Polycystic ovary syndrome is the most common hormonal imbalance, affecting approximately 5-18% of women of reproductive age. This endocrine disorder is characterized by a heterogeneous clinical picture determined by different signs and symptoms, which makes diagnosis very difficult.
Menstrual cycle dysfunction (oligo / anovulation)
Clinical or biochemical hyperandrogenism (hirsutism, acne and / or alopecia).
Ultrasound criteria (polycystic ovarian morphology)
- Sindrom policističnih jajnika, simptomi:
- Predmenstrualni sindrom
- Problemi sa plodnošću
- Insulinska rezistencija
- Najčešći uzroci
- Hormonalne promene
- Plodnost, trudnoća i PCOS
- Plodnost
- Trudnoća
- Dijeta i Sindrom policističnih jajnika
- Ishrana koja se preporučuje
- Celi ugljeni hidrati
- Koji je glikemijski indeks( GI)? Da li se GI hrane može izmeniti?
- Voće i povrće
- Voće
- Mahunarke
- Zdrave masti
- Hrana koja se ne preporučuje:
- Jednostavni ugljeni hidrati
- Rafinisani ugljeni hidrati
- Voćni sokovi
- Bezalkoholna pića i alkohol
- Vitamini koje treba uzeti u obzir
- Inositol
- Folna kiselina
- Vitamin D
- Sindrom policističnih jajnika i fizička aktivnost
Polycystic ovary syndrome, symptoms:
Very irregular menstrual cycles
Amenorrhea
Absence of menstruation. It occurs in 70% of cases.
Oligomenorrhea
Decreased menstruation (long cycles, greater than 35 days).
Polymenorrhea
Very frequent menstrual periods (short cycles, shorter than 25 days)
Hypermenorrhea
Prolonged, heavy and painful menstruation
Premenstrual syndrome
Premenstrual syndrome (PMS) is characterized by various physical changes (nausea, weight gain, fatigue, headaches, etc.) and mental (irritability, altered libido, depressed mood, behavioral changes …). These symptoms occur in the luteal phase of the menstrual cycle (a week before menstruation) and women with polycystic ovary syndrome tend to have a harder time withstanding them.
Fertility problems
Anovulation is the absence of ovulation and is one of the most common causes of female infertility.
Excess androgens (hyperandrogenism) is an increase in the male hormone in the blood. Excess androgens can lead to hirsutism (increased body hair in areas such as the face or breasts), acne or seborrhea (excessive production of sebaceous glands) and / or acanthosis nigricans (presence of localized hyperpigmentation on the back of the head, armpits or wrinkles).
Overweight women are more likely to suffer from polycystic ovary syndrome. Women with normal weight (BMI 18.5-25) also suffer from this syndrome. Therefore, it cannot be claimed with certainty that there is a direct link between being overweight and Polycystic Ovary Syndrome.
Insulin resistance
Insulin resistance code Polycystic ovary syndrome occurs due to a defect or inability of the muscle insulin receptor to capture glucose, which leads to an increase in blood glucose. Therefore, women with polycystic ovary syndrome are at increased risk of complications such as diabetes mellitus, premature atherosclerosis, hypertension, heart attack, abortion and coronary heart disease.
The exact cause of polycystic ovary syndrome is unknown. Most experts agree that this is a multifactorial entity that is increasingly influenced by genetic factors. Genes associated with gonadotropins (hormones produced by the pituitary gland responsible for the release of the female hormones LH and FSH) and other hormones associated with insulin and its receptors have been identified.
The most common causes
Hormonal changes
The pituitary gland is responsible for secreting female hormones luteinizing (LH) and follicle stimulating (FSH). In the case of Polycystic Ovary Syndrome, decompensation occurs in the production of these hormones and more LH is secreted than FSH (in normal situations, it should be the other way around). This decompensation leads to increased androgen production. Elevated levels of the male hormone can prevent the separation of the egg from the ovary (prevent ovulation) and disrupt the female menstrual cycle.
