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Polycystic ovary syndrome (PCOS)
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Polycystic ovary syndrome (PCOS)

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DIABETES AND ENDOCRINE SYSTEM

Endocrine System

Polycystic ovary syndrome (PCOS) is a condition most often characterized by irregular menstrual periods, excess hair growth (hirsutism) and obesity, but it can affect women in different ways. Irregular or heavy periods may signal the condition in adolescence, or PCOS may become apparent later when a woman has difficulty becoming pregnant.

The signs and symptoms of PCOS stem from a disruption in the reproductive cycle, which normally culminates each month with the release of an egg from an ovary (ovulation). The name of the condition comes from the appearance of the ovaries in some women with the disorder - large and studded with numerous cysts (polycystic). These cysts are follicles, fluid-filled sacs that contain immature eggs.

Although the condition has been noted since antiquity, it was first described in medical literature in the 1930s when Irving Stein and Michael Leventhal wrote about a group of women without menstrual periods (amenorrhea) who had large ovaries with multiple cysts. Doctors sometimes call the condition Stein-Leventhal syndrome, polycystic ovaries or polycystic ovary disease.

Early diagnosis and treatment of PCOS can help reduce the risk of long-term complications, which include diabetes and heart disease.

Self-care

You may hear conflicting advice from media, support groups and health care professionals on the role of diet in weight management. Much of the disagreement focuses on carbohydrates.

Carbohydrates are long chains of glucose, a type of sugar. Your digestive system splits these chains into small sugar molecules that enter your bloodstream and trigger the release of insulin.

Low-fat, high-carbohydrate diets that have been popular in recent years may increase insulin levels, so some health and nutrition advocates advise women with PCOS to follow a low-carbohydrate diet. However, a diet that calls for increased protein to compensate for decreased carbohydrates may spike your intake of saturated fats, elevating your blood cholesterol levels and increasing your risk of cardiovascular disease.

Some PCOS diet plans restrict carbohydrates to a certain percentage of calories a day — for example, 40 percent to 45 percent of total calories. Others urge you to eat carbohydrates that are high in fiber. The more fiber in a food, the more slowly it's digested and the more slowly your blood sugar levels rise. High-fiber carbohydrates include whole-grain breads and cereals, whole-wheat pasta, bulgur, barley, brown rice and beans.

A very low carbohydrate diet isn't a desirable goal. Carbohydrates provide many important nutrients, so don't severely restrict them. Instead, choose the high-fiber carbohydrates mentioned above, while limiting less healthy carbohydrates such as soda, excess fruit juice, cake, candy, ice cream, pies, cookies and doughnuts.

Additional research may determine which specific dietary approach is best, but it's clear that losing weight by reducing total calorie intake benefits women with PCOS. Work with your doctor and registered dietitian to determine the best dietary plan for you.

The importance of exercise is much less controversial. Exercise lowers your blood sugar by promoting the transfer of sugar from your blood to your cells through decreasing insulin resistance. For women with PCOS, an increase in daily physical activity and participation in a regular exercise regimen are important for treating or preventing insulin resistance and for helping weight-control efforts.

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