Discover a holistic approach to tackle inflammatory PCOS with Meri Sehat. Gain insights and strategies for a healthier life.

Inflammatory PCOS

Medilink Consultant clinic

Online Consultation

ZAKA CLINIC GULBERG LAHORE

Saad Ullah Siddiqui

Overview

In inflammatory <a href="https://merisehat.pk/disease/polycystic-ovary-syndrome-pcos">PCOS</a>, chronic inflammation due to immune and metabolic disturbances results in clinical symptoms associated with PCOS. 
&nbsp;

Generally, PCOS is a common hormonal disorder that affects people with ovaries, often during their reproductive years. Inflammatory PCOS refers to a specific type of PCOS where inflammation plays a bigger role in how the condition affects the body.

The prevalence of PCOS can vary depending on factors like age, ethnicity, and the criteria used for diagnosis. It&#39;s often diagnosed in the late teens or early 30s. Approximately 5-15% of women of childbearing age were estimated to have PCOS<a href="#accordion">[2]</a>. 
&nbsp;

Signs and Symptoms

These include<a href="#accordion">[1]</a>:

<ul>
	<li><a href="https://merisehat.pk/disease/tension-headaches">Headaches</a></li>
	<li>Unexplained fatigue</li>
	<li>Bowel issues like IBS</li>
	<li>Joint pain</li>
	<li>Skin issues like eczema 
	&nbsp;</li>
</ul>

An individual may present with other symptoms related to PCOS as well, including irregular or missed periods, thinning hair, ovarian cysts, hirsutism, and weight gain or trouble losing weight. 
&nbsp;

Causes

Chronic inflammation is a long-lasting, slow process. It&rsquo;s also called low-grade inflammation because it&rsquo;s not like a tidal wave; rather, the symptoms occur gradually. Autoimmune conditions, like rheumatoid arthritis and lupus, may be one reason for chronic inflammation. 
&nbsp;

Other contributing factors include<a href="#accordion">[2]</a>:

<ul>
	<li>Obesity</li>
	<li>Smoking</li>
	<li>Oxidative stress</li>
	<li>Psychological stress</li>
	<li>Lifestyle factors 
	&nbsp;</li>
</ul>

PCOS is a combination of genetics and other factors, such as high levels of insulin, inflammation, and androgen.

According to a study, there is a need for a better understanding of the inflammatory alterations in women with PCOS to dissect physiological versus pathological inflammatory mechanisms in reproductive functions, which can have implications for the pharmacological and therapeutic approach for women with this syndrome. 
&nbsp;

Diagnosis

The diagnosis of PCOS is typically based on a combination of clinical signs and the exclusion of other conditions that could mimic its symptoms. There&#39;s no single test that can definitively diagnose PCOS. 
&nbsp;

The Rotterdam Consensus of 2003 is the most commonly used diagnostic criteria for PCOS. According to these criteria, a person may be diagnosed with PCOS if they have at least two out of the following three symptoms:

<ol>
	<li>Irregular Periods: Menstrual cycles that are irregular, infrequent, or absent.</li>
	<li>Hyperandrogenism: Signs of excess androgens, such as excessive hair growth or elevated levels of androgens in blood tests.</li>
	<li>Polycystic Ovaries: The presence of multiple small cysts on the ovaries, as observed through ultrasound imaging. 
	&nbsp;</li>
</ol>

A typical diagnostic process involves:

