Unveiling PCOS: The Silent Epidemic Among South Asian Women

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting women worldwide, but it has been found to be notably prevalent among South Asian women. While globally 1 in 10 women of reproductive age have PCOS, the prevalence is much higher in women of South Asian ethnicities where 1 in 5 women are being diagnosed with PCOS (Wijeyaratne et al., 2010). This condition not only affects their physiological health but also has profound mental and social impacts, causing a loss of confidence and self-esteem in many women.

Women diagnosed with PCOS often experience a combination of symptoms such as irregular or painful periods, weight gain, acne, excessive hair growth (hirsutism), and male-pattern baldness. If left untreated, PCOS can lead to severe health issues, including obesity, Type 2 diabetes, cardiovascular diseases, and infertility complications. These symptoms and their impacts make PCOS a multifaceted condition that requires comprehensive management.

While the exact cause of PCOS is not fully understood, the primary underlying issue is hormonal imbalance. Women with PCOS typically present with higher levels of androgens (male hormones), such as testosterone. The other key contributor to the development of PCOS is insulin resistance. Insulin is the hormone responsible for regulating blood glucose levels. When cells stop responding to insulin effectively, the pancreas produces more insulin to maintain normal blood sugar levels. The elevated levels of insulin in the bloodstream can exacerbate PCOS symptoms by stimulating the ovaries to produce more androgens.

Why is PCOS more common among South Asians? While genetic factors play a role, that’s not all! Lifestyle choices heavily impact the prevalence of this syndrome and the severity of its associated symptoms. Modern sedentary lifestyles contribute greatly to insulin resistance. 

Most women, when first diagnosed with PCOS are prescribed birth control pills to regulate their hormones. But is that the only way to tackle their symptoms? 

Exercise and diet are crucial for managing PCOS. Regular physical activity can improve insulin resistance and help maintain a healthy body weight. Studies show that certain kinds of exercises are more effective than others for those with PCOS. These include aerobic exercise (Ribeiro et al., 2021), resistance training (Kite et al., 2022), high-intensity interval training (HIIT) (Santos et al., 2021), yoga, and pilates. 

Along with physical activity, dietary modifications must also be made. Beginning with reducing the intake of processed foods and refined sugars and transitioning to a diet low in glycemic index (GI) but high in fiber can make a massive difference. GI is a system of ranking carbohydrates based on their effect on the blood glucose levels. Whole grains such as barley, millet, quinoa, lentils, beans, chickpeas, most fruits and vegetables are all examples of low GI foods. These changes to diet can not only help alleviate PCOS symptoms and control body weight but it can also reverse insulin resistance, the root cause of this disease. 

Apart from exercise and diet, other management strategies can be effective. Spearmint tea, for instance, has been shown to have anti-androgenic effects, helping to manage hirsutism by lowering testosterone levels in the body (Ghanbarian et al., 2024).

While there is no cure for PCOS, lifestyle changes including regular exercise, healthy diet, and stress management techniques can significantly improve symptoms and overall health. Women with PCOS can achieve better management of their condition and enhance their quality of life through these sustainable lifestyle modifications. By addressing both the physiological and psychological aspects of PCOS, women can find a path to better health and well-being.

Citation:

1. Wijeyaratne, C. N., Seneviratne, R. d., Dahanayake, S., Kumarapeli, V., Palipane, E., Kuruppu, N., … Balen, A. H. (2010). Phenotype and metabolic profile of South Asian women with polycystic ovary syndrome (PCOS): Results of a large database from a specialist endocrine clinic. Human Reproduction, 26(1), 202–213. doi:10.1093/humrep/deq310 

2. Ribeiro VB, Lopes IP, dos Reis RM, et al. Continuous versus intermittent aerobic exercise in the improvement of quality of life for women with polycystic ovary syndrome: A randomized controlled trial. Journal of Health Psychology. 2021;26(9):1307-1317.  doi:10.1177/1359105319869806 

3.  Kite, C., Parkes, E., Taylor, S. R., Davies, R. W., Lagojda, L., Brown, J. E., … Randeva, H. S. (2022). Time to load up–resistance training can improve the health of women with polycystic ovary syndrome (PCOS): A scoping review. Retrieved from https://www.mdpi.com/2076-3271/10/4/53  

4. Santos, I. K. dos, Fernando Antônio Santana de Souza Nunes, Queiros, V. S., Cobucci, R. N., Dantas, P. B., Soares, G. M., … Dantas, P. M. S. (2021). Effect of high-intensity interval training on metabolic parameters in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. Retrieved from https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0245023  

Ghanbarian, R., Ranjbai, M., Babaeian, M., & Mazaheri, M. (2024). A narrative review of herbal remedies for managing hirsutism. International Journal of Preventive Medicine, 15. doi:10.4103/ijpvm.ijpvm_62_23