PCOS affects a major part of a menstruating person’s life than many of them are aware of. The lack of information about the condition and the reluctance of people to talk about the matter makes it worse. As we kick off World PCOS Awareness Month, we try to understand the proper repercussions and the best ways to manage your periods. As science progresses each day, many women have taken the initiative to further the research on PCOS and the reproductive health of women. We spoke to Dr Prarthana Shah, a doctor who specialised in preventative CVD medicine and an Integrative Health Coach to get a better understanding of the vital role nutrition plays in a woman’s reproductive cycle.

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder affecting millions of women worldwide. Characterized by irregular menstrual cycles, excess androgen production, and the presence of cysts on the ovaries, PCOS can lead to a range of health issues, including infertility, obesity, type 2 diabetes, cardiovascular disease, and endometrial cancer.

Role of Nutrition in PCOS Management

A balanced diet plays a crucial role in managing PCOS symptoms and reducing the risk of associated health complications. By focusing on nutrient-dense foods and avoiding certain triggers, women with PCOS can significantly improve their overall well-being.

According to Dr. Prarthana, “The first thing is B12. So, a common deficiency, even otherwise, which can affect a woman's hormonal balance, because it helps regulate your hair length, and so it's important to make sure that you're getting enough B12.” There are important nutrients that women must have for healthy menstrual cycles.

• Vitamin B12: Essential for hormonal balance, hair health, and regular menstruation.
• Vitamin D: Helps regulate hormones, supports ovarian function, and improves insulin sensitivity.
• Iron: Crucial for preventing anaemia, which is common during menstruation.
• Electrolytes: Help maintain fluid balance and prevent fatigue.
• Amino acids: Provide building blocks for proteins and support overall health.

Dietary Recommendations for PCOS

As Dr Prarthana mentioned, the key nutrients that women lack are the reason why their periods might be irregular and make it difficult for them to handle it. She suggested that it's essential to prioritize a nutrient-rich diet. Focus on consuming whole foods like fruits, vegetables, whole grains, lean proteins, and healthy fats.

Minimize your intake of processed foods, sugary drinks, processed meats, and refined carbohydrates, as these can contribute to inflammation and hormonal imbalances. Consider limiting or avoiding dairy products, as they may contain hormones that can disrupt your hormonal regulation.

She also emphasised the importance of seasonal fruits. While many people have expressed their reservations with cross-contamination and germs from fruits she says, “You have to eat seasonal fruits and vegetables. Greens and salad leaves, all of these things for vitamin B12. Now, of course, there will be some vendors that cut it up. So, don't buy it from there. one tip I personally suggest is that I use something called Veggie Wash where I wash my salad leaves in that at home. You can also wash it with salt or apple cider vinegar.”

When enjoying seasonal fruits and vegetables, be mindful of potential contamination from vendors who cut and sell them. Wash them thoroughly at home to ensure safety. Finally, stay hydrated by drinking plenty of water throughout the day to support overall health and prevent dehydration.

Lifestyle changes you should make for PCOS

According to Dr Prarthana, your lifestyle plays a really important role in PCOS, “So, I know most women, even though they regularly exercise, I mean the ones that do, also kind of skip it during the period and that is the wrong thing to do, ideally.”

She also expresses how much it actually helps with period pains and relief for women, “It's okay. You should go and do some sort of exercise. Go for a walk. It could be lighter if you're, you know, tired. But something in some form of movement, maybe yoga, stretching, whatever works for each person depending on how much pain they have. It really opens up the muscles and gives you relief.”

Other changes include,

• Manage stress: Practice stress-reduction techniques like meditation, yoga, or deep breathing.
• Prioritize sleep: Aim for 7-8 hours of quality sleep each night.
• Consider supplements: Consult with a healthcare professional about potential supplements, such as vitamin D and iron, to address specific deficiencies.

People living with obesity and diabetes often feel healthy in their day-to-day life, but some of the most dangerous changes may be happening silently inside their bodies.

The liver is one of the first organs to be affected. In many cases, fat slowly accumulates in the liver without causing any pain, discomfort, or obvious symptoms. This is why fatty liver disease is often called a “silent condition.” By the time it is detected, it may already have progressed to an irreversible stage.

Excess body fat, particularly around the abdomen, disrupts how the body processes sugar and fats, placing continuous stress on the liver. Because of this silent progression, experts now strongly recommend that people living with obesity and type 2 diabetes should proactively check their liver health, even when they feel completely well.

Obesity is closely linked with liver damage through a series of metabolic changes that develop over time. When the body becomes resistant to insulin, fat begins to accumulate in liver cells, triggering inflammation and gradual injury.

If this continues unchecked, the condition can progress from simple fat accumulation to more serious stages, including metabolic dysfunction-associated steatohepatitis (MASH), where inflammation and liver cell damage become more significant.

Over time, this may lead to fibrosis (scarring of the liver), and in advanced cases, cirrhosis, which can severely affect liver function. Further, patients with fatty liver may directly present with liver cancer, which can occur in up to 20% of patients.