Hyperinsulinemia
Insulin is a hormone produced by the pancreas that is involved in the metabolic use of nutrients and is responsible for regulating the amount of glucose in the blood until it is converted into energy. In women with Polycystic Ovary Syndrome, changes in insulin receptors have been observed, leading to an increase in blood glucose. The pancreas as a compensatory response produces more insulin and this overproduction has direct effects on the ovary. Excess testosterone levels are produced and typical signs of the syndrome are generated (hirsutism, anovulation, acne, etc.)
It is important to consider other causes such as stress, emotions, diet and an inactive lifestyle because they can affect and cause changes in the hormonal system.
Fertility, pregnancy and PCOS
Fertility
Women with polycystic ovary syndrome have problems with the menstrual cycle (anovulation is the leading cause of infertility in these patients). Insulin resistance and associated changes in endometrial development may adversely affect fertility. Approximately 85-90% of women who do not ovulate and want to get pregnant go to in vitro fertilization centers, although that does not mean that they cannot get pregnant naturally. 60% of women with Polycystic Ovary Syndrome are fertile and can become pregnant in less than 12 months. The chances of getting pregnant spontaneously are reduced if you have oligoovulation.
Pregnancy
Women with polycystic ovary syndrome have a higher risk of certain complications during pregnancy (gestational diabetes, hypertension, preeclampsia, premature birth). Common diseases such as metabolic syndrome (insulin resistance) and hyperandrogenism can increase the risk of pregnancy. Several studies claim that babies are more likely to be older for their gestational age and will suffer a spontaneous caesarean section or suffocation during birth.
Diet and Polycystic Ovary Syndrome
The most effective treatment for Polycystic Ovary Syndrome is to lead a healthy lifestyle accompanied by a balanced diet and regular physical activity.
Recommended diet
Whole carbohydrates
Consumption of whole grains can reduce the risks of inflammation and obesity that characterize the development of insulin resistance. Cereals contain fiber and a lower glycemic index, slightly raising blood glucose levels, unlike refined or simple sugars. It is advisable to include in your diet the consumption of cereals such as quinoa, buckwheat, millet, oats, amaranth.
What is the glycemic index (GI)? Can the GI of food be altered?
The glycemic index is the ability of foods to raise blood glucose.
Hydration, maturation and heat have the ability to increase the GI in food. It is recommended to avoid too long cooked foods: rice, white pasta and potatoes, sweet potatoes because they raise blood glucose faster (it is better to cook “al dente”).
Fruits and vegetables
Fruits and vegetables are rich in vitamins, fiber, minerals and antioxidants. Its consumption is necessary for a healthy and balanced diet. They have a very low caloric value, are well satiated, reduce appetite and are therefore recommended in all diets for weight loss.
Fruit
The fruit has a very variable GI which can be high -medium -low. Fruits consumed with the skin (strawberries, blueberries, cherries) tend to have a lower GI than those fruits that are eaten without the skin (watermelon, pineapple, mango, etc.). It is recommended to avoid consuming dehydrated fruit, fruit in the form of syrups as well as natural juices with artificial sweeteners.
Vegetables
Vegetables can be classified according to their starch content. Starchy vegetables (pumpkin, peas, carrots) have a higher glycemic index, so they can raise blood glucose more than those that do not contain it (green leafy vegetables, peppers, zucchini, peppers, etc.)
Fruit juice is not equivalent to a portion of fruit, no matter how natural it is. When we process the fruit (cut it, peel it, squeeze it, etc.), approximately 50% of vitamins and minerals are lost along with the fiber.
The fruit contains natural sugar, but it also contains other nutrients that provide numerous benefits to our health if we consume it unprocessed. If we take it in the form of juice, because it does not contain pulp or fiber, it raises blood glucose levels faster.
We have to chew the whole fruit, it gives us more satiety than the intake of juice, which is quickly absorbed and digested. You should always give priority to consuming whole fruits over juices. You do not have to eliminate vegetables that contain starch from your diet, but it is recommended to include them in your diet in small quantities.
