Polycystic Ovary Disease (PCOD) Or Polycystic Ovary Syndrome (PCOS) is a common health condition which affects women in the age group of 12 to 45 years. PCOD is one of the most overdiagnosed, misunderstood and insufficiently treated conditions. The condition, as such, implies a mix of various signs and symptoms, and it's possible to manage the symptoms. Treatment options can differ as women with PCOD may experience a range of symptoms and not merely just one of it.

Founder of Nuvovivo, Mr Rajiv Ambat, gives an account of what they do for their clients. The video gives you an idea of how Nuvovivo helps manage lifestyle conditions such as PCOD/PCOS with a combination of a healthy diet, exercise and support. 

https://www.youtube.com/watch?v=jdlcarOJzzg

What is PCOD / PCOS?

It is a condition in which the ovaries release a number of partially mature or immature eggs that eventually become cysts. In most cases, this is atributed to an imbalance in the male-female sex hormone - estrogen and testosterone.

Such an imbalance often occurs due to the insulin resistance of the body. Insulin is like the KEY that opens the cell walls, to store glucose inside it. When the body becomes resistant to insulin, the blood glucose levels increase which inturn makes our body (pancreas) produce more insulin to bring the blood glucose within the range.

As the insulin levels increase, ovaries produce more testosterone, there by leading to an imbalance in the sex hormones, leading to irregular menstrual cycle, hyperandrogenism, facial hair growth and acne.

Ovulation is regulated by a complex interplay of many hormones and a PCOD profile test would often include analysing the levels of various hormones viz - Luteinising Hormone (LH), Follicle Stimulating Hormone (FSH), Prolactin, Testosteron etc.

PCOD Treatment

PCOD treatment can aid you control the symptoms of PCOD and reduce your risk for long-term health conditions like heart disease and diabetes. PCOD meddles with the menstrual cycle and makes it difficult for young couples to conceive. PCOD treatment is often centred around reducing the symptoms like hair growth, making the menstrual cycle regular etc. If you want to get rid of PCOD related acne, then your treatment would be geared towards skin problems.

One of the great ways to manage PCOD is to exercise daily and eat well to reduce the. Many women with this condition are either obese, has a bad body composition and most often both!.

A bad body composition is when your muscle weight (lean mass) is lesser than the ideal range, while the fat mass is higher. One can be very well within the BMI range and prescribed weight, but with a bad body composition. In such cases, while the person is not visibly obese, the metabolic conditions of the person will be that of an obese person and problems like PCOD, Diabetes are more common.

Losing merely 5%-10% of your weight may relieve certain PCOD problem symptoms and make your menstruation more regular. Losing weight may also aid control difficulties with ovulation and blood glucose levels. 

As women with this condition are often found to have higher blood sugar, you may want to limit sugary and starchy foods. Alternatively, prefer foods with fibre in abundance, which slows down the release of blood glucose levels. Remaining active also aids you manage insulin and blood glucose as well. And daily exercise will aid you with your body weight. 

As losing weight aids to lower the high insulin level which occurs in PCOD, it has a knock-on effect on lessening testosterone, a male sex hormone. This improves the chance of ovulation and fertility, and can also reduce pimples and hair loss. 

However, losing weight can be hard. Going on a crash diet or skipping your dinner and having a salad etc are recipes for disaster. It is extremely important to lose weight in a healthy manner if you are diagnosed with PCOD. If you lose muscle mass during your weight loss journey, your body composition will worsen further, leading to lesser energy levels, hormone imbalances, hair loss, wrinkled skin etc.

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A mix of exercising and a calorie restricted, yet a well balanced diet is always preferred for PCOD. Guidance from a dietician or nutrition expert will help you in losing weight in a health manner - ie. lose body fat without losing lean muscle mass. The best food for women with PCOD is food which is gradually absorbed, keeping glucose levels steady, i.e., low glycemic food. This does not mean avoiding rice, or your favourite food, rather it means being sensible. You may have rice, but have it with a decent amount of vegetables (fiber) and protein. That said, it is also important to eat within your calorie limit - and most probably even maintain a calorie deficit, based on your current weight and body composition. That said, it's better to avoid or reduce the intake of sugary drinks and other sweets. Including fiber and protein alongside carbs will reduce the glycemic load of the food, which will increase the time it takes to release glucose into the blood, thereby preventing insulin spike.

