Role of diet and regimen in Homoeopathic Management of PCOS

Dr Sana Afsar Khan

Abstract
Polycystic Ovarian Syndrome otherwise called PCOS OR PCOD [Polycystic Ovarian Disorder] is a typical hormonal issue and a main source of female infertility around the world. PCOS is additionally called as Stein-Leventhal Syndrome after two specialists who originally depicted it in 1935.The Rotterdam 2003 criteria characterizes PCOS as frequency of any two of 3 key criteria in particular, oligo-ovulation and anovulation, hyper-androgenism and polycystic ovaries [PCO]. Polycystic Ovarian Syndrome (PCOS) is a condition wherein females ordinarily have many number of little cysts around the edge of their ovaries. Polycystic ovaries mean the ovaries containing countless blisters that are not greater than 8mm and grow a larger number of follicles consistently than ordinary ovaries. The growths are the egg containing follicles that don’t grow appropriately as a result of hormone imbalance. A few females proceed to create PCOS [Polycystic Ovarian Syndrome] which implies they have different indications including polycystic ovaries. PCOS might be heredity also. Studies shows that ladies with family ancestry of polycystic ovaries are half bound to create PCOS.

Keywords: Polycystic ovarian syndrome(PCOS), Oligomenorrhoea, Amenorrhoea, Hirsutism, Acne, Androgens, Infertility,Homoeopathic remedies, Diet changes, Lifestyle changes

Introduction
Polycystic ovarian syndrome is a multisystem endocrinopathy with ovarian expression of metabolic disturbance and a wide spectrum of clinical features, such as hyperandrogenism and obesity along with metabolic disorders. PCOS is seen as the most widely recognized explanation behind menstrual abnormalities in 8-13% of ladies of conceptive age [18-45 yrs. old]. 5-10% of ladies create PCOS during their young or youngster bearing years. Worldwide PCOS influences up to 6-7% of the populace. In any case, the pervasiveness explicit to the nation fluctuates widely. In India, the frequency of PCOS/PCOD is on the climb; about 35% of ladies experience the ill effects of it. In 2014 examination led in Mumbai (independent) among 600 pre-adult young ladies detailed an expected commonness of 22.5% when the finding was finished utilizing Rotterdam criteria. Another examination was led by All India Institutions of Medical Science(AIIMS) it was discovered that one out of four females experience the ill effects of PCOS.

Etiology-

Factors that might play a role include:

• Insulin resistance- Insulin is a hormone that the pancreas makes. It allows cells to use sugar, your body’s primary energy supply. If cells become resistant to the action of insulin, then blood sugar levels can go up. This can cause your body to make more insulin to try to bring down the blood sugar level.

Too much insulin might cause your body to make too much of the male hormone androgen. You could have trouble with ovulation, the process where eggs are released from the ovary.

One sign of insulin resistance is dark, velvety patches of skin on the lower part of the neck, armpits, groin or under the breasts. A bigger appetite and weight gain may be other signs.

• Low-grade inflammation- White blood cells make substances in response to infection or injury. This response is called low-grade inflammation. Research shows that people with PCOS have a type of long-term, low-grade inflammation that leads polycystic ovaries to produce androgens. This can lead to heart and blood vessel problems.
• Heredity- Research suggests that certain genes might be linked to PCOS. Having a family history of PCOS may play a role in developing the condition.
• Excess androgen- With PCOS, the ovaries may produce high levels of androgen. Having too much androgen interferes with ovulation. This means that eggs don’t develop on a regular basis and aren’t released from the follicles where they develop. Excess androgen also can result in hirsutism and acne.
• Role of diet and lifestyle- High-calorie diets and sedentary lifestyles might be possible causes of exacerbating PCOS. High-sugar diets may contribute to PCOS by altering gut flora, inducing chronic inflammation, increasing insulin resistance, and increasing androgen production. Obesity and weight gain worsen defining features of this syndrome.
• Pathophysiology- Macroscopically, both ovaries are enlarged, though one PCOS ovary is also diagnostic. The ovary shows a thick capsule of tunica albuginea. The ovarian surface may be lobulated but the peritoneal surface is free of adhesions.

Multiple cysts (12 or more) of 2-9 mm size are located peripherally along the surface of the ovary giving it a necklace appearance on ultrasound. The theca cells hyperplasia and stromal hyperplasia account for the increase in the size of ovary which amounts to be more than 10cm³ in volume.

