The four main causes of the physiological basis of PCOS include:
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Disorders of gonadotropin hormone synthesis;s
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The emergence of insulin resistance output;
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The effect of existing excess body fat; and finally,
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The metabolic pathways involved in PCOS (insulin secretion and activity, encoding steroidogenesis, and other metabolic and hormonal pathways)
When luteinizing hormone concentration is increased relative to FSH, excessive androgen production occurs, which is more common in women with PCOS.
Insulin influences PCOS pathogenesis both directly and indirectly. It acts synergistically with luteinizing hormone, increasing the production of androgens (theca cells) and reducing liver synthesis of the main binding testosterone protein (SHBG), which causes testosterone to circulate in its unbound, active form.
Excess body fat, plays a role in the development of PCOS in many ways. Adipose tissue cells (adipocytes) produce peptide hormones such as resistin and leptin, as well as some inflammatory cytokines (IL-beta, TNF-alpha)
Insulin Resistance
IR underlies obesity-related conditions such as polycystic ovary syndrome (PCOS).
Oxidative Stress and Chronic Inflammation
The relationship between body weight and IR is inflammatory The microbiota, through its metabolites, has multiple and complex effects on appetite, lipids, and carbohydrate metabolism and can affect body weight. It is associated with the growth of bifidobacteria, insulin secretion and increased glucose tolerance, regulates IR and helps reduce inflammation.
TREATMENT OF PCOS
Lifestyle Changes
Lifestyle modification helps women with PCOS It is the first-line treatment in the treatment, but it is not an alternative to pharmacological treatment. Regular physical activity, maintaining an appropriate body weight, following healthy eating patterns and avoiding tobacco use are vital in the prevention and treatment of metabolic disorders and are included in clinical guidelines for a variety of conditions.
Diet
Nutritional interventions that may be beneficial for women with PCos include to increase insulin sensitivity; restricting pure carbohydrates and total energy, consuming low glycemic index, high fiber foods and small frequent meals.
Additionally with vitamin D3 (up to 10,000 IU/day) and chromium picolinate (200-1000 mcg/day). day) supplementation has been reported to improve glucose tolerance, insulin secretion, and insulin sensitivity.
It can be used as a short-term supportive treatment with N-acetylcysteine (600 mg twice a day) in women with clomiphene-citrate-resistant infertility.
Thyroid hormone replacement therapy and additional selenium and iodine-containing foods or supplements can be used in patients with laboratory or clinical evidence of hypothyroidism.
It is imperative to remove saturated fatty acids from the diets of these patients. Dietary α-linolenic acid-rich flaxseed oil has shown beneficial effects on polycystic ovarian syndrome via the sex steroid hormones-microbiota-inflammatory axis in rats, but other sources of α-linolenic acid will likely have an equally good effect
Physical activity
Physical training potentiates the effects caused by insulin sensitivity through optimization of glucose transport and metabolism. It has been found that vigorous aerobic exercise and resistance training are warranted to improve insulin sensitivity and androgen measures for women with PCOS. Minimum aerobic activity should be 120 minutes per week
Sleeping
Sleep disorders affect the etiology and development of anxiety and depression seen in PCOS. treatment should be an integral part of treating women with PCOS. It is possible to conclude that sleep disorders can be considered as one of the first symptoms in the course of PCOS, leading to the weakening of the protective properties of the body and the intensification of the pathways associated with insulin resistance.
Herbs that Support the Treatment
A balanced diet to support insulin management is the most important treatment for PCOS; Therefore, Aloe vera, cinnamon (Cinnamomum ver um) , green tea ( Camellia sinensi ) and chamomile ( Matricaria chamomilla ) and infusions of certain herbs such as white mulberry ( Morus alba ) complement the therapy very well.
Green mint ( Mentha spicata L.), has an antiandrogenic effect and restores follicular development in ovarian tissue
The most well-studied dietary phytoestrogens are flaxseed lignans. The lignan content of flaxseed ( Linum usitatissimum ) can alter the activity of key enzymes involved in estrogen synthesis (for example, aromatase) to modulate the relative levels of circulating sex hormones and their metabolites
Turmeric ( Curcuma longa ) and especially curcumin, are biologically It is an active phytochemical component. Curcumin appears to be an effective reducer of complications related to oxidative stress in patients with PCOS. There are antioxidant active substances in thistle ( Silybum marianum ) and artichoke ( Cynara Cardunculus ) extracts.
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