<ul>
	<li>Medical History: The doctor will discuss the patient&rsquo;s menstrual history, symptoms, and any relevant family history.</li>
	<li>Physical Examination: They will check for signs of hirsutism, acne, weight gain, and other physical markers.</li>
	<li>Blood Tests: They may order tests to measure hormone levels, including testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), fasting glucose, and insulin. Inflammation is the body&rsquo;s natural response to threats such as viruses and injuries. But chronic inflammation can be a problem. And PCOS is closely related to chronic, low-grade inflammation. According to known studies, correlations have been found between increased levels of C-reactive protein (CRP), interleukin 18 (IL-18), tumor necrosis factor (TNF-&alpha;), interleukin 6 (IL-6), white blood cell count (WBC), monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-1&alpha; (MIP-1&alpha;) in PCOS women. There are also elevated levels of AGEs and increased RAGE (receptor for advanced glycation end products) expression<a href="#accordion">[9]</a>.</li>
	<li>Ultrasound: They may also conduct an ultrasound of the ovaries to look for the presence of small cysts. 
	&nbsp;</li>
</ul>

Treatment

First and foremost, it&rsquo;s important to address gut health. This may involve balancing gut bacteria, eliminating pathogenic bacteria, repairing leaky gut tissue, and improving digestive enzymes to reduce overall inflammation.

Secondly, treatment includes removing food triggers. For this, the doctor may ask the individual to keep note of any potential food sensitivity and to remove foods that cause inflammation. It&rsquo;s best to discuss alternatives with a nutritionist specializing in dealing with PCOS. 
&nbsp;

Some health practitioners may suggest medications to help manage inflammation and pain linked to the condition. This includes nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. Other medications, like metformin and contraceptive pills, can help with other symptoms of the condition.

If the inflammation is linked to a specific condition (like autoimmune disorders), addressing the underlying condition may be necessary. 
&nbsp;

<ul>
	<li>
	<h5>Stress Management</h5>
	</li>
</ul>

Chronic stress can contribute to inflammation. Techniques like meditation, yoga, deep breathing, and mindfulness can help manage stress and reduce inflammation. 
&nbsp;

Common complications and health risks include:

<ul>
	<li>Infertility and difficulty getting pregnant</li>
	<li>Type 2 diabetes</li>
	<li>Heart disease, high blood pressure, and stroke</li>
	<li>Sleep apnea</li>
	<li>Endometrial cancer</li>
	<li>Depression and anxiety 
	&nbsp;</li>
</ul>

Risk factors for PCOS include:

<ul>
	<li>Family history</li>
	<li>Obesity</li>
	<li>Ethnicity</li>
	<li>Age, with younger individuals more prone to certain PCOS symptoms</li>
	<li>Sedentary lifestyle</li>
	<li>Health issues, such as chronic stress and type 2 diabetes 
	&nbsp;</li>
</ul>

It&#39;s important to note that while these risk factors increase the likelihood of developing PCOS, they don&#39;t guarantee that someone will have the condition. Likewise, someone without these risk factors can still develop PCOS. 
&nbsp;

<ul>
	<li>
	<h5>Lifestyle Changes</h5>
	</li>
</ul>

Avoid

<ul>
	<li>Coffee</li>
	<li>Fried foods, like fried chicken or French fries</li>
	<li>Saturated foods, like margarine</li>
	<li>Processed snacks, like cakes and candy</li>
	<li>Red meat</li>
	<li>Sugary beverages, like sodas and sports drinks</li>
	<li>White rice</li>
	<li>Refined flour, like pizza and pasta 
	&nbsp;</li>
</ul>

Eat

<ol>
	<li>Whole foods are free from hormones, artificial sugars, and preservatives, like vegetables, legumes, fruits, and whole grains.</li>
	<li>Enough healthy protein and unprocessed, high-carb foods</li>
	<li>Anti-inflammatory foods, including olive oil, berries, leafy greens, tomatoes, and fatty fish like tuna.</li>
	<li>Iron-rich foods, like eggs, spinach, and broccoli (Don&rsquo;t increase the intake without consulting a doctor, as it can lead to other complications)</li>
	<li>Magnesium-rich foods, like almonds, bananas, spinach, and cashews, are also PCOS-friendly</li>
	<li>Lentils, Brussels sprouts, avocadoes, broccoli, and pears have fiber that helps with digestion 
	&nbsp;</li>
</ol>

Staying hydrated is important. So, make sure to drink plenty of water<a href="#accordion">[5]</a>.

