Liquid in the Management of Polycystic Ovary Syndrome 3 Int e r v i e w Doctor, what are the most common triggers for polycystic ovary syndrome (PCOS)? In the past few years, PCOS has become a major health burden for women across the world. Factors such as unhealthy dietary habits including consumption of processed foods, sedentary and stressful lifestyles, obesity, and insulin resistance are some of the most common causes of PCOS. What are the diagnostic criteria for PCOS in adult women? Clinical symptoms of PCOS can vary from irregular menstrual cycles or hyperandrogenism to severe metabolic and reproductive disturbances. A patient is clinically diagnosed with PCOS when she presents with oligomenorrhea; a pelvic ultrasonogram shows 12 or more cystic follicles (2–9 mm) in an ovary; and the patient presents at least 2 symptoms established by the Rotterdam criteria of PCOS (ie, polycystic ovaries, anovulation, and hyperandrogenism). Why isPCOSdiagnosisconsideredchallenging inadolescentwomen? How can one overcome this? PCOSmay bemore challenging to diagnose during adolescence as the physiologic events of puberty overlap with the diagnostic criteria of PCOS. Hence, PCOS should be diagnosed in adolescents using 2 main criteria—irregular menstrual cycles relative to the number of years after menarche and hyperandrogenism by clinical and/or biochemical analyses. What are the health complications associated with PCOS? The prevalence of type 2 diabetes mellitus and hypertension is higher in women with PCOS than in women without PCOS. Women with PCOS are also prone to coronary artery disease and myocardial infarction. PCOS can affect lipid profile, that is, it can increase low-density lipoprotein and triglyceride levels and reduce high-density lipoprotein levels. Untreated PCOS can lead to anovulation, infertility, endometrial hyperplasia, and endometrial cancer. PCOS can also cause psychologic complications such as anxiety and depression. Doctor, what would you suggest for the effective management of PCOS? Generally, a healthy diet and physical activity are part of the treatment plan for PCOS. Limiting the intake of processed foods; consuming foods with low glycemic index carbohydrates and rich in protein and fiber; and maintaining an exercise routine are recommended for women with PCOS. Lifestyle modifications can regularize the BMI, decrease the level of free androgens and the incidence of metabolic syndrome, and restore the hormonal balance. What therapeutic strategies do you recommend to your patients to manage PCOS? I usually prescribe Evecare forte, a phytopharmaceutical formulation from Himalaya Wellness Company, to my patients with PCOS. Evecare forte is a nonhormonal menstrual modulator for the effective and comprehensive management of PCOS. Evecare forte helps regularizemenstrual cycles and correct the symptoms of hyperandrogenism such as hirsutism and hyperpigmentation. Further, it improves fertility and helps reduce mood swings, anxiety, and depression associated with PCOS. Dr Devika V Chopra, MBBS, DNB Consultant Obstetrician and Gynecologist Hope Clinic Suite B1/2, Anand Nagar Forjett Street, Tardeo Mumbai 400036, Maharashtra India Regularizes endogenous hormone levels Helps reduce the number of abnormal follicles – Corrects the cyclical rhythm Helps in restoring ovulation – Improves fertility rate Insulin-sensitizing activity corrects ovarian dysfunction and other metabolic derangements associated with insulin resistance. Safe, polyherbal, and nonhormonal menstrual modulator (LIQUID, TABLET) Indication PCOS Dosage Liquid: 2–4 teaspoonsful (10–20 ml) twice daily for 3 to 6 months. Tablet: 1 tablet twice daily for 3 to 6 months. ™Trademark This open-labeled clinical study was conducted to evaluate the efficacy and safety of Evecare forte liquid in the management of polycystic ovary syndrome (PCOS). The study included 40 women (aged 18–45 y) with signs and symptoms of PCOS, such as irregular menstrual cycles, weight gain, biochemical/clinical hyperandrogenemia, and hirsutism. All women were prescribed Evecare forte liquid at a dosage of 20 mL, BID, for 3 months. Clinical assessment of signs and symptoms, ultrasonography, hematologic tests, and hormonal assays were performed at each follow-up visit. Treatment with Evecare forte liquid resulted in a significant reduction in the duration of menstrual cycles by the end of 3 months of treatment (P < .035) (Figure). The intermenstrual interval significantly reduced from the entry to month 3 of treatment (P < .0299). The levels of testosterone (P < .0063), luteinizing hormone (LH) (P < .0435), and follicle-stimulating hormone (FSH) significantly reduced by the end of the treatment. The reduction in LH and FSH levels is indicative of an improvement in PCOS. Ultrasonography showed that the number of ovarian follicles reduced to 17.50 ± 5.27 by the end of the study (P < .0252). No adverse effects were reported or recorded. Hence, the study concluded that Evecare forte liquid is a safe nonhormonal menstrual modulator that helps regularize the endogenous hormonal secretion, corrects the cyclical rhythm, and relieves the symptoms of PCOS. Source: Ahalya S. Data on file. Figure. Effect of Evecare forte Liquid on the Duration of Menstrual Cycles P < .035 At Entry Duration of Menstrual Cycles, d Treatment Duration 12 Month 1 Month 2 Month 3 10 8 6 4 2 0 mes with tagline
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