PCOS – The Importance of Diet, Physical Activity, and Other Non-Pharmacological Methods in Treatment
DOI:
https://doi.org/10.12775/QS.2024.19.53833Keywords
PCOS, diet, physical activity, treatment, supplementation, probioticsAbstract
Purpose of research: PCOS is one of the most common endocrine disorders. It is estimated to affect about 5-10% of women of reproductive age. This paper aims to highlight the challenges faced by those with PCOS and to demonstrate the importance of non-pharmacological methods in treating this condition.
Methods: Databases such as PubMed, Medline, and ResearchGate were used.
Basic results: PCOS is associated with menstrual irregularities and leads to reduced fertility, while commonly occurring hyperandrogenism causes unpleasant changes in appearance, such as hair loss, hirsutism, and acne. Women with PCOS also have an increased risk of developing type 2 diabetes, hypertension, and certain cancers.
Conclusions: The first line of treatment for PCOS is lifestyle modification. Appropriate diet and weight loss aim to reduce inflammation, regulate the menstrual cycle, restore ovulation, and reduce the risk of cardiovascular disease and cancer. An important aspect is the intake of vitamins D and E, as well as inositol. Research shows that probiotics may also have a positive effect.
References
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. Int J Mol Sci. 2021 Apr 6;22(7):3789. doi: 10.3390/ijms22073789. PMID: 33917519; PMCID: PMC8038770.
Stańczak NA, Grywalska E, Dudzińska E. The latest reports and treatment methods on polycystic ovary syndrome. Ann Med. 2024 Dec;56(1):2357737. doi: 10.1080/07853890.2024.2357737. Epub 2024 Jul 4. PMID: 38965663; PMCID: PMC11229724.
Pinto J, Cera N, Pignatelli D. Psychological symptoms and brain activity alterations in women with PCOS and their relation to the reduced quality of life: a narrative review. J Endocrinol Invest. 2024 Jul;47(7):1-22. doi: 10.1007/s40618-024-02329-y. Epub 2024 Mar 15. PMID: 38485896; PMCID: PMC11196322.
Almhmoud H, Alatassi L, Baddoura M, Sandouk J, Alkayali MZ, Najjar H, Zaino B. Polycystic ovary syndrome and its multidimensional impacts on women's mental health: A narrative review. Medicine (Baltimore). 2024 Jun 21;103(25):e38647. doi: 10.1097/MD.0000000000038647. PMID: 38905372; PMCID: PMC11191963.
Ye W, Xie T, Song Y, Zhou L. The role of androgen and its related signals in PCOS. J Cell Mol Med. 2021 Feb;25(4):1825-1837. doi: 10.1111/jcmm.16205. Epub 2020 Dec 23. PMID: 33369146; PMCID: PMC7882969.
Fica S, Albu A, Constantin M, Dobri GA. Insulin resistance and fertility in polycystic ovary syndrome. J Med Life. 2008 Oct-Dec;1(4):415-22. PMID: 20108521; PMCID: PMC3018970.
Legro RS, Dodson WC, Gnatuk CL, Estes SJ, Kunselman AR, Meadows JW, Kesner JS, Krieg EF Jr, Rogers AM, Haluck RS, Cooney RN. Effects of gastric bypass surgery on female reproductive function. J Clin Endocrinol Metab. 2012 Dec;97(12):4540-8. doi: 10.1210/jc.2012-2205. Epub 2012 Oct 12. PMID: 23066115; PMCID: PMC3513539.
Brewer CJ, Balen AH. The adverse effects of obesity on conception and implantation. Reproduction. 2010 Sep;140(3):347-64. doi: 10.1530/REP-09-0568. Epub 2010 Apr 15. PMID: 20395425.
Choudhari R, Tayade S, Tiwari A, Satone P. Diagnosis, Management, and Associated Comorbidities of Polycystic Ovary Syndrome: A Narrative Review. Cureus. 2024 Apr 22;16(4):e58733. doi: 10.7759/cureus.58733. PMID: 38779261; PMCID: PMC11110474.
Cai J, Luo X, Wang Z, Chen Z, Huang D, Cao H, Chen J, Wu J. Comparing GDF9 in mature follicles and clinical outcomes across different PCOS phenotype. Heliyon. 2024 Apr 23;10(9):e29879. doi: 10.1016/j.heliyon.2024.e29879. PMID: 38711644; PMCID: PMC11070807.
