Polycystic Ovary Syndrome (PCOS), as some of you may be aware of, is an endocrinological (hormonal) disorder, where a woman’s body produces large amounts of male hormones “androgens”.
Women are usually affected by PCOS, at their reproductive age, that is when they are between the ages of 15 and 59 (Irish Nutrition + Dietic Institute). According to The Irishtimes, nearly 10% of women in the Republic of Ireland are affected by this (which is almost 100,000 women).
What causes PCOS and what are the symptoms?
Well, although some studies link PCOS to family history, the exact cause is still unknown, even to the researchers. Women struggle with fertility issues and various signs of hyperandrogenism (too many male hormones), such as unwanted hair growth on the face and body (hirsutism), acne, male-pattern baldness, etc.
When the symptoms of PCOS are not treated longer-term, it invites a more significant set of problems. Let’s take a quick look at the long-term health issues associated with PCOS.
Challenges with Weight Management:
Excess weight is often reported in women with PCOS. 40 – 80% of women with this disorder are reported to be obese. This struggle of managing the weight paves the way for other chronic problems (Source: Reference 1). Obesity raises androgens and hormonal imbalances, resulting in a higher risk of Insulin Resistance (IR), metabolic syndrome, and hypertension (Source: Reference 2).
Impaired Glucose Tolerance and Diabetes:
Insulin Resistance is reported in over 70% of women. IR is observed in both overweight and lean women who have PCOS. Studies indicate a 7.5% -10% prevalence of type 2 Diabetes Mellitus (DM) versus 0.7% in non-PCOS women (Source: Reference 3). In short the low-grade inflammation caused by the development of PCOS can appear to cause insulin resistance.
Increased Cardiovascular Risk:
Many studies have suggested that PCOS can elevate the risk of Cardiovascular Diseases (CVD) (Source: Reference 4). Research has shown that incidences myocardial infarction (heart attack) is seven times more likely in women with PCOS. Also, extensive Coronary Artery diseases are seen more often in women with PCOS when compared to women with normal ovaries (Source: Reference 5).
As you probably know Coronary Heart Disease (CHD) is more common in men than women. Considering the male characteristics that appear in women with PCOS (anovulation, hyperandrogenism, and insulin resistance), they are naturally at a higher risk (Source: Reference 6).
The Threat of Cancer:
Women with PCOS are at a notable risk of Cancer – Out of the different forms of Cancer, Breast Cancer, Ovarian Cancer, and Endometrial Cancer are more associated with PCOS (Source: Reference 7). In a long-term follow-up of 786 women who were diagnosed with PCOS, Breast Cancer was noted as the most common reason for death (Source: Reference 8).
Ovarian Cancer also developed 2 to 3-fold more in women with PCOS (Source: Reference 9). The risk of Endometrial Cancer is higher due to the prolonged exposure of the Endometrium to unopposed Estrogen caused by anovulation (absence of ovulation).
How Can Resistance Training Help?
Physical training is strongly advocated to fight PCOS, but little information is available on which exercise regime is best (Source: Reference 10). However, there is increasing evidence that Resistance training offers huge benefits to women, with PCOS.
A recent study suggested that progressive Resistance training results in lowered plasma testosterone and fasting glucose levels. It also helps in reducing visceral fat and building lean muscle mass, which can improve hyperandrogenism, reproductive function, and body composition in women with PCOS (Source: Reference 11).
It has also been demonstrated that Resistance training could enhance health and fitness, strength and Functional capacity (Source: Reference 12) in PCOS women. Another study suggested that Resistance Training when coupled with diet and aerobic training can result in (1) a significant decline in blood pressure, fasting glucose and insulin and insulin resistance, testosterone and FAI, (2) growth in Sex hormone-binding globulin (SHBG), and (3) betterment in ovulations and/or menstrual cycle (Source: Reference 13).
Strength Training can improve body composition and Cardiometabolic profile (risk of developing diabetes, heart disease or stroke) in patients with PCOS (Source: Reference 10). A 2016 study demonstrated the reduction of testosterone and the rise in the level of the androgen receptor. This was achieved with a 16-week programme, dramatically improving quality of life (Source: Reference 14).
Exercise has also been shown to modulate insulin sensitivity and lipid metabolism (breakdown of fats) in skeletal muscle. A frequency of 2–3 days of resistance training per week is recommended for improved quality of life (Source: Reference 15). Some studies recommend lifting weights that are the equivalent of 60% to 85% of one-repetition maximum (1RM), targeting all major muscle groups (Source: Reference 16).