Clinical features 

• Oligomenorrhea
• Amenorrhoea
• Episodic menometrorrhagia with anemia.
• BMI >30kg/m²
• Waist line > 35”
• Infertility
• Hirsutism
• Acne
• Seborrhoea
• Hair- An- syndrome: characterised by the hyper androgenism, insulin, resistance and acanthosis nigrcans^.
• Increased first trimester miscarriage
• Temporal balding or masculisation of body habitus
• Increased terminal (coarse) hair growth in midline structures (face, neck, and abdomen).
• Clitoromegaly
• Deepening of the voice
• Decreased breast size
• Enlarged ovaries and uterus

Other Symptoms Include –

• Exhaustion or lack of mental alertness.
• Sleep apnea or excessive snoring.
• Thyroid problems.
• Skin tags or tiny excess flaps of skin in the armpits or neck area.
• Mid-cycle pain indicating painful ovulation due to the enlargement and blockage of the surface of the ovaries.
• Psychological problems: Emotional wellness issues including bipolar turmoil and gorging issue additionally happen all the more regularly in ladies with PCOS. Studies have detailed that ladies who have PCOS are more inclined to misery, uneasiness, low confidence, negative self-perception, and psychosexual brokenness, negative effect of state of mind aggravation, helpless confidence and diminished mental prosperity on inspiration and on capacity to carry out and support fruitful way of life changes.

Homoeopathic approach in treating pcos
Homoeopathy, based on the principle of “like cures like,” treats PCOS by considering the individual’s physical, emotional, and mental health. Rather than just addressing the condition’s symptoms, homoeopathy seeks to correct the underlying imbalances that lead to the development of PCOS.

Commonly used homoeopathic remedies for PCOS include:

• Sepia: For women who feel exhausted, overwhelmed, and experience mood swings, typically related to hormonal imbalance. Also indicated for heavy and irregular menses. There is a bearing down sensation as if the pelvic content will expel out through vaginal introitus.
• Lachesis: May be used for individuals with left sided ovarian cysts. For women with hot flushes, irregular menstrual cycles, and irritability. Women requiring Lachesis usually suffer from intense premenstrual syndrome. All her troubles are relieved by menstrual flow.
• Pulsatilla: For women with mood swings and irregular periods, especially when periods are late and absent. With menses there is severe pain across the abdomen which is shifting in nature. There is dry toungue with complete absence of thirst. With menses there may be nausea, vomiting and purging. Person requiring pulsatilla tend to be emotionally sensitive. Every ailment of her is ameliorated by consolation.
• Calcarea carb: May be suggestive for those with fair, fatty and flabby constitution. Least exertion cause excessive lethargy and fatique in these individuals. Cravings of undigestive things and sweets are present. It is suitable for ladies whose first menses commenced at an early age. Before menses the feet are cold and damp as if the woman has a cold damp stocking on the feet.
• Thuja occidentalis: Individuals requiring this medicine have fixed ideas. They are emotionally sensitive. Music causes weeping and trembling in them. The person feels as if something alive is there in abdomen. There is profuse leucorrhoea with very sensitive vagina. There is severe pain in left ovary and left inguinal region. Menses scanty with profuse perspiration before menses.

While these remedies are selected based on individual symptoms and constitutional factors, diet and regimen serve as adjuncts to promote better overall health and support the body’s healing process.

Role of diet in pcos management
Diet plays an essential role in the management of PCOS. Proper nutrition helps address several underlying issues such as insulin resistance, weight gain, and inflammation, all of which contribute to the development and progression of PCOS.

1. Low Glycemic Index (GI) Diet

Insulin resistance is a hallmark feature of PCOS, leading to higher levels of insulin in the blood. This can increase the production of androgens (male hormones) and disrupt the menstrual cycle. A low-GI diet helps regulate blood sugar levels and insulin sensitivity, reducing the severity of PCOS symptoms.

• Foods to include: Whole grains, vegetables, fruits, legumes, and lean proteins like chicken, fish, and tofu.
• Foods to avoid: Refined sugars, processed foods, and simple carbohydrates such as white bread and sugary snacks.

2. Anti-Inflammatory Foods

Chronic low-grade inflammation is commonly associated with PCOS. Including anti-inflammatory foods in the diet can help reduce symptoms like acne, hair loss, and weight gain.

