Polycystic Ovarian Syndrome (PCOS) and Polycystic Ovarian Disease (PCOD) are often confused with one another, and while they share some similarities, they are indeed distinct conditions with their own set of challenges and health implications. Let’s dive deeper into the similarities and differences between PCOS and PCOD to understand their nuances better.
What Exactly is PCOD?
Polycystic Ovarian Disease, or PCOD, involves the ovaries containing a large number of immature or partially mature eggs that eventually turn into cysts over time. This condition, which tends to run in families, stems from hormonal imbalances that disrupt the normal ovulation process. It’s quite common among women of reproductive age, and although it sounds daunting, it is often manageable with the right approach.
Key clinical features of PCOD include:
Irregular Ovulation: The release of eggs is sporadic and unpredictable.
Obesity: A common challenge that can exacerbate other symptoms.
Alopecia: Also known as male pattern baldness, this can be particularly distressing.
Irregular Menstrual Cycles: Often unpredictable and can vary in frequency and intensity.
Subfertility: While not necessarily infertile, women with PCOD may find it more challenging to conceive.
And What About PCOS?
Moving on to Polycystic Ovarian Syndrome — PCOS is considered a more severe form of hormonal imbalance involving the ovaries and is a leading cause of infertility in women. The condition is characterised by significant hormonal imbalances that affect the ovaries’ ability to release eggs properly.
Clinical features of PCOS include:
Enlarged Ovaries: These contain numerous follicles that aren’t able to release eggs regularly.
Irregular or Absent Menstrual Periods: This can complicate the ability to conceive.
Heavy Menstrual Bleeding: When periods do occur, they can be quite severe.
Severe Acne and Male-Pattern Baldness: These are not just cosmetic concerns but also indicative of underlying hormonal issues.
Android Obesity: Weight gain, especially around the waist, is common and contributes to other health risks.
Insulin Resistance: This can lead to type 2 diabetes if not managed properly.
Increased Risk of Cardiovascular Problems: The metabolic disturbances in PCOS can lead to more serious heart-related issues down the line.
Both PCOD and PCOS demand careful management, but their impact on a woman’s body and her health can vary significantly. PCOS, with its broader metabolic effects, requires a more intensive management strategy compared to PCOD, which might be tackled with lifestyle modifications and sometimes medication.
Managing PCOD and PCOS
While PCOD and PCOS both present challenges, the approaches to managing these conditions can significantly reduce the severity of symptoms and improve overall quality of life. Typically, these measures involve a combination of lifestyle changes, dietary adjustments, and, when necessary, medication.
Weight Management
For both PCOD and PCOS, achieving and maintaining a healthy weight is one of the most effective strategies for managing symptoms and reducing the risk of associated health issues like diabetes and cardiovascular disease.
Exercise: Regular physical activity is crucial. Both aerobic exercises, such as walking, running, or swimming, and strength training can help decrease insulin resistance and improve metabolic health. For those new to exercise, starting slowly and gradually increasing the intensity and duration can help build a sustainable routine.
Weight Loss Benefits: Even a modest weight loss of 5-10% of body weight can dramatically improve PCOD/PCOS symptoms, regulate menstrual cycles, and enhance fertility.
Dietary Adjustments for PCOS and PCOD
While there is some debate about which diet is best for someone suffering from PCOS or PCOD, there’s no denying that diet plays a critical role in managing both conditions. Adjustments aimed at improving diet quality can have a significant impact on managing the hormonal imbalances at the heart of these conditions.
Here are a few recommendations (we suggest taking the advice of your physician or health coach before making any changes):
Low Glycemic Index Diet: Choosing foods with a low glycemic index (GI) helps stabilise blood sugar levels and reduce the incidence of insulin spikes. High-fibre vegetables, whole grains, nuts, and seeds are excellent choices.
Lean Proteins and Healthy Fats: Incorporating lean proteins from chicken, fish, tofu, and legumes, along with healthy fats from avocados, olive oil, and omega-3 fatty acids found in fish, can help regulate hormones and promote satiety, which is essential for weight management.
