HEALTH TIPS: Polycystic Ovarian Syndrome – PCOS (PART 2)

PCOS Awareness Month – ‘Never Choose Indifference’

Dr. Tariq Jagnarine
Fam Medicine, Endocrinology/ Diabetes

PCOS interrupts the normal menstrual cycle, and makes it harder for a woman to get pregnant. Between 70 and 80 percent of women with PCOS have fertility problems. This condition can also increase the risk of pregnancy complications.
Women with PCOS are twice as likely as women without the condition to deliver their baby prematurely. They’re also at greater risk of miscarriage, high blood pressure, and gestational diabetes. However, women with PCOS can get pregnant using fertility treatments that improve ovulation.
Losing weight and lowering blood sugar levels can improve their chances of having a healthy pregnancy.

Treatment for PCOS usually starts with lifestyle changes like weight loss, diet, and exercise. Losing just 5 to 10 percent of body weight can help regulate one’s menstrual cycle and improve PCOS symptoms. Weight loss can also:
* Improve cholesterol levels
* Lower insulin
* Reduce heart disease and diabetes risks
Any diet that helps persons to lose weight can help with the condition. However, some diets may have advantages over others. Studies comparing diets for PCOS have found that low carbohydrate diets are effective for both weight loss and lowering insulin levels.
A low glycemic index (low GI) diet, which gets most carbohydrates from fruits, vegetables, and whole grains, helps regulate the menstrual cycle better than a regular weight loss diet. A few studies have found that 30 minutes of moderate-intensity exercise at least 3 days a week can help women with PCOS lose weight. Losing weight with exercise also improves ovulation and insulin levels.
Exercise is even more beneficial when combined with a healthy diet. Diet plus exercise help persons to lose more weight than either intervention alone, and lower their risks of diabetes and heart disease.
Women with PCOS are often found to have higher-than-normal insulin levels. Insulin is a hormone that’s produced in the pancreas. It helps the cells in our body turn sugar (glucose) into energy. If persons don’t produce enough insulin, their blood sugar levels can rise. This can also happen if they are insulin-resistant, meaning they aren’t effectively able to use the insulin produced.
If someone is insulin resistant, their body may try to pump out high levels of insulin in an effort to keep the blood sugar levels normal. Too-high levels of insulin can cause the ovaries to produce more androgens, such as testosterone. Insulin resistance may also be caused by having a body mass index above the normal range.
Insulin resistance can make it harder to lose weight, which is why women with PCOS often experience this issue. A diet high in refined carbohydrates, such as starchy and sugary foods, can make insulin-resistance, and therefore weight loss, more difficult to control.

* High-fibre vegetables, such as broccoli
* Lean protein, such as fish. Lean protein sources like tofu, chicken, and fish don’t provide fibre, but are very filling and are a healthy dietary option for women with PCOS.
High-fibre foods can help combat insulin-resistance by slowing down digestion and reducing the impact of sugar on the blood. This may be beneficial to women with PCOS.
* Cruciferous vegetables, such as broccoli, cauliflower, and Brussels sprouts
* Green and red peppers
* Beans and lentils
* Almonds
* Berries
* Sweet potatoes
* Squash
* Pumpkin
Foods that help reduce inflammation may also be beneficial. They include:

* Tomatoes
* Kale
* Spinach
* Almonds and walnuts
* Olive oil
* Fruits such as blueberries and strawberries
* Fatty fish high in omega-3 fatty acids, such as salmon and sardines

Foods high in refined carbohydrates, such as white bread and muffins
Refined carbohydrates cause inflammation, exacerbate insulin-resistance, and should be avoided, or limited significantly. These include highly-processed foods, such as:
* White bread
* Muffins
* Breakfast pastries
* Sugary desserts- doughnut, cinnamon roll, ice cream, baked custard
* Anything made with white flour

* Pasta noodles that list semolina, durum flour, or durum wheat flour as their first ingredient are high in carbohydrates and low in fibre. These should be removed from your diet.
* Sugary snacks and drinks
* Inflammatory foods, such as processed and red meats
Pastas made from bean or lentil flour, instead of wheat flour, are an excellent alternative.
Sugar is a carbohydrate, and should be avoided wherever possible. When reading food labels, be sure to look for sugar’s various names. These include:
* Sucrose
* High fructose corn syrup
* Dextrose
* Sugar can also lurk in the drink, such as soda and juice.
* It’s a good idea to reduce or remove inflammation-causing foods such as fries, margarine, and red or processed meats from one’s diet as well.
PCOS can disrupt a woman’s menstrual cycle and make it harder to get pregnant. High levels of male hormones also lead to unwanted symptoms like hair growth on the face and body. Lifestyle interventions are the first treatments doctors recommend for PCOS, and they often work well.
Weight loss can treat PCOS symptoms and improve the odds of getting pregnant. Diet and aerobic exercise are two effective ways to lose weight.
Medications are an option if lifestyle changes don’t work. Birth control pills and metformin can both restore more normal menstrual cycles and relieve PCOS symptoms.