Lean Polycystic Ovarian Syndrome (PCOS) may Go Undetected Because of Normal BMI Levels

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Highlights:

• When women with a BMI of 25kg/m2 suffer from PCOS it is known as Lean PCOS
• Nutrition is one of the most important modifiable risk factors in the treatment of Lean PCOS
• To ensure optimal mineral and vitamin consumption, women are encouraged to consume a healthier diet rich in fruits, vegetables, whole grains, and legumes, as well as healthy omega-3 fats, particularly fatty fish

Polycystic ovarian syndrome (PCOS) is a complex and diverse set of endocrine disorders caused by a synergistic interaction of hereditary, epigenetic, and environmental variables. It is related to both reproductive and metabolic problems, with short- and long-term health effects for women. It affects 4-8% of reproductive-age women and is the leading cause of anovulatory infertility (anovulatory refers to lack of ovulation in a menstrual cycle).

Symptoms of Polycystic Ovarian Syndrome

Polycystic ovaries, menstrual irregularities, and hyperandrogenism are all characteristics of PCOS. The presence of male sex hormones in excess is referred to as hyperandrogenism. This results in characteristics such as abundant body hair (hirsutism), acne in the lower face, neck, chest, and upper back (found in 20-40% of PCOS cases), and male pattern baldness (androgenic alopecia). Obesity is present in around 50-76% of patients. These patients have a high body mass index (BMI). Insulin resistance is another significant finding in PCOS patients.

‘Diagnostic workup and management techniques may be more difficult in patients with Lean PCOS. It may result in significant diagnosis delay aggravating the problems among these women.’

What is Lean PCOS

The majority of PCOS patients have a high BMI and exhibit common symptoms such as hyperandrogenism, polycystic ovaries, and obesity. A lesser but significant proportion of PCOS women have a normal or low BMI (25kg/m2). Most of these patients exhibit common symptoms such as irregular menstrual periods and acne. This type of PCOS presentation with a BMI of 25kg/m2 is known as Lean PCOS. Diagnostic workup and management techniques may be more difficult in patients who arrive with Lean PCOS. This may result in significant diagnosis delay in women with Lean PCOS, aggravating their problems.

Symptoms of Lean PCOS

There is some agreement that the clinical symptoms of lean and obese PCOS are equivalent. Women with Lean PCOS have a normal or low BMI, hirsutism, acne, infertility, and polycystic ovaries (on ultrasound scan). The blood test results are comparable between the two types. There will be high LH levels, low FSH and estrogen levels, and high serum insulin levels. A diagnosis of Lean PCOS can be obtained based on these clinical characteristics and test data. As a result, a woman with PCOS-like symptoms and a normal BMI and weight may be a candidate for Lean PCOS.

Management of Lean PCOS

One of the key modifiable risk factors in the management of Lean PCOS is nutrition. Contrary to popular opinion, the goal of treatment in Lean PCOS is to maintain body weight rather than to lose weight. They are urged to eat a better diet that includes more vegetables, fruits, whole grains, and legumes to acquire an adequate quantity of various minerals and vitamins. Supplementing with calcium and vitamin D will also assist. Regular exercise will also assist patients with Lean PCOS to maintain their BMI. These lifestyle changes will aid in the promotion of a healthy hormonal balance and the maintenance of regular ovulation. Other specific symptoms can be treated with medications.

Complications in Lean PCOS

Diabetes and insulin resistance may be less severe in women who have lean PCOS. It is, nevertheless, critical to keep track of key metrics to guarantee that the risk of cardiovascular disease and other problems is frequently checked.

Much more research is required to identify how Lean PCOS differs from non-lean PCOS, particularly because PCOS is not a one-size-fits-all diagnosis.

Source: Medindia

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