Introduction

Polycystic Ovary Syndrome (PCOS) is a complex condition that affects women and has hormonal imbalances, irregular periods, small cysts on the ovaries, and higher levels of male hormones in the female body. These hormones can cause some issues like stopping the normal development of follicles (the tiny sacs that contain eggs) in the ovaries. As a result, these follicles turn into small cysts. When the follicles do not develop properly, it can lead to problems with ovulation, which means that eggs may not be released as they should be during the menstrual cycle. This disruption in ovulation can cause irregular periods or even a lack of periods altogether. Let us explore more about Pcos, exploring its symptoms, diagnosis, treatment options, and lifestyle tips to manage the condition effectively.^1,2.

Causes of PCOS

Let us see some of the causes of PCOS:

Insulin resistance:

• Insulin is a hormone that controls blood glucose levels.
• Insulin resistance occurs when body tissues become less responsive to insulin.
• The body compensates by producing more insulin, leading to higher insulin levels.
• Elevated insulin levels can cause the ovaries to produce excess testosterone.
• Excess testosterone disrupts follicle development and normal ovulation.

Hormone imbalance:

• PCOS is associated with imbalances in certain hormones.
• Testosterone, often considered a male hormone, can be higher in women with PCOS.
• High levels of luteinizing hormone (LH), which stimulates ovulation, may affect the ovaries negatively if too high.
• Low levels of sex hormone-binding globulin (SHBG), a protein that binds to testosterone, can reduce its effectiveness.
• Some women with PCOS may have increased levels of prolactin, a hormone involved in milk production.

Genetic factors:

• PCOS tends to run in families.
• If close relatives like your mother, sister, or aunt have PCOS, your risk of developing it is higher.
• Although specific genes related to PCOS have not been identified yet.

It is important to note that the exact reasons for these hormonal changes and genetic influences in PCOS are not fully understood. Research is ongoing to gain more insights into the underlying causes of this condition.²

Symptoms of PCOS

Let us see some symptoms of PCOS:

• Irregular or absent periods
• Infertility or difficulty getting pregnant.
• Excessive hair growth (hirsutism)
• Weight gain
• Thinning hair and hair loss
• Oily skin or acne.

If you are experiencing any of these symptoms, it is recommended to consult with a healthcare professional.³

Ways to cure PCOS Permanently

There is no known cure for PCOS, but there are several ways to effectively manage the condition and its symptoms. Women with PCOS can improve their overall health and quality of life with the help and guidance of healthcare professionals. Here are a few ways to proactively manage PCOS:

Lifestyle changes 

Implementing positive lifestyle modifications can significantly impact PCOS management. Here are some ways you can practice these changes:

• Sleep hygiene: Prioritize sufficient and quality sleep for hormonal balance.
• Alcohol consumption: Evaluate alcohol intake and consider moderation for fertility and reproductive outcomes.
• Smoking cessation: Quit smoking to improve overall health.
• Personalized approach: Seek guidance from healthcare professionals who are experts in treating PCOS.

It is important to note that these lifestyle modifications aim to optimize PCOS management and improve overall health.⁴

Balanced diet

A balanced diet for PCOS may include the following components:

• Calorie reduction: Reduce overall caloric intake to promote weight loss.
• Low glycemic index (GI) foods: Choose carbohydrates that have a low GI to help regulate blood sugar levels and insulin resistance.
• Healthy fats: Incorporate sources of healthy fats such as avocados, nuts, and olive oil while minimizing saturated fats.
• Dietary fibre: Include high-fibre foods like fruits, vegetables, and whole grains to support gut health and promote satiety.
• Omega-3 supplementation: Consider adding omega-3 fatty acids through sources like fish to reduce inflammation.
• Ketogenic diet (optional): For some individuals, a ketogenic diet that restricts carbohydrates and emphasizes plant-based fats may provide additional benefits in terms of weight loss and hormonal balance.