How Common Is Fatty Liver In People With Diabetes And Obesity?

In India, the burden of metabolic dysfunction-associated steatotic liver disease (MASLD) or fatty liver is rising and is now recognised as a common metabolic condition. Studies from the Indian subcontinent estimate that 1 in 3 people may have MASLD. Fatty liver is particularly common among individuals with metabolic risk factors.

It is seen in nearly 40–80% of people with type 2 diabetes and 30–90% of those with obesity, often without clear symptoms.iv Hospital-based trends also suggest increasing detection in younger age groups, reflecting changes in diet, reduced physical activity, and more sedentary lifestyles.

Also read: Post-Menopausal Women Face A Higher Risk Of Fatty Liver Disease: How Falling Estrogen Levels Impact Liver Health

What Liver Checks And Preventive Measures Should You Follow?

Preventive measures to be followed:

• If you live with excess weight/obesity and type 2 diabetes or PCOS (polycystic ovarian syndrome) or dyslipidemia, seek early consultation with a physician or hepatologist.

• Your doctor may request routine metabolic screening:

• Regular liver function tests as part of annual health check-ups

• Ultrasound screening for individuals with obesity or diabetes

• Monitoring blood sugar, cholesterol, and triglyceride levels

• Liver scarring scan (annually for patients with diabetes/obesity)

• Avoiding long-term neglect of “mild” or borderline test results

Also read: From Liver Inflammation to Cancer: When Hepatitis Becomes a Serious Warning Sign

With rising obesity rates in India, early liver screening should become a routine part of preventive healthcare. Even modest weight reduction, improved diet quality, and regular exercise (approximately 150 minutes per week of moderate-intensity exercise (example: brisk walking, gardening, swimming, cycling) or 75 minutes of vigorous exercise (example: weight training) can significantly reduce liver fat and inflammation within 3-6 months.

However, once the disease progresses to MASH or fibrosis, reversal becomes more difficult and may require long-term medical management. Early-stage fatty liver disease is reversible in many cases. In fact, medications can even reverse liver fibrosis (early scarring), but in only 25% of patients. Simple homemade food is sufficient to prevent these lifestyle diseases, and there is no need for “fancy online diets or supplements”.

Our forefathers lived longer by consuming homemade food and water without any supplements. Newly approved therapies such as semaglutide (GLP1 analogues) have been shown to resolve steatohepatitis and reduce liver fibrosis. These liver benefits do not appear to be explained solely by weight loss, suggesting a broader potential impact on liver health.

The absence of symptoms does not mean the absence of risk. Taking care of the liver early is not just about preventing disease; it is about protecting long-term health, energy, and quality of life.

By Dr. Anand V. Kulkarni, Senior Consultant Hepatologist & Director – Critical Care Hepatology, AIG Hospitals, Hyderabad

There is a conversation that comes up in almost every consultation, and it is rarely the one the patient came prepared for. After graft numbers, hairline design, cost and downtime have been discussed, the question of smoking and drinking inevitably follows — and the answer is usually a shrug: occasionally, socially, nothing serious.

Yet of all the variable that determines what a patient sees in the mirror eighteen months later, these two are among the very few fully within their control, and among the most underestimated.

What Smoking and Alcohol Do to the Scalp

The hair follicle is one of the most metabolically demanding structures in the body, dividing faster than almost any other cell population and depending entirely on a dense network of microscopic vessels feeding its base. Nicotine constricts those vessels; over years, repeated narrowing combined with low-grade inflammation contributes to perifollicular fibrosis — scarring that gradually chokes the follicle.

Alcohol takes a different route, depleting the zinc, iron, folate, B12 and protein hair is built from, while fragmenting sleep and raising cortisol — both of which push follicles prematurely into their resting phase. For a transplant candidate, this matters twice over: it reflects donor-area quality, and it signals the kind of healing environment the grafts are about to enter.

Also read: The Hidden Health Risk of Sitting for Long Hours: What Young Professionals Need to Know

Why the First Week After Surgery Is So Critical

For the first few days after surgery, a transplanted follicle is essentially cut off from its blood supply, surviving on nutrients diffusing in from surrounding tissue.

New capillaries begin connecting around day four or five, with full revascularisation taking seven to ten days — the most vulnerable window in the graft's life. Smoking attacks it from two directions: nicotine causes sustained vasoconstriction after every cigarette, while carbon monoxide binds haemoglobin more readily than oxygen, so the reduced blood reaching the scalp also carries less oxygen.

The result is rarely dramatic — just poorer graft survival, patchier density, and a final outcome thinner than the graft count promised. Patients often read this as bad luck; it usually isn't. Notably, this applies equally to vaping, hookah and smokeless tobacco like gutkha or khaini — the delivery method changes, but the nicotine doesn't.

Also read: Ozempic/Wegovy Vs Zepbound/Mounjaro: Which Weight Loss Drug Is More Likely To Cause Hair Loss? Study Finds

Alcohol's More Immediate Risk

Alcohol's damage is more mechanical. It causes vasodilation and impairs clotting, meaning patients who've been drinking beforehand bleed more during surgery — which makes graft placement less precise and can dislodge grafts already sited.

