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.

The US Food and Drug Administration (FDA) has approved tradipitant to be sold under the brand name Nereus, for the prevention of vomiting induced by motion in adults — a first in the last four decades.

Motion sickness affects an estimated 65 to 78 million Americans—roughly 25 to 30 percent of adults—during everyday travel by car, plane, or boat. For decades, patients have had no meaningful new treatment options.

Tradipitant is an oral neurokinin-1 (NK-1) receptor antagonist that prevents motion-induced vomiting in adults.

It is an oral capsule, often taken 60 minutes before travel to block signals causing nausea.

The drug by Vanda Pharmaceuticals is now commercially available across the US.

"Today marks an important milestone for the tens of millions of Americans who experience motion sickness symptoms during common travel," said Mihael H. Polymeropoulos, M.D, President, CEO, and Chairman of Vanda, in a statement.

How Tradipitant Prevents Motion Sickness?

Motion sickness occurs when the brain receives conflicting signals from the eyes, inner ear, and body while in motion. This sensory mismatch is believed to trigger the release of substance P, which activates NK-1 receptors in the central nervous system and ultimately leads to nausea and vomiting.

Tradipitant works by blocking these receptors, interrupting the vomiting pathway.

"NEREUS is a selective, high-affinity antagonist of human substance P/neurokinin-1 (NK-1) receptors that can block the vomiting center of the brain,” Polymeropoulos said.

Tradipitant was approved by the FDA, following two pivotal Phase 3 clinical trials—Motion Syros and Motion Serifos—conducted under real-world conditions on the open sea.

Also read: India Installs US FDA-approved Portable MRI For Bedside Brain Scans At AIIMS Delhi

Both studies demonstrated that tradipitant significantly prevents vomiting compared to placebo, confirming the drug's effectiveness in actual sea travel conditions. It is the first new prescription option for people with a history of motion sickness in over 40 years.

It employs a novel mechanism as a selective, high-affinity antagonist of human substance P/NK-1 receptors. It offers simple dosing with just one or two capsules a day taken approximately an hour before travel.

Is Tradipitant Safe? Are There Any Side-Effects?

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According to Vanda Pharmaceuticals, tradipitant may impair abilities required for driving a motor vehicle or operating heavy machinery.

Combining tradipitant with sedatives or medications that increase the drug's levels may increase this effect. If use together cannot be avoided, your doctor may warn against driving or operating heavy machinery.

The most common side effects associated with tradipitant include drowsiness, headache, and fatigue.

Moreover, strong CYP3A4 inhibitors may increase NEREUS™ levels and the risk of side effects, the company said.

There are limited data on tradipitant's use in pregnant women and children.

Tradipitant is also not recommended in patients with liver problems or severe kidney problems.

Type 2 diabetes was once rare among the young. Now, it is a common diagnosis for Indians in their 20s and 30s. The country currently faces a massive health crisis with 101 million confirmed diabetic patients and 136 million prediabetics. This sudden spike did not happen because human genetics broke down overnight. It happened because the way we live has completely transformed.

Asians (Indians ) already have a " thin- fat " body phenotype, which has a heavy genetic disadvantage. Even when an Indian person appears thin, they typically carry a much higher body fat percentage than a European person of the exact same weight. This fat builds up dangerously as visceral fat around the internal organs. Because of this, Indians develop severe insulin resistance at a much lower Body Mass Index (BMI).

Secondly, we tend to have faster beta-cell exhaustion. The pancreas simply stops producing enough insulin earlier in life.

Thirdly, if you have a positive family history, then the risk is higher and happens at an early age as compared to the previous generation.

But definitely it is not just genetics. Our DNA remains exactly the same as it was a century ago. Still, the age of onset is dropping at an alarming rate. Data from the massive ICMR-INDIAB study reveals that the real "take-off" point for diabetes now sits squarely in the 25 to 34 age bracket. Out of all the people under 25 diagnosed with diabetes today, one in four has Type 2. It used to be very rare to see anything other than Type 1 in young adults.

Now, the situation is completely different. States like Goa, Kerala, and Tamil Nadu are recording huge numbers, especially in city areas. Data collected in Tamil Nadu from 2006 to 2016 proved that the 20 to 39-year-old age group was getting sick at a faster pace than older generations. Across India, the total prevalence rate jumped from 7.1 percent to 11.4 percent. If current trends hold, we are looking at 152 million cases nationwide by 2045.

Why Diabetes Is Rising?

The absolute driver behind this youth explosion is a drastic shift in how we live. Urbanization wiped out physical activity. Young professionals sit at desks for ten hours, endure stressful commutes, and spend their remaining free time staring at screens.

