Polycystic ovary syndrome (PCOS), in some aspects now known as polyendocrine metabolic ovarian syndrome (PMOS), is a complex hormonal and metabolic condition that is associated with menstrual health, fertility, metabolism and long-term cardiovascular health. It is not only the weight loss, but yoga may also be a way to keep the body healthy, scientists at AIIMS have said in research that can lead to weight loss as well as the long term.
Both AIIMS-led studies show that a 12-week yoga programme with more structured treatment for PCOS can improve hormone levels, insulin resistance, cholesterol profile and menstrual maintenance. The results are consistent with the growing body of evidence that lifestyle interventions can be part of a combination of conventional medical care and lifestyle to treat the disease.
The study studied women diagnosed with PCOS who were led in supervised yoga classes with yoga postures, pranayama and meditation for three months. The intervention was carried out on various physical, hormonal and metabolic markers prior to and after the programme. During the programme, the participants had positive changes in several health indicators.
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Among the improvements reported were a reduction in body weight, waist circumference, insulin levels and testosterone levels. Low-density lipoprotein (LDL) cholesterol levels were also improved, which are a cholesterol associated with cardiovascular risk and increased if they are elevated. Menstrual cycles were also more regular among the participants and hormone changes associated with the condition were also found, suggesting that the intervention may have affected some of the hormonal disturbances associated with the condition.
Importantly, those studies argued that yoga may not only be great for weight loss but also for hormone production, which can make symptoms worse. PCOS is often related to insulin resistance (where the cells in the body do not respond effectively to insulin). Insulin levels can then increase and hormone production may also be affected (i.e., irregular periods and high testosterone).
There were also improvements in metabolic markers associated with insulin sensitivity and glucose regulation in AIIMS. Laboratory analyses also identified favourable changes in biological pathways associated with insulin signalling, lipid metabolism and inflammation. These findings are important because metabolic dysfunction is considered an important component of PCOS for many women.
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Dr Rima Dada of AIIMS explained that the condition is hormonal and metabolic. High testosterone levels, for example, may lead to irregular periods, unwanted facial hair and acne while metabolic disturbances can increase the risk of diabetes and cardiovascular disease.
The genetic and molecular changes were also investigated. Yoga was associated with changes in genes in insulin sensitivity, lipid metabolism and inflammation, the researchers found. It could make scientists better aware of how lifestyle interventions can affect some biological mechanisms associated with PCOS.
Another positive observation was fertility. Among 16 women with long-standing infertility who participated in the programme, seven were pregnant either during the intervention or within three months of completion. But pregnancy was not a predefined outcome of the study, researchers said. Therefore the observation is to be interpreted cautiously, and larger clinical trials will be needed to determine if yoga actually boosts fertility outcomes in women with PCOS.
PCOS is estimated to affect about one in eight women of reproductive age and is associated with symptoms and complications which vary significantly from person to person. Irregular periods, difficulty conceiving, acne, excess facial or body hair and weight problems are usually noted. It has also been associated with increased risk of metabolic disease (type 2 diabetes, fatty liver disease and cardiovascular problems).
Based on AIIMS findings, yoga could be used as a low-cost, accessible, non-drug addition to standard PCOS management. There can be no more effective management plan than physical activity, nutrition, sleep, stress management and care from the health department.
But yoga should not be substituted for medical evaluation or treatment. PCOS is a very individual condition and treatment will depend on symptoms, reproductive objectives and metabolic health. Women who have irregular periods, infertility or other persistent symptoms should consult a qualified healthcare professional for appropriate assessment and treatment.
The AIIMS studies on yoga in general have shown that yoga can affect many aspects of PCOS, as opposed to weight loss only. By promoting hormonal balance, insulin sensitivity, metabolic health and menstrual frequency, a structured yoga practice could be a beneficial complement for women who fight this delicate disease. To what extent yoga works for long term and which specific practices should be done regularly, more study is needed.
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