Remember, it is essential to consult with a healthcare professional or registered dietitian to create a personalized and sustainable diet plan that suits your specific needs and goals.⁵

Regular exercise

• Exercise is an effective approach for managing PCOS.
• Physical training improves insulin sensitivity by enhancing glucose transport and metabolism.
• In PCOS, high-intensity exercise has a great influence on cardiorespiratory fitness, insulin resistance, and body composition. Studies have shown significant reductions in insulin resistance and BMI with exercise.
• Aerobic exercise improves insulin resistance, body composition, lipid profiles, and aerobic fitness.
• Resistance training improves waist circumference and body fat percentage, but effects on HDL cholesterol and BMI may vary.
• Both aerobic exercise and resistance training improve insulin sensitivity and androgen levels in women with PCOS.
• Supervised exercise of shorter duration, targeting women above a healthy weight, tends to yield better outcomes. The recommended amount of time to perform exercise is 120-150 minutes per week.
• Vigorous aerobic exercise has shown benefits in improving insulin responsiveness, insulin sensitivity, body composition, and cardiorespiratory fitness in PCOS.
• Combining diet with exercise, especially vigorous aerobic exercise, leads to greater reductions in BMI, waist circumference, and insulin resistance compared to exercise alone.

It is important to note that exercise should be tailored to individual needs and supervised by professionals for the best outcomes.^4,5.

Weight management

• Weight loss maintenance is challenging, with many individuals experiencing weight regain after initial success.
• Lifestyle interventions, including a healthy diet and regular physical activity, are recommended for preventing weight gain and maintaining health.
• Behavioral support, such as self-monitoring, countering negative thoughts, stress management, and increased physical exercise, is important for long-term weight maintenance.
• Healthy lifestyle modifications, including dietary interventions without caloric restriction and regular physical activity, are recommended for women with PCOS.⁶

Medication and supplements

• Inositol (myo-inositol and di-chiro inositol) supplementation may improve metabolic profiles and reduce hyperandrogenism in PCOS.
• B-group vitamins (B1, B6, B12), folic acid (B9), and vitamins D, E, and K play critical roles in metabolic and reproductive processes in PCOS.
• Vitamin D supplementation improves insulin resistance, lipid profiles, and androgen levels in PCOS.
• Research suggests potential benefits of vitamin E and vitamin K supplementation in PCOS.
• Bioflavonoids, carnitine, and alpha-lipoic acid have antioxidant properties and may have metabolic benefits in PCOS.
• Minerals such as calcium, zinc, selenium, magnesium, and chromium picolinate have been explored for their insulin-sensitizing and antioxidant properties in PCOS.
• Omega-3 fatty acids, N-acetyl-cysteine (NAC), CoQ10, probiotics, quercetin, resveratrol, and melatonin have shown potential benefits in improving metabolic and reproductive outcomes in PCOS.

It is important to consult with a healthcare professional before starting any medications or supplements for PCOS to ensure appropriate dosage and safety.⁴

Herbal remedies

• Aloe vera, cinnamon, green tea, chamomile, and white mulberry are herbs that can complement the treatment of PCOS by supporting insulin management and regulating lipid and carbohydrate metabolism.
• Green mint and licorice root are recommended for women with PCOS who have increased levels of androgens due to their antiandrogenic effects.
• Herbs such as Serenoa repens, Camellia sinensis, Rosmarinus officinalis, and Glycyrrhiza glabra can lower androgen levels and inhibit androgenetic alopecia.
• Vitex agnus-castus is an herb that regulates the menstrual cycle and has been used in traditional medicine for centuries.
• Flaxseed lignans, found in flaxseed, may modulate hormone levels and estrogen synthesis.
• Turmeric (curcumin) and nettle have antioxidant and anti-inflammatory properties, which can help reduce oxidative stress and inflammation in patients with PCOS.
• Milk thistle (silymarin), artichoke extract, dandelion, and black cumin have hepatoprotective activities and may benefit individuals with PCOS who have accompanying metabolic syndrome or fatty liver disease.

It is important to consult with a healthcare professional before incorporating herbal medications into the treatment plan for PCOS.⁵

Acupuncture

• Acupuncture in PCOS has been linked to decreased LH and testosterone levels, and the restoration of menstrual cycles.
• It may positively impact sympathetic function and ovarian blood flow.
• A recent meta-analysis showed improved menstrual regularity with acupuncture, but no significant increase in live birth, pregnancy, or ovulation rates.

However, more research is required to establish the overall effectiveness of acupuncture for PCOS.^4,7.

