Emily (not her real name) came to my office for a nutrition consultation. She had recently found out that she had Polycystic Ovary Syndrome (PCOS) because she and her husband were trying to get pregnant for the past year unsuccessfully.
She didn’t want to take medications, and her doctor told her that if she reduced 5-10% of her body weight it would restore ovulation, and would increase her chances of getting pregnant. Her only goal in seeing me was to get pregnant.
Before we began, I asked Emily what she knew about PCOS. I remember her saying “I googled PCOS and spoke with my doctor about it and it just says I will have trouble getting pregnant, which I am.”
As a mother myself, I could relate to her struggle and was really excited to help her. I was confident that optimizing Emily’s lifestyle behaviors would help manage PCOS and restore her fertility.
PCOS is very common among women, an alarming 1 in 10 women of childbearing age have polycystic ovaries, and many women go undiagnosed. While the main focus for the individual and doctor may be to regulate period cycles and increase fertility, PCOS has other associations with disease states, which are often overlooked.
A case in point is the relationship between PCOS and heart disease. Are women with PCOS at a higher risk of getting a heart attack?
Yes, studies have shown that the risk of a heart attack may be up to 7 times higher in women with PCOS compared to women of the same age who don’t have PCOS. But why?
First, let’s revisit what PCOS means. PCOS is identified by two or more of the following:
- “Polycystic” ovaries, identified via ultrasound of 12 or more follicles visible on one ovary or increased size of one or both ovaries.
- High level of ‘male’ hormones in the blood – symptoms may include excess hair growth or acne.
- Menstrual dysfunction – either lack of menstrual cycles, irregularity or lack of ovulation (where an egg is released).
These hormonal disruptions also lead to insulin resistance in women with PCOS.
The high levels of insulin resistance pose an increase in the risk of heart disease, with the body unable to process blood sugars efficiently.
Insulin resistance leads to increased fat storage which leads to weight gain which puts women with PCOS at higher risk for high blood sugar levels, high blood pressure, high cholesterol, elevated body mass index (BMI – defined as weight and height ratio that is used to categorize weight status; 25-30 is overweight, 30+ is considered obese) and elevated abdominal weight (waist circumference above 35 inches).
PCOS creates a cycle that is perpetuated by insulin resistance. The good news is that we can break this cycle.
Lifestyle modification is the first line of therapy for all women with PCOS, according to The Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society.
With proper lifestyle modifications, we can reduce blood sugar levels, blood pressure, high cholesterol and promote weight loss which can help restore fertility and also reduce cardiovascular disease risk.
The first step is identifying if you have PCOS. PCOS does not have any symptoms and can only be diagnosed via blood work and/or ultrasound. Consult your doctor or a doctor who specializes in women’s health.
The next step is to develop a treatment plan that is personalized to you. A lifestyle modification program which treats PCOS and also reduces the risk of heart disease should hone into your nutrition, physical activity, stress, alcohol, hydration and smoking habits and bring about a sustained behavior change that is easily adaptable into your routine.
Achieving the best results in such situations require having a customized approach and recognizing that no two women are the same.
“Weight loss in PCOS patients is very difficult, your body is engaged in a fight with insulin resistance to lose weight.
It is great to be able to offer a personalized lifestyle treatment regimen for these PCOS patients that also enables measuring, monitoring and reducing their risk of heart disease”, says Dr. Monica Grover, CardiatricsDoctor, who is also a New York City based Family Medicine and Women’s Health Physician.
Emily is now happily pregnant, while also reassured that she has significantly reduced her risk for heart disease.
Feature Image: shutterstock.com
In-Post Image: shutterstock.com, Cardiatricshealth.com