Legumes
Legumes are rich in fiber and have a low GI, in addition to providing satiety, they are associated with weight loss. In several studies, it has been noticed that their regular consumption (at least 2-3 times a week) can help increase the levels of the transport protein SHBG (sex hormones), which would help reduce the levels of free testosterone in the blood.
Proteins
Proteins do not raise insulin levels like carbohydrates. Their consumption is associated with weight and fat loss, as well as with the stabilization of blood sugar levels. Proteins are found in foods of animal and plant origin (legumes, nuts, tofu …). There is no standard protein intake. Your recommendation should be personalized, because it varies depending on the intensity and type of sport you play. Although not standardized, several studies have found that consuming about 1.8-2g / kg / day of protein has positive effects on weight loss.
Healthy fats
Omega-3 fats are essential because they improve insulin sensitivity and blood cholesterol levels. Women with polycystic ovary syndrome can have very high levels of prolactin (a hormone produced by the pituitary gland), which leads to changes in the menstrual cycle (anovulation) and possible fertility problems. It is necessary to include the consumption of healthy fats in order to increase the level of HDL cholesterol, which is necessary for optimal hormone production (all sex hormones come from cholesterol). Healthy fats are found in walnuts, seeds, egg yolks, avocados or extra virgin olive oil.
Not recommended foods:
Simple carbohydrates
Simple carbohydrates quickly raise blood glucose levels by increasing insulin resistance and body weight. We can find them in ultra processed products such as pastries, sweet cereals, chocolate, ice cream, pastries, sweets, soft drinks.
Refined carbohydrates
Refined carbohydrates are low in nutrients. They do not provide many nutrients other than starch. By purifying them, in addition to fiber, large amounts of microelements are lost, which makes them useless food. Like simple carbohydrates, they raise blood glucose levels, but not as fast. More energy is needed to process them. White bread, pasta, rice and sweet cereals would be examples of simple carbohydrates.
Pastry
Pastries are enriched with sugars, saturated or trans fats and refined flour. They have a high GI that worsens insulin resistance, and its consumption is especially counterproductive in women who suffer from Polycystic Ovary Syndrome. Examples are sweets, cookies and pastries.
Fruit juices
Fruit juices do not saturate, are easily digested, quickly raise blood glucose levels and contain almost no vitamins. It is better to opt for a whole piece of fruit and reduce the use of juices, regardless of whether they are natural or not.
Milk
There is a lot of controversy and discussion regarding milk consumption. There is evidence that milk, especially skim milk, can contribute to an increase in androgens, worsening acne and hirsutism. This association was not found in fermented dairy products, because they generate less activation of IGF-1. In conclusion, it is advised to limit the consumption of milk and increase the consumption of fermented dairy products (kefir) or herbal drinks without added sugar.
Soft drinks and alcohol
They raise the level of glucose in the blood, worsen insulin resistance and their consumption seriously harms our health.
Vitamins to consider
Inositol
A substance that belongs to the B group of vitamins and provides numerous benefits: it helps regulate hormonal cycles (reduces the level of free testosterone and increases the level of LH), improves hirsutism and acne, and intervenes in the metabolism of sugar and fat in favor of weight loss. It has been determined that taking 3-4 g of inositol a day increases insulin sensitivity and improves ovulation. Foods that contain: citrus fruits, legumes, nuts.
Folic acid
Vitamin B9 supplementation can help treat ovulatory infertility. Several studies have shown that the addition of vitamin B9 together with inositol has a positive effect on women and regulates their menstrual cycle. Green leafy vegetables and legumes are rich in folic acid.
Vitamin D
Vitamin D deficiency is associated with increased insulin resistance and weight gain. Sun exposure is a major factor in the production of calciferol (vitamin D3). It can also be found in foods such as dairy products, oily fish and egg yolks.
Polycystic ovary syndrome and physical activity
The impact of physical exercise on women with Polycystic Ovary Syndrome provides a number of benefits:
Improves emotional state (depression, anxiety, mood swings …)
Increases insulin sensitivity
Improves the hormonal profile of LH / FSH
Increasing SHBG helps reduce testosterone levels in the blood
Weight loss and body fat
Reduces and improves premenstrual pain