Our diets worsened at the same time. Traditional balanced meals gave way to heavily refined carbohydrates and ultra-processed food, which the younger generation highly depends on. Polished white rice, refined wheat, and cheap ultra-processed foods flood our daily plates. Young people eat far less protein and fiber. This combination of daily sugar spikes and zero physical movement directly causes the abdominal obesity driving this epidemic.

The rapid rise in youth diabetes comes down to a severe gene-environment mismatch. Young Indians live in bodies biologically programmed to store fat to survive famines, but they now live in an environment of constant fast food and zero movement. We cannot rewrite our DNA. We can, however, change our daily habits.

As per RSSDI, early medical screening before age 25 is now an absolute necessity. Replacing heavy carbs with a low-carb, high-protein diet, fixing bad sleep schedules, and making time for daily physical activity can stop this crisis. Youth diabetes is entirely preventable. We just need to act before it is too late.

India holds the record for the highest number of blind individuals in the entire world. The impact that the fact can have on those who hear it should be enough to cause them to stop dead in their tracks. The fact that it is preventable makes it all the more problematic, more than just a number. According to experts from AIIMS, New Delhi, more than 85% of blindness is preventable in the country, and not due to an incurable disease or insurmountable genetic condition.

The overwhelming majority of instances of blindness in India are due to a lack of glasses, or could be prevented by a surgical procedure lasting approximately 20 minutes. And yet, we are left with millions of blind people.

What Is Preventable Blindness?

Preventable blindness refers to vision loss that could have been avoided through timely screening, treatment, correction, or surgical intervention. It is not the same as blindness caused by trauma, hereditary disorders, or conditions beyond medical reach.

The leading culprits in India are well-documented: cataract is responsible for 66.2% of all blindness cases, uncorrected refractive errors for 18.6%, glaucoma for 6.7%, and diabetic retinopathy for 3.3%. Every single one of these is either treatable or manageable with early detection.

Cataracts can be reversed in under thirty minutes. Refractive error can be corrected with spectacles that cost less than a meal at a restaurant. Diabetic retinopathy, if caught early, can be treated before it takes vision at all.

The tragedy of preventable blindness is not medical. It is systemic.

The Scale Of The Problem In India

India carries one of the heaviest burdens of vision loss in the world, and the weight is only growing. There are disparities regarding the burden of vision loss. There are about 75% of the resources and health infrastructure that are found in urban locations whereas there are only 27% of the population and most of the hundreds of millions of people living in rural India do not have access to see an eye doctor because they would need to take a day off work without pay, travel over one hundred kilometers, and pay for the office bill in cash out-of-pocket.

Most people do not try to see an eye doctor, and when they do, it is usually too late to treat the problem.

At the same time, the problem has been exacerbated by the rapidly aging population of India and the incidence of age-related disorders increasing, such as cataracts and the diabetes epidemic, which is one of the largest in the world, has been causing a massive increase in diabetic retinopathy, which will cause continuing loss of vision without proper detection. These are not isolated cases but rather a direct result of the failure of the health care system in India to keep pace with the growing number of diseases in the population.

What Can Be Done?

On the infrastructure side, the priority must be decentralization. Eye care cannot remain a service that lives primarily in urban hospitals. Vision screening needs to be integrated into primary health centers, school programs, and community outreach camps. The private sector, which runs over 70% of all eye care institutes in India, has a role, but so does public policy in incentivizing rural postings and strengthening district-level facilities.

On the workforce side, training mid-level ophthalmic personnel, optometrists, ophthalmic nurses, and vision technicians can extend the reach of a limited specialist pool significantly. Telemedicine-assisted models, where a technician in a rural camp transmits data to a city-based specialist for review, have already shown promise and need to be mainstreamed rather than treated as pilot experiments.

Early detection is arguably the most powerful lever of all. Most people in India visit an eye doctor only after vision loss is already severe. Routine screenings, especially for:

- Adults above 40

- People living with diabetes

- School-going children

Accessing vision care is not complicated. Availability is a major factor. Vision care must also be affordable to be accessible; currently, affordability is at the bottom of the list of priorities.

Examples of initiatives that have been implemented include subsidized cataract surgeries, free glasses for school children, free glasses for senior citizens, and community insurance models for eye care. All of these have been successful with valid results, and there’s plenty of evidence available that supports all these types of programs.

India can solve this. It has the necessary eye surgeon specialists, the model of care, and the evidence needed to make this happen. The issue preventing more people from receiving care, preventing blindness, which could be avoided, has always been a lack of awareness or attention to the problem to turn a statistic into an urgent need. At some point, we need to stop asking why this is happening and start asking why we will allow it to keep happening.