Worldwide, polycystic ovary syndrome (PCOS) affects between 10 to 15 per cent of women in their reproductive years, says Mehfuza Haffiz, a Senior Clinical Dietitian at DHA. While no data is available on incidence in the UAE, some doctors believe PCOS may hit more women in the UAE because of its correlation with obesity and diabetes.
However, Haffiz says awareness of PCOS is not very high in the UAE. “Women still consider it a taboo subject, but early detection and treatment can go a long way in reversing it,” she says. Crucially, it’s worth remembering that you can get pregnant even if you have PCOS: by managing the condition’s symptoms carefully, many women go on to have healthy pregnancies and deliver healthy babies.
What is PCOS?
PCOS is a genetic, hormonal, metabolic and reproductive disorder that affects women and girls everywhere. Simply put, you may have irregular periods, and consequently, fertility problems. Your body may produce surplus quantities of the hormones androgen and insulin, or you may have enlarged ovaries with fluid-filled sacs or follicles that surround the egg.
A major concern is difficulty ovulating, which means your ovaries do not release eggs as they should, says Dr Fady Hachem, Consultant – Obstetrics & Gynaecology at Burjeel Hospital. This is why you may have infrequent or prolonged menstrual periods. Hyper androgenesis, such as excess facial and body hair, severe acne, and baldness are often visible concerns. Pelvic pain, sudden weight gain, abnormal amounts of lipids in the blood (dyslipidaemia) and insulin resistance are other symptoms. Exhibiting two or three of these features may lead to a diagnosis of PCOS, Dr Hachem adds.
PCOS, insulin resistance and obesity
Doctors don’t yet know what causes PCOS, although the syndrome often runs in families. It is closely linked to insulin resistance and obesity, conditions that have their own intricate relationship with each other. In view of the worldwide obesity epidemic, PCOS is now being seen in more women.
“Up to 70 per cent of women with PCOS have insulin resistance,” Dr Hachem explains. This means that their cells can’t deploy insulin properly to turn sugar from dietary sources into energy. “When cells can’t use insulin properly, the body’s demand for insulin increases. The pancreas makes more insulin to compensate. Extra insulin triggers the ovaries to produce more male hormones.”
Insulin resistance is often caused by obesity. Together, the conditions can increase your risk for type 2 diabetes. “Up to 80 per cent of women with PCOS are overweight or obese. Both obesity and PCOS increase your risk of high blood pressure and high blood sugar, while decreasing the amount of HDL or good cholesterol and increasing quantities of high LDL or bad cholesterol in the body. “Together, these factors are called metabolic syndrome, and they increase the risk for heart disease, diabetes, and stroke.”
Scientists have also found that chronic low-grade inflammation is a key cause of PCOS. Dietary triggers such as glucose may incite oxidative stress and an inflammatory response, a phenomenon independent of obesity.
How is PCOS treated?
Although there’s no cure for PCOS, there are a number of ways to manage the different symptoms and mitigate their effects. Doctors typically work out treatment plans based on each patient, often combining medicines with lifestyle approaches.
“Treatment for PCOS usually starts with lifestyle changes such as weight loss, diet, and exercise. Losing just 5 to 10 per cent of your body weight can help regulate your menstrual cycle and improve PCOS symptoms,” Dr Hachem says. “Diet plus exercise helps you lose more weight than either intervention alone, and it lowers your risks for diabetes and heart disease.”
Dr Dana Al-Hamwi, a Clinical Dietitian who runs the Dr Dana Diet Centre in Dubai Healthcare City routinely advises women in Dubai on how to approach PCOS through diet. “I often tell my patients that overweight, inactive lifestyle, high sugar/salt intake are the main enemies. Losing weight and extra abdominal fat can have a better effect on PCOS medications, reduce insulin and androgen levels, and may restore ovulation,” she says.
Of course, recent events have reinforced sedentary lifestyle habits. The recent lockdown hasn’t been particularly beneficial for us, Haffiz says. “More people are staying home and spending more time online without any physical activity. This has a direct effect on obesity – and could impact the incidence of PCOS over time.”
What to eat when you have PCOS
Some basic dietary changes can go a long way to combating PCOS. “Learning that you have PCOS is not the end of the world and by following the right kind of diet, activity and medications, most of the symptoms can be reversed,” Haffiz says. “The first-line therapy for PCOS is a diet and lifestyle makeover with the primary goal of improving the body’s sensitivity to insulin. Following a balanced diet and replacing simple carbohydrates with complex carbohydrates and low glycaemic index foods (foods that help in slow rising of blood sugar levels in the body) has been shown to be helpful in reducing the symptoms of PCOS.