Medications for PCOD: A series of medications are prescribed for PCOD by the doctor after diagnosis. Since insulin resistance is the prime reason for increased testosterone levels, diabetes medications to lower blood glucose like Metformin are often prescribed by the doctors. Birth control pills are also suggested to reduce the chances of endometrial cancer and also to reduce the excessive hair growth, regulate the cycle and improve the hormonal balance. Progestin (synthetic progesterone) tablet is yet another medication prescribed by the doctors for 10-14 days during the cycle to regulate the hormone levels and menstruation.

Medicines are prescribed by the gynaecologist based on their evaluation and assessment. Along with these medicines, the long term management of PCOD always include losing weight in a healthy manner, ie - without losing muscle mass and also improving the insulin sensitivity

PCOD Problem Symptoms

Some of them start experiencing PCOD symptoms around the time of their first menstruation during puberty. Others only find out that they have this condition when they have trouble conceiving or have gained much weight. Below are a few common PCOD symptoms: 

Irregular or no menstruation at all: As there is a lack of ovulation, it hinders the shedding of the uterine lining (endometrium) each month. Some women with this condition have less than eight periods a year. 

Heavy bleeding: The endometrium (lining of the uterus) builds up for a longer time, so your menstruation can be heavier than usual.

Excessive Hair growth: Over 70% of women with PCOD experience excessive hair growth on their body, face, belly, back and chest. This condition is known as Hirsutism. 

Acne: Male hormones can bring about breakouts on the upper back, chest, and face and make the skin oilier than normal. 

Weight gain: About 80% of women with PCOD condition are obese. 

Hair Loss: Hair on the scalp area becomes thinner and falls off. 

Skin darkening: Dark patches of skin can appear in body creases such as those below the chest, the groin and neck. 

Headache: Change in hormones can cause headache in some women. 

Trouble falling asleep or feeling tired every time: Another PCOD symptom is that you might have a sleep disorder called sleep apnea or could have problem sleeping. This implies that even when you sleep, you won't feel well-rested after waking up. 

If you notice symptoms of PCOD, it will typically become evident in your early 20s or the late teens. However, not all women with this condition experience all of these symptoms and every sign can differ from mild to severe. Some of them merely have menstrual disorders or are not able to become pregnant, or even both. 

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PCOD Diet

Research shows that the diet has a tremendous effect on PCOD. That being said, there is no standard PCOD diet at present. But there is a general agreement regarding what foods are helpful and would help women control PCOD and what they should avoid. A few inputs in controlling the symptoms of PCOD - 

A low GI Diet - GI (Glycemic Index) indicates the time it takes to release carbs into the blood as glucose. Foods with a high GI value are released as glucose much faster than those with low GI value. In other words, your body digests low glycemic foods more gradually, which implies that they won't cause insulin levels to increase as rapidly or as much as other foods. Including protein and fiber in the diet will bring down the GI of the whole food and hence it is advised to include ample vegetables and protein in the diet. Avoid or restrict processed carbs, sugary drinks, sweets etc 

An anti-inflammatory diet - Anti-inflammatory foods, like leaf vegetables, fatty fishes, extra virgin olive oil and fatty fish might lower symptoms related to inflammation like chills, fever, etc. Omega 3 (Fish oil) is helpful in reducing inflammation in the body.

Women often stop taking dietary fat as they are scared of gaining further weight. This should not be done as it can create more hormonal imbalances. Fat is much more dense in calories, as compared to other macronutrients, however, dietary fat plays an important role in hormonal balance and it also aids absorption of many micronutrients like - Vit A, D, E, K etc which are important.

The sex hormones estrogen and testosterone are infact based of steroid (type of fat / lipid) and hence dramatically reducing the fat intake can have a detrimental impact on the hormonal balance. That said, it is very important to note that not all fat is good for the body. Reduce the intake of trans fat and saturated fat, while increasing the intake of unsaturated fat. Monounsaturated fat is suggested for those with PCOD

