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.

One of the major challenges in rehabilitation is that patients may discontinue midway through the recovery process. In rehabilitation, it is not just the physical journey; it involves both emotional and psychological factors.

When patients begin the rehabilitation journey, they are usually informed of the prognosis, which helps them start the journey with hope. During the process, they might face unexpected encounters such as slow progress and fatigue during exercises. Financial burden, family responsibilities, and social pressures can further add to their stress.

Some patients will not expect the recovery to be too long. Unlike a surgery, where results may appear immediately, rehabilitation demands repeated efforts and commitment for weeks or sometimes months. This might make the patient feel like they have put in a lot of effort, but results might be delayed.

As a rehabilitation physician, it is important to understand that this is not non-compliance or laziness. In a few cases, it is the patient’s exhaustion, fear, and loss of confidence. Additionally, patients might also experience a lack of engagement and fatigue in the exercises. They might feel uninterested in the exercise routine. Once these problems are addressed, there will be more measurable progress. The core idea of rehabilitation is not only to treat the body but to support the patient's mental and emotional well-being.

Barriers To Rehabilitation

The main barriers in rehabilitation are fatigue and pain. For instance, in a spinal cord injury, stroke, post amputation, orthopedic condition such as chronic musculoskeletal pain, and polytrauma, the patient will already be experiencing pain due to the injury. In rehabilitation, physical therapy, and occupational therapy, experts will make the patient do repetitive movements, resulting in emotional fatigue.

From a rehabilitation perspective, repetition is necessary for the development of neuroplasticity; the nervous system learns from repetition. On the contrary, from the patient's perspective, it might feel like a punishment. Even though they understand the benefit, they are frustrated, and it might alleviate the pain. This pain might develop into a fear response associating exercising with suffering, affecting the rehabilitation process.

Rehabilitation must be patient-centered, engaging, and goal-oriented. Today, several newer technologies are helping improve patient involvement and engagement in therapy. Approaches such as gamification and functional training can make rehabilitation more interactive and motivating for patients. For instance, new age AI-enabled devices such as ‘ArmAble’ that have games like chapati rolling, mosquito swatting, dosa making, etc. keep the patient very engaged as they do those activities. Though it might be repetitive, it is still very engaging for the patients.

Importance Of Progress During The Recovery Journey

Small achievements and visible progress can make a significant difference to the patient. For example, standing for 10 seconds longer, climbing one extra step, or moving a finger that could not be moved earlier. As human beings, when we begin to notice progress, hope naturally starts to grow. That hope becomes an important part of rehabilitation.

The challenge in rehabilitation is that progress is often slow in neurological recovery. Improvements may be microscopic, which are not immediately visible to the patient. This is why it is important to actively help patients recognize and understand their progress.

To help the patient understand, we document the patient’s condition from the beginning and show them the difference with the help of functional scores. We record videos to show the patient’s movement and compare it over the weeks of treatment. We also use functional assessment scores and balance testing equipment that convert progress into measurable numerical values. This can help patients see how much they have improved over time.

Setting weekly or fortnightly milestones. Smaller milestones are more realistic and achievable. Patients see progress after certain milestones. This helps rebuild their confidence and belief in the process.

Long-term risks of skipping rehabilitation

In case of neurological conditions like stroke or spinal cord injury, there is a golden period for rehabilitation. This is the time for spontaneous recovery, where the brain starts to relearn. The brain keeps making new connections with repetition. If the patient is not actively participating or completing rehabilitation during that time, they may lose the opportunity to achieve the results.

Even if the patient resumes rehabilitation after a period of time, benefits might not be as significant as envisioned. Discontinuing rehabilitation can lead to stiffness, reduced mobility, and functional limitations. In such cases, if the surgery may be technically successful, the outcome may not be satisfactory.

Beyond physical complications, incomplete or skipping rehabilitation can result in loss of independence. The ultimate goal of rehabilitation is to help patients restore their maximum potential and help them perform everyday activities with ease. Thus, completing rehabilitation is necessary, especially at the right time.

Motivated And Consistent During The Rehabilitation

Motivation is the fuel for rehabilitation. Motivation should not depend only on the patient’s willpower; it should be supported and guided throughout the journey.

Set Realistic goals

For example, in a high spinal cord injury, independent walking with an orthosis may be unrealistic, resulting in loss of motivation. Instead, rehabilitation should focus on short-term goals that can be achieved gradually. If goals are realistic, patients stay encouraged and committed to the process.

Importance of Family Involvement

Recovery is never limited to the patient alone; it should involve the entire support system to see desirable results. Families should be educated about the goals and be updated on the patient’s progress. Documenting the improvements can also help both patients and families stay positive and motivated during rehabilitation.

Communication

Tracking progress

Celebrating small victories, such as a slight improvement in balance or movement, should be acknowledged. This can significantly boost the patient’s confidence and motivation in the journey.

At times, we as rehabilitation professionals do much more than provide clinical treatment. We also become motivators, coaches, educators, and emotional support systems for our patients throughout their recovery journey.

We work with the patients during the most vulnerable phase of their lives, when they are not only struggling with the disease but also with their identity, confidence, and independence. So our responsibility is not just to improve muscle strength or to correct gait. We have to help restore their independence, daily functional movements, and help restore dignity, which makes it more meaningful.