Brennan L, Teede H, Skouteris H, Linardon J, Hill B, Moran L. Lifestyle and Behavioral Management of Polycystic Ovary Syndrome. J Womens Health (Larchmt). 2017 Aug;26(8):836-848. doi: 10.1089/jwh.2016.5792. Epub 2017 Jun 1. PMID: 28570835.
Faghfoori Z, Fazelian S, Shadnoush M, Goodarzi R. Nutritional management in women with polycystic ovary syndrome: A review study. Diabetes Metab Syndr. 2017 Nov;11 Suppl 1:S429-S432. doi: 10.1016/j.dsx.2017.03.030. Epub 2017 Apr 5. PMID: 28416368.
Jan American Diabetes Association. 6 Glycemic Targets: Standards of Medical Care in Diabetes-2021.Diabetes Care. 2021 and 33298417. 44(Suppl 1):S73-S84. doi: 10.2337/dc21-S006.
Al Khalifah RA, Florez ID, Zoratti MJ, Dennis B, Thabane L, Bassilious E. Efficacy of Treatments for Polycystic Ovarian Syndrome Management in Adolescents. J Endocr Soc. 2020 Oct 17;5(1):bvaa155. doi: 10.1210/jendso/bvaa155. PMID: 33324861; PMCID: PMC7724745.
Sadeghi HM, Adeli I, Calina D, Docea AO, Mousavi T, Daniali M, Nikfar S, Tsatsakis A, Abdollahi M. Polycystic Ovary Syndrome: A Comprehensive Review of Pathogenesis, Management, and Drug Repurposing. Int J Mol Sci. 2022 Jan 6;23(2):583. doi: 10.3390/ijms23020583. PMID: 35054768; PMCID: PMC8775814.
Hakimi O, Cameron LC. Effect of Exercise on Ovulation: A Systematic Review. Sports Med. 2017 Aug;47(8):1555-1567. doi: 10.1007/s40279-016-0669-8. PMID: 28035585.
Ahmed AF, Sharkawi SS, AbdelHameed SS, Bayoumi AM, Moussa RS, Alhakamy NA, Al Sadoun H, Mansouri RA, El-Moselhy MA, El-Daly M, Anter AF. Ketogenic diet restores hormonal, apoptotic/proliferative balance and enhances the effect of metformin on a letrozole-induced polycystic ovary model in rats. Life Sci. 2023 Jan 15;313:121285. doi: 10.1016/j.lfs.2022.121285. Epub 2022 Dec 13. Erratum in: Life Sci. 2023 Aug 1;326:121829. doi: 10.1016/j.lfs.2023.121829. PMID: 36526050.
Reiser E, Lanbach J, Böttcher B, Toth B. Non-Hormonal Treatment Options for Regulation of Menstrual Cycle in Adolescents with PCOS. J Clin Med. 2022 Dec 21;12(1):67. doi: 10.3390/jcm12010067. PMID: 36614868; PMCID: PMC9820988.
Zeind C.S. Carvalho M.G. Applied Therapeutics: the Clinical Use of Drugs. Wolters Kluwer Health and Philadelphia PA, USA: 2017.
Muscogiuri G, Altieri B, de Angelis C, Palomba S, Pivonello R, Colao A, Orio F. Shedding new light on female fertility: The role of vitamin D. Rev Endocr Metab Disord. 2017 Sep;18(3):273-283. doi: 10.1007/s11154-017-9407-2. PMID: 28102491.
Fernandes R, do Rosario VA, Mocellin MC, Kuntz MGF, Trindade EBSM. Effects of inulin-type fructans, galacto-oligosaccharides and related synbiotics on inflammatory markers in adult patients with overweight or obesity: A systematic review. Clin Nutr. 2017 Oct;36(5):1197-1206. doi: 10.1016/j.clnu.2016.10.003. Epub 2016 Oct 8. PMID: 27771020.
Rashad, N.M., El-Shal, A.S., Amin, A.I., & Soliman, M.H. (2017). Effects of probiotics supplementation on macrophage migration inhibitory factor and clinical laboratory feature of polycystic ovary syndrome. Journal of Functional Foods, 36, 317-324.
Bouillon R, Manousaki D, Rosen C, Trajanoska K, Rivadeneira F, Richards JB. The health effects of vitamin D supplementation: evidence from human studies. Nat Rev Endocrinol. 2022 Feb;18(2):96-110. doi: 10.1038/s41574-021-00593-z. Epub 2021 Nov 23. PMID: 34815552; PMCID: PMC8609267.