Afterward, the same vasodilation worsens normal post-op swelling, its diuretic effect fights the hydration healing tissue needs, and its immune-suppressing effect arrives just as the scalp carries thousands of small open wounds. There's a medication risk too: alcohol combined with post-op antibiotics, anti-inflammatories or steroids raises the chance of gastric irritation or a genuinely unpleasant systemic reaction.

Recommended Windows

For smoking: stop at least two weeks before surgery (four is better), and stay off it for two weeks to a month afterwards — the long lead-in accounts for how slowly small-vessel and immune function normalise, and the long tail covers graft revascularisation.

For alcohol: stop five to seven days before, and avoid it for ten to fourteen days after, or as long as medication continues, since its effects reverse faster. One caveat worth repeating: patients often say they've "stopped" when they've merely cut back. A single cigarette produces measurable scalp vasoconstriction — in this window, occasional isn't the same as fine.

Also read: Love Travelling? Here's How Flying Frequently Impacts Your Health

The Myth That Lifestyle Stops Mattering

A costly misconception is that once surgery is done, lifestyle no longer matters. It's a half-truth: transplanted follicles, taken from the DHT-resistant back and sides of the scalp, are permanent and won't miniaturise. But a transplant only redistributes existing hair — every native follicle remains susceptible to ongoing loss.

If that native hair keeps thinning, overall density falls even though every graft survives, and patients often mistake this for transplant failure. In reality, the surroundings have receded, accelerated by smoking, poor sleep, chronic stress and poor nutrition. Surgery buys a foundation; lifestyle determines how long the picture around it holds.

Practical Guidance

Honesty at consultation matters — knowing a patient smokes heavily changes the surgical plan toward more conservative density and staging, which protects the result. The pre- and post-op window should be treated as non-negotiable, even if permanent quitting feels distant; a defined four-week commitment is far more achievable than an open-ended one.

Switching to vaping or nicotine gum isn't automatically safe — it removes carbon monoxide and tar, but nicotine, the actual vasoconstrictor, remains, so replacement therapy should be discussed with the surgeon. Fundamentals also help: adequate protein, iron and vitamin D, seven to eight hours of sleep, hydration, and gentle movement once cleared.

Turning Surgery into Leverage

Finally, surgery itself can be motivating. Patients who've just invested significant money and recovery time in their appearance are often more driven to quit than at any other point in

By Dr. Harikiran Chekuri, Hair Transplant Surgeon, Founder and Chief Plastic Surgeon, Redefine Hair Transplant & Plastic Surgery Center

It is difficult to determine emotions because of the neurological differences, the surrounding in childhood, the psychological ways of survival, and absence of emotional training.

Alexithymia or "emotional blindness" is the neuropsychological trait associated with severe problems with identification, recognition, and description of the person's emotions. Alexithymia is not a psychiatric disease but a personality trait.

It is characterized by the inability to identify and distinguish emotions and body sensations, difficulty of finding the words to express feelings, inability to understand facial expression and body language of another person and emotional detachment during stressful situations.

It is diagnosed in people with autism spectrum disorder, depressive disorder, generalized anxiety disorder and after traumatic brain injuries. It can be inherited or acquired as a result of childhood trauma, abuse or neurological damage.

The Brain Science Behind Alexithymia

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The cause of alexithymia is the brain wiring and neurological differences. Therefore, there is impaired interception, which is the inability of the brain to recognize its own physical sensations. Also, an unusual structure of the brain regions like amygdala and insula, that regulate emotions, makes difficult to decode emotional signals.

Early childhood environment and emotional competence must be developed in childhood, because, without that, there can be emotional neglect and emotional vocabulary deficiency. Due to the inability to interpret emotional data, the person misses the compass that directs decisions and self-calming. This leads to emotional outburst, panic, hyperarousal, social and psychological consequences.

How Alexithymia Differs From Emotional Numbness

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Emotional numbness is the transient psychological state caused by acute trauma, deep grief or burnout.

The lack of emotional intelligence is the lack of social and emotional competence, when the person feels his emotions correctly, but he cannot control temper, lacks empathy, makes inappropriate social decisions or do not know what kind of effect his behaviour causes on the room.

But alexithymia is different since it is long-term personality trait and the person is unaware of the particular emotion.

In terms of neurodevelopment, the insular cortex and the anterior cingulate cortex (ACC) are the structural core of the brain's salience network. They work as a translator, transforming chaotic physical sensations into recognizable emotional experience.

Although there isn't any cure for alexithymia, one can improve his emotional awareness through certain measures. Interoceptive training where individuals are taught how to associate physical body sensations (such as tightness in the chest) with particular emotions (such as stress).

The use of emotion wheel or list of emotional words to bridge the link between vague physical sensation and precise description. Mindfulness, which involves observing oneself without judgment or without trying to suppress those internal feelings right away. And it is always good to seek professional help from a psychologist or a counselor.

By Dr. Arun Shah, Director - Neurosciences, Sir H.N. Reliance Foundation Hospital