Managing Carbohydrates: Especially in PCOS, where insulin resistance is more pronounced, it’s vital to watch carbohydrate intake. Opting for complex carbohydrates and monitoring portion sizes can help manage insulin levels effectively.
Medical Treatment of PCOD vs PCOS
In some cases, lifestyle and dietary changes alone are not enough to manage PCOD and PCOS effectively, and medical treatment becomes necessary. Again, we must stress that you start any course of medication only after consulting your primary physician.
Hormonal Contraceptives
Birth control pills are frequently prescribed to help regulate menstrual cycles, reduce levels of male hormones, and clear acne. This treatment helps manage the menstrual irregularities and hormonal imbalances associated with PCOD and PCOS.
Metformin
Originally used to treat type 2 diabetes, Metformin can also be prescribed for PCOS to improve insulin resistance and lower insulin levels. This can help with weight loss and restore regular ovulation.
Other Medications:
In addition to Metformin, other medications such as spironolactone and clomiphene can be used to treat specific symptoms like hirsutism and infertility, respectively.
What we have included here are merely common practices currently adopted for treatment of PCOD/PCOS, and these should not be construed as medical advice.
Long-term Management of PCOD and PCOS
Managing PCOD and PCOS is often a long-term endeavour. Regular follow-ups with healthcare providers are crucial for monitoring progress and adjusting management plans as necessary. Additionally, joining support groups and seeking counselling can help address the psychological impacts of living with chronic conditions like PCOD and PCOS.
Regular Testing for Managing PCOD and PCOS
If you’re diagnosed with PCOD or PCOS, consistent monitoring through specific tests is crucial to manage your condition effectively and prevent potential complications. Regular testing not only helps in tracking the progression of the disease but also in adjusting treatment plans as needed.
Your primary physician is in the best position to suggest which tests you need to get done. Here’s a rundown of some essential tests that are generally recommended:
Hormonal Profiles
Androgen Levels: Since both conditions are associated with elevated androgen levels, testing for testosterone and other androgens is essential. These hormones are often responsible for symptoms such as hirsutism (excessive hair growth) and acne.
Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH): An LH to FSH ratio that is higher than normal is indicative of PCOS. These hormones control the menstrual cycle and affect ovulation.
Prolactin: Elevated levels can disrupt menstrual function and are often checked if menstrual irregularities are present.
Blood Glucose and Insulin Resistance Tests
Fasting Glucose and Insulin Levels: These tests measure blood sugar and insulin levels after an overnight fast to check for insulin resistance, a common issue associated with PCOS.
Oral Glucose Tolerance Test (OGTT): This test involves drinking a sugary drink followed by several blood sugar measurements over a few hours to see how well the body processes glucose.
Lipid Profile
Cholesterol and Triglycerides: Women with PCOD and PCOS often have higher levels of LDL (bad) cholesterol and triglycerides, which increase the risk of cardiovascular disease. Regular checks can help manage these risks.
Ultrasound
Pelvic Ultrasound: This imaging test can visualise the ovaries and assess the presence of multiple cysts as well as check the thickness of the endometrium (lining of the uterus), which can be affected by irregular menstrual cycles.
Reproductive Health Assessments
Endometrial Thickness: Regular monitoring through ultrasound can help in assessing the risk of endometrial hyperplasia, especially if periods are infrequent or absent, which is common in PCOS.
Ovulation Tracking: For those trying to conceive, monitoring ovulation can help in understanding the best times to attempt pregnancy and assess the effectiveness of any treatments aimed at inducing ovulation.
Tests Recommended for General Physical Health
Blood Pressure: Regular checks are important, as hypertension can be a comorbidity of PCOS.
Weight: Monitoring body weight and body mass index (BMI) helps in assessing the effectiveness of lifestyle interventions on weight management.
Regular Screenings
Depression and Anxiety Screening: Given the increased risk of mental health issues in PCOS, regular mental health screenings and access to psychological support are essential.
Regular Health Consultations
Regular consultations with a healthcare provider are crucial for interpreting the results of these tests. They can provide guidance on necessary lifestyle adjustments or medical interventions and help plan ongoing management strategies tailored to individual needs.
