Understanding the causes and cures of PCOS

PCOS is a hidden epidemic that India is facing today, with a large percentage of the female population in their reproductive years suffering from it. In fact, Gynoveda, the world’s first Ayurveda FemTech brand, conducted India’s largest Period Health study. Released in September that is observed as International PCOS Awareness Month, the data is pretty revealing: 

• 60% of women suffer from Polycystic Ovary Syndrome (PCOS) in the age group of 24-35 years. 
• PCOS accounts for a major menstrual health concern in India, with 54% of women suffering from it.
• 60% of women have excessive weight gain, 59% have facial hair growth, amongst other bodily changes due to PCOS.

Let’s understand the causes and cures of this widespread phenomenon with expert inputs on what causes PCOS and how to deal with it.

What is PCOS?
Polycystic Ovary Syndrome (PCOS) is a hormonal disorder most seen in women of reproductive age. It usually begins in adolescence, but its symptoms might continue well after menopause. 

PCOS leads to enlarged ovaries with small cysts, causing irregular menstrual cycles, excess androgen levels, and various symptoms like acne, weight gain, and hair growth. Globally, it affects 10-13% of women, but in India, around 54% of women of reproductive age experience mild to severe symptoms of PCOS. Unfortunately, about 70% of affected women remain undiagnosed about this condition globally. PCOS is a chronic condition and cannot be cured completely, but its symptoms can be managed through changes in lifestyle, medications, and treatment.

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Why do you have PCOS?
Are you suffering from prolonged, heavy, intermittent, and unpredictable periods? Do you notice excessive hair growth on the face, weight gain around the belly, sudden hair thinning, and male-pattern baldness? Most likely, you are suffering from PCOS. The exact cause of PCOS is unknown, but there are myriad reasons for young women to have PCOS. These are some of the common causes:

1. Genetics
   No single gene has been found to cause this condition; thus, the link is likely to be multiple genes. It has been seen that about 33% of affected women have had a relative suffering from PCOS. Some ethnic groups might have a higher percentage than others. 
2. Hormones
   Ovaries produce hormones, which are chemicals that control various bodily functions. Women produce more estrogen, also called the female hormone, and some amount of androgen or the male hormone. Women suffering from PCOS have an imbalance in these hormones and tend to produce more of the male and less of the female hormones. This disturbs the menstrual cycle, causes follicles to stop developing eggs, leads to infertility, and increases acne and excessive hair growth. 
3. Insulin 
   Insulin is another hormonal imbalance in women with PCOS and can wreak havoc on natural body functions. About 85% of PCOS-affected women are insulin resistant, which means the body stops glucose from reaching your cells. This, in turn, causes the body to produce more of it, and higher levels of insulin increase the male hormone (androgen) in the ovaries, which interferes with the menstrual cycle.
4. Weight gain
   Women in all weight ranges can get PCOS, but if you are heavier on the weighing scale, the chances of getting it are greater as weight increases the hormones accountable for PCOS symptoms. 
5. Toxin imbalance
   Ayurveda terms PCOS as a ‘kapha’ (associated with earth and water) and ‘vata’ (air and space) imbalance disorder. It occurs when excessive kapha blocks the naturally balanced flow of the reproductive fluids and channels. “PCOS is primarily caused due to excessive ama (toxins) caused by a faulty diet, sedentary lifestyle, and stress, and it is not limited to a specific age group,” Rachana Gupta, co-founder of Gynoveda, explains. 

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Impact on fertility and reproductive health
PCOS has a significant impact on the reproductive health of a woman. Most women suffering from this disease cannot conceive naturally. Gupta explains why:

1. PCOS prohibits ovulation
   Ovulation is when a mature egg is released from the ovaries. This is the first step in conception. Without a healthy and developed egg, there can be no conception. PCOS obstructs egg growth and development. When a woman has PCOS, her ovary channels are blocked, and they don’t get the hormones required for proper growth, development and timely egg release. 
2. PCOS deteriorates egg quality 
   Egg quality is crucial for a successful and healthy pregnancy. PCOS prevents healthy egg growth and development. Generally, it doesn’t even allow the egg to mature and ovulate. Nevertheless, poor egg quality increases the risk of early pregnancy loss, even when ovulation occurs. 
3. PCOS causes hormonal imbalance 
   Hormonal imbalances lead to implantation failures. When a woman with PCOS achieves ovulation and fertilises her eggs, the risk of implantation failure tends to be high. For successful implantation in the uterus, the egg requires several hormones. Unfortunately, PCOS hinders the release of these hormones.

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Prevention and cure of PCOS
PCOS cannot be cured, but it can be managed and its symptoms controlled with medical treatment, lifestyle changes, healthy eating habits and Ayurvedic remedies.

1. Medical treatments
   Depending on the symptoms and severity of the disease, your doctor might recommend medicines to regularise menstruation. You might be put on hormonal contraception to get pregnant, which would include the combined oral contraceptive pill to reduce the production of male-type hormones, progesterone hormone to stimulate the uterus, hormonal implants, and intrauterine devices (IUDs) that contain progesterone. If you are not looking at getting pregnant, the treatment could include birth control pills to regularise the menstrual cycle, reduce androgen levels and control acne. You might also be given diabetes medication to lower insulin resistance caused by PCOS.
2. Lifestyle changes Making simple lifestyle changes can be beneficial in controlling PCOS. Dr. Ketan Mangwal, MD Ayurveda, advises, “Incorporate nourishing foods like fruits, vegetables and whole grains into your daily dietary choices while decreasing your meat intake, saturated fats, salt, and refined sugar. Women, especially those with PCOS, are encouraged to consume seeds such as pumpkin, sunflower, chia, flax, and sesame as they are high protein sources.” 
   Besides eating healthy, you should also have an active life. Indulge in some form of physical workout to keep the weight under check, as weight loss can help maintain ideal insulin and androgen levels, which are required for timely ovulation. 
   
   “Yoga can offer relief to women experiencing PCOS by alleviating abdominal pain and promoting the regulation of anxiety, hormones, menstrual cycles, and various metabolic factors. Incorporating pranayama, or breathing exercises, into your routine can help reduce stress and maintain a calm mind. Making a few lifestyle modifications makes it possible to mitigate PCOS symptoms and lead a well-rounded life filled with happiness, improved fertility and boosted self-confidence,” recommends Dr. Mangwal. 

Shweta Dravid is a self-confessed explorer who writes on travel, health, wellness, mindfulness and life truths.

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