PCOD Problem Home Treatment

Exercise Regularly

• It is best to include a combination of cardio exercises, weight training and yoga. Each of the above exercises have a different impact on the body. However, they need to be done only based on the current physical conditions. For ex - if you are overweight or have back pain related to IVDP (Intervertebral Disc Prolapse), or has an arthritic knee, cardio exercises are not your cup of tea. Similarly, if you have flares of Hemorrhoids (Piles), then weight training needs to be done cautiously
• Walking is not an exercise! It is an activity - a great cardiovascular activity, but not an exercise. However, if you have specific physical conditions that prevent you from exercising, then walking is a great alternative. 
• You may do cardio or exercise at the gym, but see to it that you perform it daily. Refrain from performing too much too soon. Slowly increase your physical activity so that it won't turn out to be a hard activity. 
• Do not get too engrossed to the weighing scale number. One of the difficulties that women with PCOD face is not able to cut weight easily. But, be mindful that despite not noticing the difference on the weighing machine, it will help you lower your symptoms in the long run. A right measure of progress will be to check both weight in kilograms and also inch loss around the belly and waist.

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Have a Healthy Diet 

• A wholesome and timely diet work wonders to relieve PCOD symptoms and prevent the condition. 
• You should avoid having fried items and sweets. Generally, abstain from high-calorie food, as you may end up in calorie surplus and gain weight.
• Spreading meals on time, instead of one large meal helps in preventing the insulin spike. It will also help you refrain from frequent snacking. 
• Planning the meal for the day will aid you refrain from unhealthy snacking and binge eating. 
• Include fibre in your diet, such as green leafy vegetables

Get Enough Sleep

Get seven to eight hours of good night sleep every day. It will not only help you deal with stress, but also help your body recover after you physical activity and exercises. Interrupted sleep can cause hormonal imbalance which can cause PCOD. These actions aim at maintaining the wholesome functioning of every organ in your body. Healthy organs bring about the optimum functioning of the endocrine system and no hormonal imbalance. 

Natural Treatment for PCOD

Losing Weight

Not just losing weight, but losing weight in a healthy manner is extremely crucial. If you lose lean muscle mass along with body fat, your metabolism will crash and the body composition will only worsen. The extra body fat not only causes hormonal imbalances and PCOD, but also increases the odds of heart disease, diabetes and other related metabolic syndromes. Lifestyle modifications, like following a balanced diet of wholesome foods and exercising, can help lose weight and lower the odds of health complications. 

Have a Good Sleep Hygiene

Sleep doesn't just aid regulate cortisol to balance your hormones, but also affects your stress levels. But sleep disturbances are common in PCOD patients. To up your sleep hygiene, you can:

• Set a regular bedtime routine
• Intent for eight hours of sound sleep every night.
• Before bedtime, refrain from fatty foods and stimulants.

Dietary Changes 

PCOD is regarded as a low-level chronic inflammation. Including anti-inflammatory foods in your diet can help ease your PCOD signs.

Add whole foods to your diet; they are not only free from preservatives and artificial sugars, but also are close to their organic, unprocessed state. Some of the examples are vegetables, fruits, nuts, legumes and whole grains among others. 

Also, increase iron intake. Some PCOD patients experience heavy bleeding during their time of the month. It can cause anaemia or iron deficiency. Add food rich in iron to your diet, such as spinach, broccoli and eggs. It will be a good idea to include Vit - C in your diet as Vit C will aid the absorption of iron in the diet.

If you are planning to conceive and thus trying to reverse PCOD, then start folic acid supplementation, or include food rich in folic acid such as pomegranate. Along with fiber and protein, also include MUFA (Monounsaturated fatty acid) such as almonds, nuts etc. Cut down on refined and processed carbs and reduce sugary juices and sweets.

PCOD Problem Solution Naturally

Diet: Having the right foods and abstaining from some ingredients can aid you control the symptoms you experience. A nourishing diet can aid regulate periods and hormones. Having heavily preserved, processed foods can lead to insulin resistance and inflammation. 

It's important to balance the intake of carbohydrates and protein. Both these nutrients can affect your hormone levels and energy. Foods which are unprocessed yet rich in carbs can be eaten. So rather than following a low carb diet, centre on getting much wholesome protein and carbs, and do not completely shun fat in your diet. Add plant based proteins like whole grains, nuts, pulses and legumes to your diet along with animal protein like egg, lean meat like fish etc.

Just as important as having a healthy diet is maintaining a wholesome body weight. It doesn't just aid regulate your menstrual cycle or lower insulin resistance, but also lower your odds of conditions linked to Diabetes, Cardiovascular diseases etc. A slow and steady weight loss with a well balanced (right protein, fat and carb content) calorie deficit diet is the best solution for PCOD. 