Working with a Health & Fitness Coach
Managing Polycystic Ovarian Syndrome (PCOS) and Polycystic Ovarian Disease (PCOD) can often feel overwhelming due to the complex interplay of hormonal imbalances, metabolic challenges, and their impact on physical and emotional well-being. Partnering with a health and fitness coach can be a transformative step for individuals navigating these conditions.
The Benefits of Working with a Health and Fitness Coach
Here’s how a specialised coach can make a significant difference:
Personalised Guidance
Health and fitness coaches who have experience with PCOS and PCOD can provide personalised guidance tailored to individual needs and symptoms. They understand the unique challenges these conditions pose, such as weight management difficulties, insulin resistance, and hormonal fluctuations, and can design personalised exercise and nutrition programs to address them effectively.
Accountability and Motivation
One of the hardest parts of managing chronic conditions like PCOS and PCOD is staying motivated and consistent with lifestyle changes. A health and fitness coach acts as an accountability partner, helping you stay committed to your health goals. Regular check-ins can motivate you to stick with dietary adjustments, maintain an exercise regimen, and make other necessary lifestyle changes more consistently.
Expertise in Nutritional Management
Diet plays a crucial role in managing PCOS and PCOD, particularly in controlling insulin levels and maintaining a healthy weight. Health and fitness coaches with a background in nutrition can provide expert advice on which foods to include or avoid and help plan meals that are balanced, nutritious, and supportive of hormone health. This approach is crucial in managing symptoms and can prevent the progression of the conditions.
Emotional and Psychological Support
Living with PCOS or PCOD can be stressful and emotionally draining. Health and fitness coaches who are familiar with the psychological aspects of chronic health conditions can provide much-needed emotional support. They can help address body image issues, boost confidence, and provide strategies to manage stress and anxiety, which are often heightened by hormonal imbalances.
Education and Resources
Health and fitness coaches can be excellent resources for the latest research and information about PCOS and PCOD. They can educate you about your condition in ways that are easy to understand and apply. This knowledge empowers you to make informed decisions about your health and treatment options.
Holistic Health Improvement
By addressing not just physical symptoms but also dietary and emotional factors, a health and fitness coach can help improve overall quality of life. This holistic approach ensures that all aspects of health are considered, leading to more sustainable health outcomes.
Integration with Medical Treatment
While health and fitness coaches do not replace medical professionals, they can work alongside your healthcare team to ensure that your lifestyle adjustments complement your medical treatments. This collaborative approach can optimise management of PCOS and PCOD, enhance treatment effectiveness, and prevent complications.
References:
Toosy, S., Sodi, R. and Pappachan, J.M., 2018. Lean polycystic ovary syndrome (PCOS): an evidence-based practical approach. Journal of Diabetes & Metabolic Disorders, 17(2), pp.277-285.
Maharaj, S. and Amod, A., 2009. Polycystic ovary syndrome. Journal of Endocrinology, Metabolism and Diabetes in South Africa, 14(2), pp.86-95.
Shrestha, A., Dixit, A. and Zaidi, A., 2019. Assessment of Lifestyle and Diet Modification of Patients Suffering from Polycystic Ovarian Disease (PCOD) in North India. Journal of Food and Nutrition Sciences, 7(4), pp.60-65.
Barrea, L., Arnone, A., Annunziata, G., Muscogiuri, G., Laudisio, D., Salzano, C., Pugliese, G., Colao, A. and Savastano, S., 2019. Adherence to the mediterranean diet, dietary patterns and body composition in women with polycystic ovary syndrome (PCOS). Nutrients, 11(10), p.2278.
Shele, G., Genkil, J. and Speelman, D., 2020. A systematic review of the effects of exercise on hormones in women with polycystic ovary syndrome. Journal of Functional Morphology and Kinesiology, 5(2), p.35.
Minocha, N., 2020. Polycystic Ovarian Disease or Polycystic Ovarian Syndrome: How to Identify and Manage-A Review. Archives of Pharmacy Practice, 11(2).
Adebisi OD, Denwigwe-aggrey BC, Tairu AB, Ozoemena N, David JF, Monday EO. 2021. The effect of polycystic ovarian syndrome on the mental health of women of reproductive age. Int J Res Med Sci. 9:1741-5.