Nutritionist for PCOS and PCOD in Delhi - Archana Agarwal
Nutritional Guidelines for Treating PCOS/PCOD
Polycystic Ovary Syndrome (PCOS) is a HORMONAL IMBALANCE disorder ear marked by Irregular Periods or by No Menstruation at all. Women with PCOS typically have multiple Cysts in their Ovaries and it is a disorder involving over production of hormones called Androgens. The diagnosis can be difficult due to the variability of presentation; hence the actual prevalence may be considerably higher than the 2-26% of the women that are Diagnosed.
The etiology is unknown but the condition appears to be a complex outcome of Genetic, Metabolic and Environmental Factors. The following factors appear to play role in the development of Clinical PCOS:
- Alterations in Gonadotropin Secretion And Action
- Insulin Secretion and Action
- Weight and Energy Balance
- Androgen Biosynthesis
The common cause of this Hormonal Imbalance is Insulin Resistance, which leads to increased Insulin Production which in turn Stimulates Ovarian Cells leading to Androgen Production.
Diagnosis of Hormonal Imbalance
Diagnosis of PCOS can be difficult as presentation can be atypical. A thorough history and physical examination are essential especially in patients which are not hirsute or obese.
Two of the following 3 criteria should be met for Diagnosis in Adults as well as to rule out other Diseases with similar Clinical Presentation
- Menstrual Irregularity – Anovulation, Oligo-Ovulation, Amenorrhea ,Oligomenorrhea or Irregular Bleeding.
- Signs of Hyperandrogenism – Hirsutism, Acne , Male Pattern Baldness or Elevated Serum, Total or free Testosterone concentration are the common symptoms. Anabolic Steroids and Antiepileptic drugs cause symptoms similar to PCOS.
- According to Rotterdam criteria 12 or more follicles of sufficient size and / or increased Ovarian volume are required for this criterion to be fulfilled. Trans Vaginal Ultrasound is employed in atypical presentation to evaluate Ovarian or Adrenal Neoplasms.
In adolescents PCOS can be Diagnosed if Clinical Or Biochemical evidence of Hyperandrogenism is present along with persistent Oligomenorrhea.
Postmenopausal women can be Diagnosed with PCOS if they have a long term history of Oligomenorrhea and Hyperandrogenism.
Because PCOS results in increased Cardio Metabolic Risk, Cardio Vascular Risk Factors, including BMI, Blood Pressure and Lipids should be evaluated. Smoking should be strongly discouraged in all patients.
Symptoms of PCOS/PCOD
Common symptoms of PCOS include:
- Irregular Periods or No Periods at all
- Weight Gain
- Excess Hair Growth (hirsutism) – usually on the Face, Chest, Back or Buttocks
- Thinning hair and hair loss from the head
- Oily Skin or Acne
- Difficulty getting Pregnant (because of irregular ovulation or failure to ovulate)
Women with PCOS are at increased risk of developing other health problems later in life like:
- High Blood Pressure And High Cholesterol – which can lead to Heart Disease and Stroke.
- Type 2 Diabetes – A condition that is marked by elevated Blood Sugar Levels called Hyperglycaemia.
- Depression and Mood Swings – The Hormonal Imbalances and the symptoms caused by them can affect the Confidence and Self-esteem.
- Sleep Apnoea – This is a condition that causes interrupted breathing during sleep and is majorly related to the Weight Gain and Hormonal Imbalances during PCOS.
Treatment of Hormonal Imbalance
Weight loss – Aggressive but sustainable Weight Loss strategies are considered first as many PCOS sequelae improve with Weight Loss, both in case of Obese Women and Obese Adolescence.
Oral contraceptives – These are used as first line therapy in adolescents and adults to manage Menstrual Irregularity, Hirsutism and Acne.
Combined Estrogen Progestin Oral Contraceptive to Protect Against Endometrial Hyperplasia.
Metformin – Metformin is used to help with patients who cannot take Oral Contraceptives or who desire Pregnancy.
Treatment of Infertility
If the patient desires Pregnancy the following measures are suggested –
- Weight loss and Exercise are beneficial, as even small Weight Reduction may improve Fertility.
- Assisted Reproductive Technologies (IVF) may be necessary.
- Clomiphene may be used to induce Ovulation.
Nutritional Considerations and Guidelines for Treating and Supporting PCOS/PCOD
Dietary goals for treating PCOS target at reducing Excess Weight and Insulin Resistance as PCOS is highly related to Diet and Lifestyle Factors.