Then comes balancing your exercise. It is vital for maintaining a wholesome body weight. You can practice low-impact, gentle exercises such as walking, cycling etc for prolonged periods if you are extremely overweight or have physical ailments like rheumatoid arthritis, osteoarthritis, lower back pain etc. Other activities like long-distance running can also aid relieve PCOD symptoms however, it should be done only based on your bodily conditions  and after talking to a medical-fitness expert

Bringing down stress can regulate the stress hormone cortisol. A lot of the above mentioned solutions like balancing exercise, getting sufficient sleep can contribute to less stress levels. Taking a stroll outdoors or making space to rewind and self care also make you feel less stressed.

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PCOD Problem Solution

Your doctor may suggest weight loss through moderate physical activities and a low-calorie diet. Even a small reduction in body weight, for instance, 5% reduction in body weight might improve your condition. Shedding weight may also help with infertility.

Maintain a Healthy Weight: Losing weight doesn't just help restore ovulation, but also lower androgen and insulin levels.

Reduce high GI carbohydrates intake: High-carbohydrate foods, especially with high glycemic index may shoot up insulin levels. Prefer complex carbohydrates which increase your blood glucose levels more gradually. 

Be active: Physical activity aids reduce glucose levels. If you have PCOD, increasing your regular activity and doing a daily exercise program may prevent or treat insulin resistance and aid you keep your body weight in check and avoid diabetes.

Prefer fibre-rich and low Glycemic index foods: PCOD patients have insulin resistance and due to that doctors recommend a diet which is what they would give to diabetics. Your PCOD diet should include foods rich in fibre, without processed carbohydrates. 

In the gym, many women often spend their time doing cardio exercises like cycling, treadmill etc. Women often shy away from lifting weights as they fear of becoming muscular like a man. Do not shy away from weight training or resistance training; lifting weights has immense health benefits apart from improving the insulin sensitivity dramatically. Lifting weight (resistance training) is not new to women and women of all ages used to do it as part of their regular household work.

Best options for high-fibre foods are:

• Green Leafy vegetables like spinach, kale, microgreens, lettuce
• Vegetables such as cauliflower, broccoli
• Red and green peppers
• Pumpkin
• Lentils and beans
• Almonds

You should also cope with water retention during PCOD. Women with PCOD often suffer from water retention so the best way to deal with it is to drink plenty of water and to avoid sugary drinks. 

What do we offer at Nuvovivo?

At NuvoVivo, we help our customers manage their lifestyle related issues, including PCOD. We essentially plan their diet and exercise based on their eating habits, preferences and medical conditions. Apart from this, we also give necessary followup and support to help them achieve their goals.

The programs are online and hence anyone could join us form anywhere in the world.

Nutrition Planning

Entails making a diet plan to fit your goals, specifically carbs/fat/protein ratio. This plan will be regularly evaluated, based on the plan (Low Touch or High Touch)

The diet plan will change periodically  based on the progress (centimetres reduced around the belly and kilograms reduced). We do not sell any supplements, and we prefer that you eat normal food - one you typically cook at home. For the vast majority of foods, the plan of your choice will be adjustable with alternatives. For example, you can swap three dosas with a certain number of idly, chapati, bread, and more for breakfast. 

Exercise Planning

Includes video explanations, depending on your goals and our review of your capability to do it. The physical activity can be gym or home-based, based on your goals.For a beginner, we expect a home-based exercise for a minimum of half an hour for 5 days a week. The exercise plan created will be evaluated every one or two months, based on your plan (Low touch or high touch).

Followup & Support

As you start the program, you would have a lot of questions and need regular support. This will be done through a combination of whatsapp, emails and telephonic calls. In a low touch program, our team will be in touch with you every 3 days on whatsapp, apart from occasional telephone calls. In the high touch program, our team will be calling you on the phone every alternate day to check on you and clear your doubts.

You can enrol for our programs and get underway from anywhere in the world as long as you have a smartphone and an internet connection. After enrollment, our team will call to understand your eating habits, current medications, physical conditions, other medical conditions etc. We would also need details such as weight in kilograms, cms around the belly and waist etc, and based on all these info a diet plan and exercise plan will be shared with you on email and on whatsapp along with necessary follow up, hand holding and support.

Whatsapp us on +91 7994999914 to know more.