Title : Lifestyle Changes in Polycystic Ovary Syndrome (PCOS)
Author : Mrunal Sanjay Khandagale
Literature Review
1. Sustainable Weight loss through Dietary Modification in PCOS
According to this article ,PCOS is a hormonal disorder causing enlarged ovaries with small cysts on the outer edges. It causes reproductive and metabolic consequences including diabetes, infertility and anovulation. The central treatment should focus on reducing the risk factors such as obesity and insulin resistance. Short term changes have shown successful results such as weight loss but for the long run, these quick treatments are not being helpful as maintaining the weight is a problem. Recent research says that long term lifestyle changes might reduce the chances of diabetes in general population of women. Emphasize should be on sustainable weight loss through dietary modifications and exercise. (Robert J Norman et all, 2002)
2. Effect of Healthy Lifestyle in PCOS
According to this article, PCOS affects 4% to 18% of women. It is associated with metabolic, reproductive and psychological dysfunction. These include reduced frequency of ovulation and irregular menstrual cycle, reduced fertility, diabetes, cardiovascuscular diseases and high amount of testosterone which can cause excess facial or body hair growth and acne. The study showed that healthy lifestyle like incorporating diet, exercise and behavioural intervention has reduced body weight and abdominal, testosterone levels and improves insulin resistance which helps to prevent PCOS. As obesity worsens the presentation of PCOS and weight management. (Lisa J Moran et all, 2011)
3. Lifestyle Advice to Women with PCOS
According to this article, PCOS is a common endocrine disorder affecting up to 13% pf women. This review summarises the barriers on weight and lifestyle management in women with PCOS and suggested strategies for overcoming these challenges, mapped to the capacity, opportunity, Motivation and Behaviour Model. Motivation to adopt healthy lifestyle maybe impacted by suboptimal risk perception and intrinsic motivation. To address such barriers, screening and management of eating disorders, disordered eating, depression and obstructive sleep apnoea should be taken as guidelines. ( Caroln Ee et all, 2021)
4. Anti- Obesity Therapies for PCOS
According to this article, Obesity is frequently present in patients with PCOS and plays an important role in the pathogenies of the endocrine, metabolic and reproductive abnormalities associated with this syndrome. Lifestyle changes including diet, exercise and behavioural modification, appear to improve the metabolic and reproductive abnormalities of overweight and obese patients with PCOS. Anti- obesity agents that have been studied in PCOS include orlistat, sibutramine and rimonabant. Therefore, combining lifestyle changes and anti- obesity agents improves the state of obese patients and suffering from PCOS. ( Dimitrios Panidis et all, 2013)
5. Metformin Vs Lifestyle Changes in Women with PCOS
According to this article, when 15bwomen women in the metformin group and 12 in the lifestyle changes group completed the study. The menstrual pattern was improved by 67% in both the groups, which says that both are effective for the treatment of PCOS. There was also reduction in the waist size and the BMI of the people taken for this study. ( Daniella D. G. Curi et all, 2012)
6. Obesity and PCOS
According to this article, obesity is likely not a cause of PCOS, as high prevalence of PCOS among relatively thin population demonstrates. However, obesity does exacerbate cardiovascular risk factors. It is associated with infertility and risk for pregnancy complications. Weight loss is the front- line therapy for PCOS even though bariatric surgery can be an option. ( Richard S. Legro, 2012)
7. Polycystic Ovary Syndrome
According to this article, Polycystic Ovary Syndrome (PCOS) affects 5 – 20% of women of reproductive age worldwide. This condition is characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology with excessive androgen production by the ovaries being a key feature of PCOS. PCOS increases the risk for type 2 diabetes, gestational diabetes, venous thromboembolism and endometrial cancer. The treatment includes lifestyle changes, medication and potential surgery. ( Robert Norman et all, 2004)
8. The Management of Insulin Resistance in PCOS
According to this article, PCOS has reproductive and metabolic implications. Insulin resistance, secondary to genetic and lifestyle factors is integral in the pathogenesis, metabolic, clinical features and the long-time sequelae in the majority of women with PCOS. Therapeutic strategies targeting IR in PCOS ameliorate clinical features and might reduce long term sequelae including diabetes. In PCOS, metformin reduces IR, improves ovarian function and regulates cycles, lowers androgens clinical hyperandrogenism and potentially improves fertility. (Helena J Teede et all, 2007)
9. Analysis on Implementation of PCOS Lifestyle
According to this article, Polycystic Ovary Syndrome (PCOS) affects 8 – % 13 of women of reproductive age worldwide. Women with PCOS are more likely to have excess BMI, which in turn exacerbates the symptoms of PCOS in these women. The latest evidence-based guideline recommends lifestyle management as the first- line treatment for PCOS. Women with PCOS expressed the need for multidisciplinary, integrated as a recurrent theme. Lifestyle change is the implementation plan for women with PCOS. (Siew Lim et all, 2021)
10. Effect of Lifestyle Change on Symptoms of PCOS
According to this article, PCOS is a complex endocrine disorder that affects 6% to 10% of women in reproductive age. Lifestyle changes include diet, exercise and behavioural modification, appear to improve the metabolic and reproductive abnormalities of overweight obese girls with PCOS. Which in turn reduces all the risk factors and consequences associated with PCOS. (Somaya Ouda Abd Elmenim et all, 2016)
11. Conclusion
According to all the 11 reviews, we can say that PCOS is an endocrine disorder affecting 5- 20% of women worldwide. It is associated with metabolic, reproductive and psychological dysfunction. These include reduced frequency of ovulation and irregular menstrual cycle, reduced fertility, diabetes, cardiovascuscular diseases and high amount of testosterone. Lifestyle changes with anti- obesity and Metformin will improve and help in the treatment of PCOS.
Reference
• Lisa J Moran, Samantha K Hutchison, Robert J Norman, Helena J Teede, Cochrane Database of Systematic Reviews, July 2011
• Carolyn Ee, Stephanie Pirotta, Aya Mousa, Lisa Moran, Siew Lim, BMC endocrine disorders 21, November 2021
• Siew S Lim, Samantha K Hutchison, Emer Van Ryswyk, Robert J Norman, Helena J Teede, Lisa J Moran, Cochrane Database of Systematic Reviews, March 2019
• Robert J Norman, Michael J Davies, Jnathan Lord, Lisa j Moran, Trends in Endocrinology & Metabolism, 13, 6, August 2002
• Dimitrios Panidis, Konstantinos Tziomalos, Christos Vosnakis & IIias Katsikis, Endocrine, 44, April 2013
• Daniella DG Curi, Angela Maggio Fonseca, Jose Antonio M Marcondes & Jose Maria Soares, Gynecological Endocrnology,28, 2012
• Siew Lim, Breanna Wright, Melissa Savaglio, Denise Goodwin, Stephanie Pirotta, Lisa Moran, Seminars in Reproductive Medicine 39, 2021
• Richard S Legro, Seminars in Reproductive Medicine, 30, 2012
• Robert Norman, Ruijin Wu, Marcin Stankiewicz, Australasian Med Publ Co Ltd, 2004
• Helena J Teede, Samantha K Hutchison, Sophia Zoungas, Trends in Endocrinoloy & Metabolism, 18, 2007