Management of PCOS and Primary Infertility with Low Carb-Diet

Author: Dr. Sushma Pachouri (B.H.M.S,PGNAHI)

ABSTRACT:

The polycystic ovary syndrome(PCOS) is one of the most common cause of infertility due to anovulation in women. It is a common endocrine condition associated with hyperandrogenism, infertility and metabolic function. It is highly dependent on heredity obesity and lifestyle. Obesity has a large effect on pathophysiology and the clinical manifestation of PCOS. Compared to normal women with PCOS those with obesity are characterised by worsened hyperandogenic and metabolic state, poorer menses and ovulatory performance and ultimately, poorer pregnancy rates. The increase in prevalence of infertility among the young females with PCOS may be due to the obesity or inherited genetically. In this study we will see how the low carb diets and exercise treats infertility related to PCOS.

INTRODUCTION:

The polycystic ovary syndrome(PCOS) one of the most common cause of infertility due to anovulation which affects 4-7% of women[1] following criteria are sufficient for the diagnosis: Oligo and/or anovulation, clinical and/or biochemical signs of hyperandrogenism and polycystic ovaries at ultrasound. The clinical features of PCOS and heterogeneous and may change throughout the lifespan starting from adolescence to postmenopausal age[2]. this is largely dependent on the influence of obesity and metabolic alterations including an insulin-resistant state and the metabolic syndrome, which consistently affect most women with PCOS[3]. this article is particularly focused on the effect of low carb diet on women with PCOS having infertility.

Polycystic ovary syndrome (PCOS) is a set of symptoms due to elevated androgens (male hormones) in women. Signs and symptoms of PCOS include irregular or no menstrual periods, heavy periods, excess body and facial hair, acne, pelvic pain, difficulty getting pregnant, and skin. Associated conditions include type 2 diabetes, obesity, obstructive sleep apnea, heart disease, mood disorders, and endometrial cancer.

PCOS is due to a combination of genetic and environmental factors. Risk factors include obesity, not enough physical exercise, and a family history of someone with the condition. Diagnosis is based on two of the following three findings: no ovulation, high androgen levels, and cysts. Cysts may be detectable by ultrasound. Other conditions that produce similar symptoms include adrenal hyperplasia, hypothyroidism, and hyperprolactinemia.

PCOS has no cure. Treatment may involve lifestyle changes such as weight loss and exercise. Birth control pills may help with improving the regularity of periods, excess hair growth, and acne. Metformin and anti-androgens may also help. Other typical acne treatments and hair removal techniques may be used. Efforts to improve fertility include weight loss, clomiphene or metformin. In vitro fertilization is used by some in whom other measures are not effective. In this article we will deal with the effect of weight loss on the hormonal and metabolic abnormalities on menses, ovulation and fertility rates.

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FINDINGS:

PCOS is the most common endocrinopathy in women. Various findings have been suggested which includes hyperandrogenism and/or hyperandrogenemia, oligo ovulation or anovulation. In majority of cases insulin resistance is present. Environmental and genetic factors also have a role in the development of PCOS.The syndrome is associated with many morbidities including infertility obstetrical complication type 2 diabetic mellitus.

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BACKGROUND:

PCOS is a common endocrine condition associated with hyperandrogenism. It is a hormonal imbalance in women that is thought to be one of the leading cause of female infertility [3][4][5][6]. Weight management through diet and lifestyle modifications are fundamental to its management. This study aimed to explore the dietary and lifestyle strategies followed by women with PCOS resulting in infertility and its contribution of fitness consultant to its management.

METHOD:

We examine the effects of low carb diets on the women with PCOS. The women were categorized into two categories, twenty women followed low carb diet whereas the other twenty women were kept on the normal diets (with no concomitant disease). At the end of 1 month lots of improvement was found in women who followed LCD which include weight loss, decrease in the cyst size and hormonal correction.

DISCUSSION:

Despite there being no known cure for polycystic ovary syndrome, there are variety of treatments available which can effectively control the symptoms. Weight gain is one of the most common side effects of PCOS.According to observation, individual loosing just 5% of their body weight will experience on improvement in symptoms of PCOS

Dr.walter futterweit, clinical professor of the division of endocrinology of the Mount Sinai school of medicine suggest that non obese women with PCOS who get regular periods eat a balanced diet. An obese insulin resistant women should consume carbs less than 40%. Clearly this is an area which needs to be researched more and more.

RESULT:

Those who completed the short term hypocaloric diet has a significant weight loss and a significant change in hormonal balance. A low carb high protein diet helped insulin resistance. A high carb low protein diet made insulin resistance worse. (Medical journal Metabolis: no.12:1481-1487).

CONCLUSION:

A moderate reduction in dietary carbohydrate reduced the fasting and post challenge insulin concentrations among women with PCOS, which overtime may improve reproductive/endocrine outcomes.

REFERENCES:

1. Ehrmann DA. Polycysticovarian Syndrome Engl J Med 2005; 352:1223-1236 cross ref/PubMed/web of science times cited 280.

2. Pasquali R, Gambier A.PCOS; a multifaceted disease from adolescence to adult age. Ann NY Acad sci 2006(in pres) Wiley online library/PubMed/web of science Times cited: 19.

3. Golden berg N, Gluck C (2008, medical therapy in women with polycystic ovary syndrome before and during pregnancy and lactation mierva Ginecol 60(1) 63-75.
4. Boomsma CM Fauses BC Maudon Ns (2008): pregnancy complication in women with PCOS”semin reprod.Med
26(1);72-84.

5. Palacio JR etal.the presence of antibodies to oxidative modified proteins in serum from polycystic ovary syndrome patients clin exp immunol.2006 may;144(2)217-222 PMID 16634794

6. AZZIZ R etal the prevalence and features of the polycystic ovary syndrome in an unselected population.Jclkin endocrinol metab.2004 Jun,89(6):2745-9PMID 15181052.

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