Between 30 to75 % of women with PCOS are Obese and women with PCOS often have excess Body Fat particularly Central Adiposity, even in the absence of obesity. A series of studies have shown that Losing as Little as 5 to 10% results in resumption of Menses and decrease in Blood Androgen Levels.
A Low Fat, Plant Based Diet helps to influence the following symptoms associated with PCOS:-
- Increased Body Weight
- Insulin Resistance
- Oxidative Stress
- Increased Androgen Activity
PCOS/PCOD Diet Plan- NUTRITIONAL CONSIDERATIONS
Foods to add
High Fibre Foods
– High Fibre Foods like Fruits, Vegetables, Whole Grains and Legumes help to combat Insulin Resistance by slowing down Digestion and reducing the impact of Sugar in the Blood. This is particularly important because of Insulin Tendency to reduce Sex Hormone – binding globulin (SHBG) and increase Free Testosterone concentrations.
Low Fat High Fibre Diets reduce circulating Androgens, increase SHBG and effectively address:
- Dyslipidemia (elevated triglycerides, low HDL)
- Elevations of C-reactive Protein and Homocysteine
Diets high in Fruits, Vegetables, Whole Grains and Legumes also reduce Oxidative Stress and Inflammation which impairs Glucose Uptake in Muscle and Adipose tissue.
One of the key ingredients in a diet rich in whole grains, legumes and nuts is Inositol Hexaphosphate
- Insulin action
- Decreases androgen levels
- Improves Ovulatory Function in both Lean and Obese Women
some of the good options for High Fibre Foods include
- Cruciferous vegetables, such as broccoli, cauliflower and Brussels sprouts
- Greens, include Red Leaf Lettuce and Arugula
- Green and Red peppers
- Winter squash
- Sweet potatoes
- Beans and Lentils
Diet Rich in Lean Protein
Lean protein sources like Tofu, Chicken and Fish are very Filling and provide a Healthy Dietary option for women with PCOS.
Reducing Dairy intake or keeping it limited to Low Fat Dairy products can potentially help women with PCOS to Loose Weight and some of their hormonal PCOS symptoms.
The following dairy products should be limited:
- Artificial and heavily processed cheeses
- Yogurts with added sugar
- Ice-cream with sugar alcohols or tons of added sugar
Anti inflammatory Foods and Spices
Refined Carbohydrates cause Inflammation, increase Insulin Resistance and should be minimised or totally avoided. These include the highly processed foods such as:
- Sugary desserts
- Cakes and pastries
- White Bread
- Anything made with refined flour
- Pastas that are made from Durum Flour or Durum Wheat Flour are high in Carbohydrates and Low in Fibre. They should be substituted by pastas made from Bean or Lentil flour.
It’s essential to read Food Labels to look for various names of sugar and sugar alternatives and avoid where ever possible. These include:
- High fructose corn syrup
- Soda and Juices
It’s essential to reduce, in fact minimise Inflammation causing foods like Fries, Margarine, Red or Processed Meats from the diet and instead include Anti-Inflammatory Food such as:
Dark Coloured, Red, Yellow or Orange Seasonal Fruits and Vegetables, Anti-Inflammatory Herb and Spices like Ginger, Garlic, Clove, Black Pepper, Bay Leaves etc in your diet.
Holistic Treatment for PCOS/PCOD by Archana Agarwal
A Healthy & Balanced & Antiinflammatory Diet which helps you to Reach your Desirable Body Weight as well as Prevent Insulin Resistance is the Biggest Support to the ongoing PCOS Treatment !!
Archana Agarwal –A passionate Lifestyle Nutritionist and Dietician for PCOS/PCOD in Delhi with more than 30 years of Experience & Expertise in Nutrition n Diet Counseling for PCOS /PCOD , Hormonal Imbalances & Cancer treatment Support !!
NOTES/ TIPS –
- PCOS responds positively to pro-active Lifestyle Choices like Exercise and Daily Physical Movement. This reduces Insulin Resistance especially when coupled with a Low Fat High Fibre Diet.
- PCOS and its symptoms can cause Stress and Frustration. Hence it is essential to include stress reduction techniques like Yoga and Meditation in daily routine.
- One of the good ways to Sustain a Healthy Meal Plan is to create a GOOD FOOD/ BAD FOOD list under guided supervision and stick to it.