More and more fitness centres are springing up in the cities, offering an interesting range of activities like mixed martial arts, zumba, aerial yoga, in addition to the traditional gym workouts and aerobics. Yet, the overall sedentary lifestyle — erratic work hours, unhealthy food habits and poor sleeping patterns — results in women suffering from several problems. One among them being Polycystic Ovarian Syndrome (PCOS).

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PCOS manifests in the body in the form of irregular or delayed periods. Presence of acne or hirsutism is another indicator of PCOS. When left undiagnosed or uncontrolled for long, it affects fertility and makes it difficult for women to conceive. It can even increase chances of a miscarriage. Additionally, women are likely to develop hypertension, stress, diabetes (since PCOS causes insulin resistance), and can suffer heart attack at an early age, informs Dr Sharda Jain, chairperson, Delhi Gynaecology Forum.

Cause and diagnosis

While the exact cause is not known, Dr Anushree Patil, gynaecologist and in-charge of Mumbai-based PCOS clinic, believes its origin is multi-factorial. It could be genetic predisposition where it runs in families, a sedentary lifestyle, increasing pollution and even consumption of chemicals. "Many of the containers we use to store or heat food in are made from plastic that contains Bisphenol A (BPA). In one of our studies, which is at a publishing stage, we found BPA levels to be five times higher in women with PCOS," says Dr Patil as she discusses the various kinds of diagnostic criteria. There's Androgen Excess Society (AES) criteria, the National Institute of Health (NIH) criteria, and the most commonly referred one, Rotterdam criteria. The latter relies on the presence of two or three criterias to be diagnosed as PCOS, ultrasound evidence, anovulation (delayed period) and hyper androgens. This criterion eliminates the possibility of PCOM (Polycystic Ovarian Morphology), where ovaries may appear polycystic even when not. This criterion also saves girls from an incorrect diagnosis as doctors are still apprehensive of examining the pelvis through a transvaginal ultrasound on unmarried women. "Diagnosis in young girls is very difficult because we can't do a vaginal ultrasound on them as they are not sexually active," reveals Dr Duru Shah, founder president of the PCOS Society of India.

While Dr Shah observes that 80 per cent of women with PCOS are obese, Dr Jain calls PCOS a nuance in infertility and that it's mainly a problem with urban women solely because of their lifestyle. Though lifestyle correction can reduce obesity, some PCOS patients find it difficult to lose weight despite the right exercise and diet as the syndrome is insulin-resistant. In fact, a study by AIIMS doctors revealed that insulin resistance is an integral part of PCOS and women with the condition are more prone to diabetes.Even stress also heightens PCOS and so Dr Patil suggests that people take part in recreational activities, especially yoga.

Allopathy vs Alternatives

Although doctors prescribe period inducing drugs including contraceptive pills alongside other drugs, the larger change comes from lifestyle correction, agree most gynaecologists. However, judging by the way medication is meted out, it appears that medicines are given precedence over changes to lifestyle, complain women with PCOS. Tired of taking medicines and bearing the side effects of depression, fatigue, excessive bleeding or spotting, many women are looking for alternatives.

When Mumbai-based actor Vinti Idnani visited a gynaecologist after missing her periods for a few months, she was diagnosed with PCOS and was put on medication. Additionally, she was advised to eat healthy and exercise. "But the exercise and diet advice was shelled out so casually, it doesn't appear very relevant. The way my doctor spoke, it appeared that medicines are the primary treatment," says Idnani, who stopped taking medicines after a while and instead enrolled at a yoga camp at Rishikesh, lasting for a few weeks. "Even after the programme, I continued with yoga for two hours every day with a healthy diet. I could feel the difference and when I did an ultrasound again, there were no cysts," says Idnani who lost about eight kgs.Similarily, Delhi-based journalist Bhagyashree Sagar found the solution to PCOS in an Ayurvedic treatment at a Bengaluru-based centre. "The treatment, given in two parts, included strict diet, Ayurvedic massages and yoga. Afterwards, I was asked to continue with diet, exercise and ayurvedic medicines for three months. I will be completing the treatment in another week, but I can already feel the difference," she says, coming to the conclusion that one must not completely discard the medication, but pay more attention to diet as wellas exercise.