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.

Obstructive hypertrophic cardiomyopathy (oHCM) remains one of the most misunderstood cardiac conditions, despite being the most common inherited cardiomyopathy. Misconceptions around the disease often lead to fear, delayed diagnosis, and hesitation in seeking appropriate medical care.

While oHCM has historically been associated with sudden cardiac death, particularly in young athletes, advances in diagnosis and treatment have significantly transformed its management. Today, with early diagnosis and appropriate treatment, many patients can lead active and fulfilling lives.

Understanding the facts is essential, not only for patients living with the condition, but also for families, caregivers, and the wider community. Separating myths from medical evidence can help ensure timely diagnosis, informed treatment decisions, and better long-term outcomes.

Understanding oHCM

Obstructive hypertrophic cardiomyopathy (oHCM) is a form of hypertrophic cardiomyopathy (HCM)—an inherited heart muscle disorder caused by genetic mutations that affect heart muscle structure and function. These changes cause the heart muscle to become abnormally thick, most commonly affecting the wall (septum) between the two lower chambers of the heart.

In nearly two-thirds of patients with hypertrophic cardiomyopathy, the thickened heart muscle can block the flow of blood leaving the heart—a condition known as obstructive HCM (oHCM). As a result, the heart must work harder to pump blood throughout the body, often leading to symptoms such as breathlessness, chest pain, fatigue, dizziness, palpitations, or fainting during physical activity.

Myth: A diagnosis of oHCM inevitably leads to sudden death.

Fact: While oHCM was once primarily recognised for its association with sudden cardiac death, advances in medical science have significantly improved patient outcomes.

With timely diagnosis, appropriate medical care, and ongoing monitoring, many people with oHCM can lead active lives with a good quality of life and a near-normal life expectancy. Regular follow-up helps assess disease progression and guides individualized care over time.

Myth: People with oHCM need to avoid physical activities

Fact: Complete avoidance of physical activity is no longer recommended for most patients.

Although high-intensity competitive sports may not be suitable for everyone with oHCM, mild-to-moderate exercise is generally encouraged and offers important cardiovascular benefits. Exercise recommendations should always be individualised after a comprehensive assessment by a cardiologist, taking into account symptoms, severity of obstruction, and overall risk profile.

Myth: Diet and lifestyle are the primary causes of oHCM.

Fact: oHCM is a genetic condition. It is not a lifestyle disease.

Unlike heart conditions caused by high blood pressure, diabetes, or high cholesterol, oHCM develops because of inherited genetic mutations affecting heart muscle proteins. Healthy lifestyle choices remain important for overall cardiovascular health, but they do not cause or prevent the condition itself. Because the disease often runs in families, screening of close relatives may also be recommended.

Myth: Every patient with oHCM will require surgical treatment.

Fact: Surgery is only one of several available treatment options. Care is individualized, and the most appropriate approach depends on each patient's symptoms and clinical condition.

Myth: oHCM cannot go unnoticed.

Fact: The condition can remain silent for years. Some individuals carrying the genetic mutation never develop symptoms, while others experience mild or intermittent symptoms that may be attributed to more common conditions. Typical symptoms include:

• Shortness of breath
• Chest pain
• Fatigue
• Palpitations
• Dizziness or light-headedness
• Fainting, particularly during or after exercise

Given this variability, individuals with persistent symptoms or a family history of cardiomyopathy or sudden cardiac death should undergo appropriate cardiac evaluation.

Myth: Medication can cure the disease

Fact: Advances in treatment have significantly improved disease management, helping many patients lead healthier and more active lives. While current therapies focus on controlling symptoms and reducing complications, ongoing research continues to expand treatment possibilities.

Treatment aims to reduce symptoms, improve blood flow, minimize obstruction, and lower the risk of complications such as abnormal heart rhythms and heart failure. Long-term follow-up remains an important part of care, allowing treatment to be adjusted as the condition evolves.

Myth: There's no benefit to diagnosing oHCM early

Fact: Early diagnosis can make a significant difference. Because oHCM symptoms often resemble those of other conditions, timely testing is important—especially for those with a family history of the disease. Early detection can help patients access appropriate treatment, manage symptoms effectively, and reduce the risk of complications.

Why Awareness Matters

The understanding and management of obstructive hypertrophic cardiomyopathy have evolved considerably over the past decade. Although it remains a lifelong condition, it is no longer viewed through the lens of fear alone. Advances in medical therapies, improved diagnostic tools, and personalized treatment strategies have changed the outlook for many patients.

By challenging common myths and promoting awareness, more individuals can be diagnosed earlier, receive appropriate treatment, and live healthier, more active lives with confidence.

