are not only one of the best exercises for a sculpted butt, but they will also help keep your back healthy and pain-free. It helps eliminate period cramps with ease. Place a block under your sacrum (tailbone area) for added support, especially if your back pain is intense.
How To Do It:
- Lay face-up on the floor with your knees bent and your feet flat on the floor.
- Raise hips so your body forms a straight line from your shoulders to your knees.
- Pause in the up position, then lower your body back to the starting position.
8. Supta Virasana (Reclining Hero Pose)
The reclining variation of Virasana is an intermediate pose. It helps get rid of menstrual discomfort and helps regulate your menstrual flow as it stretches the abdomen.
How To Do It:
- Placing the palms on the floor beside the buttocks, slowly bend back, placing the right forearm and the elbow on the ground and then the left.
- Bring the back of your head to the ground while arching the back.
- Place the hands on the thighs. If necessary, separate the knees, avoid overstraining the muscles or legs.
- Breathing in and taking the support of the elbows and the arms raise the head above the ground.
- Then shift the body weight on the left arm and elbow by sliding the body, then slowly coming to the starting position.
5 Things You Should Know About PCOS Acne
Nearly 30% of women with Polycystic Ovary Syndrome (PCOS) struggle with acne. They are often found around your jaw, cheeks, chin and upper neck. And they are painful as the inflamed cysts or nodules which are formed can be hard and long-lasting. But what else do we know about PCOS acne? Here are 5 things you should know about PCOS Acne.
1. Excess Androgens lead to hormonal imbalance that causes PCOS acne
Polycystic Ovary Syndrome (PCOS)is a hormonal condition where there is an excess of androgens (male hormones) in the body. This disturbance in the hormonal milieu in the body of a female leads to hormonal acne of PCOS.
2. PCOS-induced breakout is tougher to treat than a standard breakout
The standard acne breakout has few salient features like premenstrual flare-up, acne around the cheeks, chin, nose and forehead. PCOS induced hormonal acne are usually more severe and stubborn to treat. They appear near the jaw and sometimes near the neck part of the jawline, rather than on the upper part of the face or cheeks.
3. Glycolic acid and salicylic acid can bring relief from PCOS acne along with DIY face packs
Glycolic acid and Salicylic acid based face washes, non-comedogenic face washes, creams containing Alpha and Beta Hydroxy acids and tea tree oil can decrease PCOS acne. Applying Multani mitti, turmeric and chandan face packs once a week also help. Scrubs should be avoided, in case the patient has active inflammatory acne.
4. Diet, weight loss & exercise are effective solutions for all PCOS related problems
Diet and lifestyle are the most important factors for having PCOS, and hence treating PCOS is incomplete without weight loss, diet and exercise. One must eat fibre rich foods like grains, millets, cereal, nuts. Their diets must also include loads of vitamins and minerals.
And they must avoid foods with no fibre or foods injected with hormones (dairy, eggs, meat, seafood). Ultra-processed and ultra-refined plant foods like maida, refined sugar, white rice should be switched with millets, single hand-pounded local varieties of rice, jaggery and dates.
5. Treating the root cause and prescribed medication, together, is an effective treatment plan against PCOS acne
PCOS Acne treatment needs two-pronged therapy. One is dealing with treating the root cause which is PCOS. The second is dealing with acne which needs courses of oral treatment (which can span from antioxidants, zinc, antibiotics and Isotretinoin) and topical creams (based on Benzoyl Peroxide, Tretinoin/ Adapalene) as per the treating dermatologist. With these, few fortnightly sessions of chemical peels using Alpha and Beta Hydroxy Acids and stronger formulations, help in clearing the acne faster with better treatment of post-acne pigmentation.
Tips For Pcos Patients To Get And Maintain Flawless Skin
- Weight loss and having BMI less than 23 should be the first target
- Weight loss with only food changes doesn’t suffice, exercise is equally important where strength training is more important than cardio
- Consume fibre-rich foods and eating fresh home-cooked meals rather than packaged foods
- Use a non-comedogenic moisturizer.
- Use a face wash with Glycolic acid or Salicylic acid (always check for sensitivity, by applying on the back of the ear for 48 hours before using on the face)
- Consult your dermatologist, because treating acne is easier than treating dark spots or scars left after acne