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40 NUTRITION PCOS This month we delve into the world of polycystic ovarian syndrome (PCOS) – what it is, who it affects and how it’s managed – to help pharmacy assistants provide support to their customers who may be suffering this, at times, debilitating condition. ABy Margaret Mielczarek. ccording to Accredited Practising Dietitian Christie Johnson from sportsdietitian.com polycystic ovarian syndrome (PCOS) is “a hormonal condition that affects about one in five1 women of child-bearing age”. “That’s more than half a million Australian women, though many go undetected,” she said. In terms of diagnosis, Ms Johnson says PCOS typically means “there will be cysts on the ovaries”. However, she adds that, to be diagnosed with the condition, women generally need to experience “two out of three factors”. According to Ms Johnson, these factors include lack of “ovulation and/irregular menstrual cycles (some women can have quite heavy or long periods), excess testosterone in the blood and \\\\\\\[as mentioned\\\\\\\], cysts on the ovaries (which not all women may have)”. “Other signs and symptoms of PCOS include weight gain, insulin resistance, anxiety, depression, sleep apnoea, fertility issues/difficulty conceiving, hair growth or loss, and skin changes such as acne,” she said. Community Pharmacist and Accredited Herbalist Gerald Quigley adds that PCOS is also associated with the “metabolic syndrome, where you have high blood pressure, high cholesterol and elevated blood glucose levels”. “Symptoms arise in adolescence with irregular menstrual cycles,” he said. “So, you might have a 16-, 18-, 19-year- old who either isn’t menstruating at all or it’s infrequent. That, over time, can affect fertility and often can drive a person to obesity as well. It seems to get worse with age. “As a syndrome, it’s a collection of a whole range of symptoms. PCOS is a hormone condition associated with excess production of androgens that affects your metabolism as well. It’s a complicated thing.” As with other syndromes, if not managed, PCOS may put a woman at increased risk of other health conditions. “Because women with PCOS typically experience insulin resistance (when glucose in the blood can’t be removed easily, so insulin levels and potentially blood sugar levels rise), they can be at a greater risk, long term, for type 2 diabetes \\\\\\\[T2DM\\\\\\\], weight gain (particularly around their abdomen), cardiovascular disease and endometrial cancer,” Ms Johnson said. Mr Quigley added: “Women with PCOS have seven times the risk of heart attack and heart disease compared with other women, and by the age of 40, up to 40 per cent of them will have developed T2DM. That’s a very important statistic.” The role of diet Due to the increased risk of complications, management of PCOS is important, with one aspect of management being nutrition. “With PCOS, when we’re looking at diet and lifestyle strategies, we’re RETAIL PHARMACY ASSISTANTS • MAR 2021 NUTRITIONAL MANAGEMENT OF