(Dr. Daljeet Kaur, Cardiac Electrophysiologist at AIG Hospital, Hyderabad)

It is a common belief that metabolic dysfunction-associated steatotic liver disease (MASLD)—formerly known as non-alcoholic fatty liver disease (NAFLD)—is primarily associated with diet, sedentary lifestyles, and obesity. However, there are other factors as well that affect this aspect. Post-menopausal women experience a significantly higher incidence and faster progression of fatty liver disease, even when maintaining a stable body weight.

In Pre-menopausal women, estrogen plays a central role in metabolism by promoting healthy fat accumulation in subcutaneous tissue (below the skin) rather than around internal organs; it also increases insulin sensitivity and suppresses liver inflammation.

After menopause, when estrogen levels drop, this protective function is lost; there is redistribution of fat leading to more fat accumulation around internal organs, including the liver, thus leading to increased chances of NAFLD and also increasing insulin resistance. Needless to say, with age, our metabolic rate also goes down, which also plays a role in this.

The important part lies not only in understanding the above but in going further in early detection and prevention of menopause associated NAFLD. As we know, fatty liver is a silent disease and often does not cause any signs and symptoms till a very advanced stage.

First and foremost is to change lifestyle with advancing age, changing both the dietary habits and physical activity. Regular screening and monitoring are warranted with blood tests, routine metabolic panels, keeping a tab on weight, sugar, and cholesterol levels, and a basic ultrasound of the abdomen. For someone already diagnosed with second or third stage fatty liver, a simple non-invasive FibroScan can help monitor and assess the response to treatment.

Coming to the treatment part of NAFLD in post-menopausal women, being primarily a lifestyle disease, the core of management also lies in managing lifestyle. Medicines are available for treating and controlling NAFLD in conjunction with lifestyle management. Hormone replacement therapy (HRT), when initiated early in post-menopausal women for symptomatic relief, may offer secondary benefits by maintaining metabolic health. However, HRT should always be initiated after proper evaluation and expert guidance.

NAFLD is a silent epidemic and primarily a lifestyle disease; knowing about it and knowing the triggering and precipitating factors helps with understanding and prevention better. Menopause, being a natural biological phenomenon in every female’s life, makes it essential for us to know how it affects our liver health and overall health as well.

Eating healthy is often associated with loading your plate with salads, fruits, whole grains, legumes, smoothies and sugar-free products. However, a diet that is considered healthy for one person may trigger digestive discomfort in another. Bloating, excessive gas, abdominal cramps, constipation or loose stools after eating “healthy” foods may indicate that your gut is struggling with the quantity or type of foods you are consuming.

One common reason is a sudden increase in dietary fibre. Fibre is essential for bowel health and can support regular bowel movements, but increasing it too quickly can cause fermentation in the large intestine, resulting in gas and bloating. Adults generally need around 22–34 grams of fibre daily, depending on age and sex, but it is better to increase intake gradually rather than making a sudden dietary shift.

Certain nutritious foods can also contain FODMAPs—short-chain carbohydrates that are poorly absorbed in the small intestine. Foods such as onions, garlic, beans, lentils, cauliflower, certain fruits and some dairy products can trigger bloating, abdominal discomfort, diarrhoea or constipation in susceptible individuals, particularly those with irritable bowel syndrome (IBS). A low-FODMAP diet may help selected IBS patients, but it should ideally be undertaken with medical or dietetic guidance and followed by gradual reintroduction of foods.

“Sugar-free” does not necessarily mean gut-friendly either. Sugar alcohols such as sorbitol, mannitol, xylitol and maltitol can be incompletely absorbed and may cause gas, bloating or diarrhoea in some people. Similarly, large quantities of fruit, fruit juices or certain whole grains may aggravate symptoms in people with specific carbohydrate intolerances.

Another overlooked factor is how we eat. Eating very quickly, consuming large meals, drinking fizzy beverages, chewing gum or using straws can increase swallowed air and contribute to belching and bloating. Smaller meals, slower eating and adequate hydration can often make a meaningful difference.

The solution is not to abandon healthy foods, but to personalise your diet. Maintain a food-and-symptom diary, introduce fibre gradually, identify individual triggers and avoid unnecessarily restrictive diets. Persistent symptoms should not simply be attributed to “food intolerance.” Recurrent abdominal pain, unexplained weight loss, anaemia, blood in the stool or black stools require medical evaluation because these may indicate an underlying gastrointestinal condition rather than simple dietary sensitivity.

A healthy diet should nourish your body without consistently making your gut uncomfortable. The goal is not to follow every trending diet, but to understand what works for your individual digestive system.