What is PCOS And How to Treat it Effectively?
In India itself, one in every five women are diagnosed with PCOS. Often misdiagnosed and poorly understood by research, PCOS is a hormonal disorder that affects women throughout their reproductive lives.
What is PCOS and how to treat it?
We all want to know what is PCOS. So, PCOS is a syndrome, which means it presents itself as a complex set of symptoms associated with hormonal imbalance, affecting reproductive and metabolic health.
There is no complete cure for PCOS but many of the symptoms can be managed with lifestyle modifications and medications — and making lifestyle changes is often the first line of treatment. It is important to remember that each woman will have a different set of symptoms so the treatment pathways will vary.
- Managing PCOS with lifestyle
In most cases, making lifestyle changes should be your first line of treatment. A healthy lifestyle means having a nutritious and a well-balanced diet combined with regular physical activity.
If you are overweight, losing even 5% to 10% of your body weight can have a great impact in reducing your PCOS symptoms. Losing excess weight helps regularize your periods, improve fertility, lowers your risk of developing diabetes and reduces other symptoms associated with PCOS such as acne, and excessive hair growth.
Focusing on diet and physical activity
Regardless of your weight, your nutrition and activity levels are important in managing PCOS. Your diet can consist of healthy carbohydrates, proteins and fats from unprocessed food sources. Cut down on processed food items such as packaged foods, fried food and junk food.
When it comes to exercise, start with reducing inactivity and increasing movement through the day. This could mean going for an evening walk, doing household chores or playing a sport. It is recommended to get at least 30 minutes of physical activity daily to start with — which you can break down through the day. Along with doing cardio (walking, running, cycling), also include strength training exercises for a holistic approach.
- Managing PCOS with medications
For some women, making lifestyle changes is all they need to reduce their symptoms. But for others, medications may also be required to manage other health problems such as fertility issues, diabetes or high cholesterol. Some commonly used therapies include:
- Combined oral contraceptive pill
Essentially, oral contraceptive pills (OCP’s) are just a combination of oestrogen and progestin. Oestrogen and progesterone are two naturally-occurring female hormones that control your cycle and ovulation (egg release). In women with PCOS, there is an imbalance of these hormones due to elevated levels of male hormones (androgens). These pills help make your cycle more regular by reducing the level of androgens produced.
Metformin is primarily used to treat insulin resistance and diabetes by making your body more sensitive to insulin and maintaining a stable level of sugar in your blood. In women with PCOS, this can help with weight loss, reduce the production of androgen and help regularise periods.
- Anti-androgen drugs
Since androgen levels are elevated in women with PCOS, these medications help prevent the production or reduce the effects of these hormones. This can in turn reduce symptoms of excess hair growth (hirsutism) and acne.
- Cosmetic treatments
Shaving, threading, waxing, and laser, are some common hair removal methods. For acne, using over-the-counter creams or ointments that are antibacterial and help unclog pores are useful. For scalp hair loss, the first line of treatment is applying minoxidil (available as liquid or foam) to the scalp. Additional treatments include laser therapy and hair transplantation.
- Fertility treatment
Letrozole is a widely used treatment for infertility in women with PCOS and has been shown to be more effective than other ovulation induction agents such as clomiphene citrate. These medications are associated with a higher rate of multiple gestations (ex: twins, triplets) and so their use should be monitored by a physician.