Akbari M, Ostadmohammadi V, Lankarani KB, Tabrizi R, Kolahdooz F, Heydari ST, Kavari SH, Mirhosseini N, Mafi A, Dastorani M, Asemi Z. The Effects of Vitamin D Supplementation on Biomarkers of Inflammation and Oxidative Stress Among Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Horm Metab Res. 2018 Apr;50(4):271-279. doi: 10.1055/s-0044-101355. Epub 2018 Feb 23. PMID: 29475212.
Unfer V, Dinicola S, Laganà AS, Bizzarri M. Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS. Int J Mol Sci. 2020 Sep 28;21(19):7157. doi: 10.3390/ijms21197157. PMID: 32998310; PMCID: PMC7582282.
Ramanand SJ, Ghongane BB, Ramanand JB, Patwardhan MH, Ghanghas RR, Jain SS. Clinical characteristics of polycystic ovary syndrome in Indian women. Indian J Endocrinol Metab. 2013 Jan;17(1):138-45. doi: 10.4103/2230-8210.107858. PMID: 23776867; PMCID: PMC3659881.
Yildizhan R, Kurdoglu M, Adali E, Kolusari A, Yildizhan B, Sahin HG, Kamaci M. Serum 25-hydroxyvitamin D concentrations in obese and non-obese women with polycystic ovary syndrome. Arch Gynecol Obstet. 2009 Oct;280(4):559-63. doi: 10.1007/s00404-009-0958-7. Epub 2009 Feb 13. PMID: 19214546.
Lenarcik A Milewicz A. Polycystic ovary syndrome in Endocrinology in everyday medical practice ed. Publisher Pomeranian Academy of Medicine in Szczecin, Szczecin. 2009 i 1:413-420.
Bahmani F, Karamali M, Shakeri H, Asemi Z. The effects of folate supplementation on inflammatory factors and biomarkers of oxidative stress in overweight and obese women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled clinical trial. Clin Endocrinol (Oxf). 2014 Oct;81(4):582-7. doi: 10.1111/cen.12451. Epub 2014 Apr 15. PMID: 24628390.
Torres PJ, Siakowska M, Banaszewska B, Pawelczyk L, Duleba AJ, Kelley ST, Thackray VG. Gut Microbial Diversity in Women With Polycystic Ovary Syndrome Correlates With Hyperandrogenism. J Clin Endocrinol Metab. 2018 Apr 1;103(4):1502-1511. doi: 10.1210/jc.2017-02153. PMID: 29370410; PMCID: PMC6276580.
Heshmati J, Farsi F, Yosaee S, Razavi M, Rezaeinejad M, Karimie E, Sepidarkish M. The Effects of Probiotics or Synbiotics Supplementation in Women with Polycystic Ovarian Syndrome: a Systematic Review and Meta-Analysis of Randomized Clinical Trials. Probiotics Antimicrob Proteins. 2019 Dec;11(4):1236-1247. doi: 10.1007/s12602-018-9493-9. PMID: 30547393.
Nafiu A Alimi S, Babalola A, et al. Anti-androgenic and insulin-sensitizing actions of Nigella sativa oil improve polycystic ovary and associated dyslipidemia and redox disturbances. J Complement Med Res. 2019 and 10.5455/jcmr.2019061304 10(4):186199. doi: 10.5455/jcmr.20190613045154.
Razavi M, Jamilian M, Karamali M, Bahmani F, Aghadavod E, Asemi Z. The Effects of Vitamin D-K-Calcium Co-Supplementation on Endocrine, Inflammation, and Oxidative Stress Biomarkers in Vitamin D-Deficient Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial. Horm Metab Res. 2016 Jul;48(7):446-51. doi: 10.1055/s-0042-104060. Epub 2016 Apr 6. PMID: 27050252.
Jia LY, Feng JX, Li JL, Liu FY, Xie LZ, Luo SJ, Han FJ. The Complementary and Alternative Medicine for Polycystic Ovary Syndrome: A Review of Clinical Application and Mechanism. Evid Based Complement Alternat Med. 2021 Feb 26;2021:5555315. doi: 10.1155/2021/5555315. PMID: 33727939; PMCID: PMC7935573.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Monika Turek, Klara Wojciechowska, Aleksandra Jaroń, Katarzyna Jastrzębska, Agata Wiklińska, Maria Witkowska, Joanna Skotnicka, Karolina Błaszczak, Adrian Borkowski, Mateusz Sawicki
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 234
Number of citations: 0