Stress management

• A study examined the effectiveness of a mindfulness stress management program for women with PCOS.
• The intervention resulted in decreased levels of stress, anxiety, and depression, and improved overall quality of life.
• Similar findings have been reported in studies involving mindfulness techniques in other patient groups.
• Cortisol levels and BMI were identified as predictors in specific subgroups of patients.
• The study emphasized that mindfulness techniques primarily affect emotions and mood rather than thinking and cognitive processes.
• Mindfulness stress management techniques can be considered as an adjunctive approach for reducing stress and improving the quality of life in women with PCOS.

However, longer follow-up periods and larger studies are needed for more conclusive results.⁸

Getting enough sleep

• Women with PCOS are at a higher risk of both clinical sleep disorders and non-clinical sleep disturbances.
• Hormonal imbalances, such as reduced levels of estrogen, progesterone, and melatonin, contribute to sleep-related issues in PCOS.
• Estrogen and progesterone play roles in regulating sleep patterns and promoting sleep quality.
• Melatonin is involved in circadian rhythm regulation and ovarian function.
• OSA (obstructive sleep apnea) is more likely in women with PCOS and should be screened for and treated.
• Sleep disturbances, including hypersomnia and insomnia, are prevalent in PCOS cases.
• Sleep disturbances in PCOS can worsen metabolic outcomes and contribute to weight gain, insulin resistance, and cardiovascular risks.
• Sleep disorders impact adherence to dietary interventions and may be linked to mental health issues.
• Improving sleep quality is important for promoting healthy lifestyle changes in women with PCOS.⁴

Conclusion

In conclusion, PCOS (Polycystic Ovary Syndrome) is a complex condition without a cure, but there are evidence-based strategies that can contribute to its long-term management. It is important to remember that each person’s journey with PCOS is unique, so it is essential to work closely with healthcare professionals and tailor these tips to your specific needs. With dedication and a positive approach, it is possible to achieve lasting relief.

FAQs

Disclaimer: The information included at this site is for educational purposes only and is not intended to be a substitute for medical treatment by a healthcare professional. Because of unique individual needs, the reader should consult their physician to determine the appropriateness of the information for the reader’s situation.

References

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2. Causes -Polycystic ovary syndrome [Internet]. NHS; [cited 2023 May 16]. Available from: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/causes/  
3. Symptoms -Polycystic ovary syndrome [Internet]. NHS; [cited 2023 May 16]. Available from: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/symptoms/ 
4. Cowan S, Lim S, Alycia C, Pirotta S, Thomson R, Gibson-Helm M, Blackmore R, Naderpoor N, Bennett C, Ee C, Rao V. Lifestyle management in polycystic ovary syndrome–beyond diet and physical activity. BMC Endocrine Disorders. 2023 Jan 16;23(1):14. Available from: https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-022-01208-y 
5. Szczuko M, Kikut J, Szczuko U, Szydłowska I, Nawrocka-Rutkowska J, Ziętek M, Verbanac D, Saso L. Nutrition strategy and life style in polycystic ovary syndrome—Narrative review. Nutrients. 2021 Jul 18;13(7):2452. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308732/ 
6. Ozgen Saydam B, Yildiz BO. Weight management strategies for patients with PCOS: current perspectives. Expert review of endocrinology & metabolism. 2021 Mar 4;16(2):49-62. Available from: https://pubmed.ncbi.nlm.nih.gov/33719818/ 
7. Wu J, Chen D, Liu N. Effectiveness of acupuncture in polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. Medicine. 2020 May 29;99(22):e20441. Available from: https://journals.lww.com/md-journal/Fulltext/2020/05290/Effectiveness_of_acupuncture_in_polycystic_ovary.93.aspx 
8. Stefanaki C, Bacopoulou F, Livadas S, Kandaraki A, Karachalios A, Chrousos GP, Diamanti-Kandarakis E. Impact of a mindfulness stress management program on stress, anxiety, depression, and quality of life in women with polycystic ovary syndrome: a randomized controlled trial. Stress. 2015 Jan 2;18(1):57-66. Available from: https://www.tandfonline.com/doi/full/10.3109/10253890.2014.974030