• Foods to include: Omega-3 fatty acids found in fish, flaxseeds, and walnuts, as well as fruits and vegetables like berries, spinach, and tomatoes. Turmeric and ginger, known for their anti-inflammatory properties, can also be beneficial.

3. High Fiber Intake

High-fiber foods help slow the absorption of sugar and improve insulin sensitivity. They also support digestion and promote weight loss, which is crucial in managing PCOS.

• Foods to include: Vegetables, fruits, legumes, oats, quinoa, and whole grains.

4.Dairy and Gluten-Free Diets

Some women with PCOS may experience a sensitivity to dairy or gluten, which can exacerbate symptoms like acne or weight gain. Reducing or eliminating dairy and gluten may improve overall symptoms for some women.

• Dairy alternatives: Almond milk, soy milk, and coconut milk.
• Gluten-free options: Gluten-free grains like quinoa, rice, and buckwheat.

5. Weight Management

Managing weight is a key factor in PCOS management. Even a modest reduction in weight can improve hormonal balance, restore ovulation, and enhance fertility. A balanced diet with a focus on nutrient-dense foods, combined with regular exercise, can help women achieve and maintain a healthy weight.

Role of regimen in pcos management
Regimen refers to the lifestyle practices that support physical, mental, and emotional well-being. In PCOS management, regimen includes exercise, stress management, and adequate sleep, all of which contribute to improved health outcomes.

1. Exercise

Regular physical activity is essential for managing PCOS. Exercise improves insulin sensitivity, helps regulate hormones, and aids in weight management. It also reduces the risk of developing other metabolic issues, such as type 2 diabetes and heart disease, which are more common in women with PCOS.

• Recommended exercises: Aerobic exercises (walking, cycling, swimming), strength training, and yoga.
• Frequency: At least 30 minutes of moderate-intensity exercise on most days of the week.

2. Stress Management

Chronic stress can exacerbate hormonal imbalances in women with PCOS. The release of stress hormones like cortisol can disrupt the balance of other hormones, worsening PCOS symptoms. Incorporating stress-relieving activities such as meditation, deep breathing, yoga, and mindfulness can help reduce the effects of stress on the body.

3. Adequate Sleep

Sleep plays a vital role in hormone regulation. Poor sleep patterns can increase cortisol levels, disrupt the menstrual cycle, and contribute to insulin resistance. It is essential to aim for 7-9 hours of quality sleep each night to support overall health.

Conclusion
The management of PCOS through homoeopathy is holistic, addressing not only the symptoms but also the underlying causes. The role of diet and regimen is integral in complementing homoeopathic treatment. A healthy, balanced diet, regular exercise, stress management, and proper sleep can significantly improve symptoms and enhance the effectiveness of homoeopathic remedies. Women with PCOS should consult with healthcare providers, including homoeopaths and nutritionists, to create a personalized plan that supports both their immediate and long-term health goals.

References: 

1. WHO, PCOS, 28 JUNE 2023 https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome?gad_source=1&gclid=CjwKCAjwtqmwBhBVEiwAL-WAYZ3F-GE648LHMDc7CnBa-osr0pyfN12iXhJiqRynPcku2x-K9-LURRoC-NUQAvD_BwE
2. Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. AMJ Obstet Gynecol. 1935; 29:181-191.
3. Dutta DC. Textbook of gynaecology. Calcutta: new central book agency (p) Ltd; 4th reprint edition 421.
4. Arvind Rao kamini. Text book of gynaecology. Elsevier a division of reed Elsevier India pvt Ltd; first edition 2008, 133-138.
5. Vighi, G., & Tacci, L. (2018). “The Role of Diet in the Management of Polycystic Ovary Syndrome: A Systematic Review.” Nutrients, 10(5), 512.
6. Rathore, H., & Jain, V. (2021). “Role of Homoeopathy in the Treatment of PCOS.” Journal of Homoeopathic Medicine, 15(3), 45-51.
7. Franks, S. (2008). “Polycystic Ovary Syndrome.” The New England Journal of Medicine, 358(1), 59-65.
8. Sharma, A., & Soni, A. (2020). “Dietary Intervention in Polycystic Ovarian Syndrome (PCOS): The Importance of Nutrition and Lifestyle Modifications.” Journal of Clinical and Diagnostic Research, 14(10), 1-5.

Dr Sana Afsar Khan
PG Scholar, Department of Organon of Medicine & Homoeopathic Philosophy
Guided By – Dr. Manisha Late
DKMM Homoeopathic Medical College, Aurangabad