Moreover, physical activity can improve insulin resistance, lower inflammation levels, and help maintain a moderate weight. According to studies, 120 minutes of intense and vigorous exercise per week, like swimming, kickboxing, running, and HIIT, can reduce the risk of PCOS complications<a href="#accordion">[2]</a>. 
&nbsp;

Note: Some people may prefer natural anti-inflammatory supplements like omega-3 fatty acids, vitamin D, ginger, and turmeric. They may opt for other holistic methods, such as acupuncture treatments or reducing exposure to endocrine disruptors, chemicals, and other environmental toxins, to lower inflammation. However, there is not enough research backing these methods, and it&rsquo;s better to consult a doctor before doing so<a href="#accordion">[2]</a>. Likewise, more research is needed to see if popular diets like intermittent fasting are safe and beneficial for individuals with PCOS. 
&nbsp;

<ul>
	<li>
	<h5>Adequate Sleep</h5>
	</li>
</ul>

Prioritize getting enough sleep each night, as sleep plays a role in managing inflammation and overall health. 
&nbsp;

<ul>
	<li>
	<h5>Regular Health Checkups</h5>
	</li>
</ul>

Regular checkups with a healthcare provider can help monitor health, catch any potential issues early, and receive appropriate guidance. 
&nbsp;

<ul>
	<li>
	<h5>Avoid Smoking</h5>
	</li>
</ul>

Avoid smoking as it can contribute to inflammation and negatively affect overall health. 
&nbsp;

According to a recent study, obesity in young PCOS women intensifies dyslipidemia, insulin resistance, and low-grade inflammation. Given that obesity may play a significant role in the etiology and complications seen in PCOS, it emphasized early weight control to reduce the burden on both the economic and health conditions of PCOS. It also suggested molecular-level insight into the genetic component of the disease<a href="#accordion">[6]</a>.

One clinical trial in the US is currently aiming to examine the effect of salsalate administration in women with PCOS. The hypothesis is that it will decrease ovarian androgen secretion and reduce inflammation irrespective of adiposity or IR status<a href="#accordion">[7]</a>. 
&nbsp;

Key Points

<ul>
	<li>PCOS is a common hormonal disorder that affects girls and women of reproductive age.</li>
	<li>Some studies suggest a potential link between inflammation and PCOS. A low-grade chronic inflammatory state is caused by the accumulation of many inflammatory cells and cytokines in PCOS patients.</li>
	<li>Inflammation may contribute to insulin resistance and hormonal imbalances seen in PCOS.</li>
	<li>Treatment focuses on managing symptoms and addressing underlying factors through lifestyle changes, medication, and sometimes hormone therapy.</li>
</ul>

[1] Jensen E. 4 types of PCOS - and how to know which one you have. Emily Jensen Nutrition &amp; Natural Medicine. February 21, 2023

[2] Watson K. PCOS and chronic inflammation, what’s the connection? Healthline.

[3] Watson K. Natural treatment PCOS: 30 ways to help hormones, insulin, and more. Healthline.

[4] Nicole Galan R. Learn about the relationship between PCOS and inflammation. Verywell Health.

[5] PCOS diet. JHM.

[6] Complications of obesity in polycystic ovary syndrome: Insulin resistance and inflammation. PJMD.

[7] Treating inflammation in polycystic ovary syndrome to ameliorate ovarian dysfunction - full text view. ClinicalTrials.gov.

[8] Inflammation and reproductive function in women with polycystic ovary syndrome. eScholarship, University of California.

[9] Rudnicka E, Suchta K, Grymowicz M, Calik-Ksepka A, Smolarczyk K, Duszewska AM, Smolarczyk R, Meczekalski B. Chronic Low Grade Inflammation in Pathogenesis of PCOS. International Journal of Molecular Sciences. 2021; 22(7):3789.