It can be very disheartening for women suffering from PCOS. At Educogym we believe that every little can help – Medication, Strength and improved lifestyle – but especially exercise and diet can make an enormous difference.
We have seen first hand how Resistance Training can help. We will closely look at the benefits of nutrition and what’s a recommended diet for women with PCOS. Stay tuned for my next post.
Hope you like this blog. If you did, please do share it with your friends and family.
1.Obesity and Polycystic Ovary Syndrome. Susan Sam. Obes Manag. Author manuscript; available in PMC 2010 Apr 30. Published in final edited form as: Obes Manag. 2007 Apr; 3(2): 69–73. doi: 10.1089/obe.2007.0019 PMCID: PMC2861983
2. Obese and Non-obese Polycystic Ovarian Syndrome: Comparison of Clinical, Metabolic, Hormonal Parameters, and their Differential Response to Clomiphene. Garima Sachdeva, Shalini Gainder, Vanita Suri, Naresh Sachdeva, and Seema Chopra. Indian J Endocrinol Metab. 2019 Mar-Apr; 23(2): 257–262. doi: 10.4103/ijem.IJEM_637_18 PMCID: PMC6540884
3. Cardiovascular Risk in Women With PCOS. Pietro Scicchitano, Ilaria Dentamaro, Rosa Carbonara, Gabriella Bulzis, Annamaria Dachille, Paola Caputo, Roberta Riccardi, Manuela Locorotondo, Cosimo Mandurino, Marco Matteo Ciccone. Int J Endocrinol Metab. 2012 Autumn; 10(4): 611–618. Published online 2012 Sep 30. doi: 10.5812/ijem.4020. PMCID: PMC3693634
4. Polycystic ovary syndrome (PCOS) and the risk of coronary heart disease (CHD): a meta-analysis. Luqian Zhao, Zhigang Zhu, Huiling Lou, Guodong Zhu, Weimin Huang, Shaogang Zhang, Feng Liu. Oncotarget. 2016 Jun 7; 7(23): 33715–33721. Published online 2016 May 22. doi: 10.18632/oncotarget.9553. PMCID: PMC5085114
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8. Association between polycystic ovarian syndrome and endometrial, ovarian, and breast cancer: A population-based cohort study in Taiwan. Dah-Ching Ding, Weishan Chen, Jen-Hung Wang, Shinn-Zong Lin. Medicine (Baltimore) 2018 Sep; 97(39): e12608. Published online 2018 Sep 28. doi: 10.1097/MD.0000000000012608. PMCID: PMC6181615
9. Polycystic Ovary Syndrome (PCOS): Arguably the Most Common Endocrinopathy Is Associated with Significant Morbidity in Women. Enrico Carmina, Rogerio A. Lobo. The Journal of Clinical Endocrinology & Metabolism, Volume 84, Issue 6, 1 June 1999, Pages 1897–1899, https://doi.org/10.1210/jcem.84.6.5803
11. Resistance Exercise Impacts Lean Muscle Mass in Women with Polycystic Ovary Syndrome. Kogure GS1, Miranda-Furtado CL, Silva RC, Melo AS, Ferriani RA, De Sá MF, Dos Reis RM.
12. Hyperandrogenism Enhances Muscle Strength After Progressive Resistance Training, Independent of Body Composition, in Women With Polycystic Ovary Syndrome. Kogure GS1, Silva RC1, Miranda-Furtado CL1,2, Ribeiro VB1,3, Pedroso DCC1, Melo AS1, Ferriani RA1, Reis RMD1.
13. Can resistance training improve the symptoms of polycystic ovary syndrome?. Paraskevi Pericleouscorresponding author and Savvas Stephanides. BMJ Open Sport Exerc Med. 2018; 4(1): e000372. Published online 2018 Aug 21. doi: 10.1136/bmjsem-2018-000372. PMCID: PMC6109818
14. Quality of Life in Women with Polycystic Ovary Syndrome after a Program of Resistance Exercise Training. Rev Bras Ginecol Obstet 2016; 38(07): 340-347. DOI: 10.1055/s-0036-1585457
15. Shetty D, Chandrasekaran B, Singh AW, Oliverraj J. Exercise in polycystic ovarian syndrome: An evidence-based review. Saudi J Sports Med 2017;17:123-8
16. Progressive resistance training in polycystic ovary syndrome: can pumping iron improve clinical outcomes? Cheema BS, Vizza L, Swaraj S. Sports Med. 2014 Sep; 44(9):1197-207.
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