Epilepsy is one of the most common neurological disorders and a leading cause of disability worldwide. Research has suggested that associated conditions, such as stigma, anxiety, and depression, can sometimes be more debilitating than the seizures themselves.

Stigma related to epilepsy can exist at both societal and individual levels, with many patients experiencing feelings of shame, fear, discrimination, and social isolation.

Now, research led by AIIMS New Delhi has suggested that yoga may help reduce epilepsy-related stigma while also improving seizure control. The 2023 study, published in Neurology, found that yoga-based interventions may offer benefits for both mental well-being and disease management.

“Yoga has been clinically proven to reduce the ‘felt stigma’ associated with epilepsy. By alleviating anxiety and improving both mindfulness and overall quality of life, mind-body interventions empower individuals to feel more in control and less socially isolated,” lead author Dr. Manjari Tripathi, Head of the Department of Neurology at AIIMS, told HealthandMe.

What Did the Study Find?

According to Dr. Manjari, the study identified three key benefits of yoga for people living with epilepsy:

• Stigma Reduction: Patients who participated in a six-month yoga and psychoeducation program reported a significant reduction in perceived stigma compared with the control group.

• Improved Seizure Control: The yoga intervention was associated with a higher rate of seizure reduction. "Participants were more than four times as likely to experience a greater than 50% reduction in seizures and were significantly more likely to achieve complete seizure remission," Dr. Manjari told HealthandMe.

• Better Mental Health: Yoga practice was linked to lower anxiety levels, improved emotional regulation, and reduced cognitive impairment.

Also read: Yoga's Increasing Role As Great Soft Power And Preventive Healthcare: Ayush Secretary

Dr. Rajesh Sagar, Professor of Psychiatry at AIIMS, told HealthandMe that yoga reduced the burden of epilepsy and improved the overall quality of life in epilepsy patients by reducing the perceived stigma. The overall quality of life was also improved in the yoga group.

How Was the Study Conducted?

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Researchers conducted a randomized clinical trial involving 160 adults with epilepsy who were followed for six months. Participants were assigned either a structured yoga program or a sham yoga intervention, while both groups also received epilepsy-related psychoeducation.

The yoga program included loosening exercises , breathing techniques, meditation, and positive affirmations.

While the impact on seizure frequency was reduced compared with the control group, the researchers cautioned that larger studies are needed to conclusively determine the effect of yoga on seizure control.

Yoga For Mental Health

Further, mood disturbances have been common among people with epilepsy and often remain inadequately addressed, particularly in developing countries.

According to the researchers, yoga may offer a scalable and accessible option for helping patients manage these challenges alongside conventional treatment.

Dr. Rajesh further told HealthandMe that yoga has well-established benefits for mental health.

“Yoga is important in mental health care, and it has been found that the three important things, which are pranayama, that is, breathing techniques, asanas, that is, physical posture, and dhyana, that is, meditation, have a positive effect on anxiety and even depression, and also improve sleep".

He added that yoga can help reduce stress, improve mood, lower anxiety levels, and enhance sleep quality.

“There is substantial evidence from around the world showing that yoga can benefit people living with certain mental health disorders,” he said.

Every morning, millions begin their day with a quick breakfast and blood pressure (BP) medication swallowed mechanically. But what happens when BP remains uncontrolled despite medicines? Uncontrolled hypertension is one of the most underestimated health threats. Often called the silent killer, it quietly damages the heart, brain, kidneys, and blood vessels.

The BP reading on the cuff captures only a visible measurement. BP that remains above goal over time despite treatment is concerning. Hypertension affects approximately 1.4 billion adults worldwide. Studies suggest that almost 54% of Indian patients have uncontrolled hypertension even while taking ≥2 medications. Thus, treatment does not necessarily mean control.

Why Does BP Control Matter?

Global organizations recommend stricter BP targets, aiming for readings below 130/80 mmHg or even 120 mmHg if tolerated. Studies show that each 10 mmHg reduction in systolic BP can decrease the risk of major cardiovascular events by 20%, stroke by 27%, heart failure by 28%, and death by 13%.

On the other hand, uncontrolled hypertension increases the risk of heart attacks, strokes, heart failure, end-stage kidney disease, type 2 diabetes, and death.

But What If The Numbers Don’t Change Despite Medication?

In persistently uncontrolled hypertension that other causes cannot explain, a hidden culprit called aldosterone is an under-recognized driver. Normally, aldosterone balances sodium and water to regulate BP.

However, in patients with uncontrolled hypertension, aldosterone production may remain abnormally high, causing sodium and fluid buildup, increasing BP.

Approximately 30% of patients with hypertension may have aldosterone dysregulation, and patients with resistant hypertension, obesity, type 2 diabetes, sleep apnea, and hypokalemia are at greater risk. Nearly 10–20% of patients with hypertension are treatment resistant, increasing their risk. In these patients, aldosterone dysregulation could be an important cause.

It is time to look beyond the cuff, as uncontrolled hypertension is a chronic, progressive, and often silent condition with serious consequences. Improving patient outcomes requires greater urgency, earlier intervention, better treatment optimization, and stronger awareness of underlying drivers such as aldosterone.

It is time to identify and treat the root causes of uncontrolled hypertension, so that patients can regain lasting BP control.