Presentation on theme: " LONG TERM WEIGHT MANAGEMENT TO PROMOTE REPRODUCTIVE HEALTH IN OVER WEIGHT/OBEASE WOMEN WITH POLYCYSTIC OVARIAN SYNDROME. DR.PREMA.H.S,"— Presentation transcript:
1 LONG TERM WEIGHT MANAGEMENT TO PROMOTE REPRODUCTIVE HEALTH IN OVER WEIGHT/OBEASE WOMEN WITH POLYCYSTIC OVARIAN SYNDROME. DR.PREMA.H.S,
2INTRODUCTIONObesity in women induces a range of co-morbidities like irregular menstrual cycle, anovulatory infertility, hirsutism, acne, hyperinsulinemia, dyslipidemia and hyperandrogenism. These are said to constitute the polycystic ovarian syndrome
3PCOS is an excellent example of a syndrome for which early recognition and intervention of - Weight controlDiet modificationLife style changesPrevent or delay the development of further problems.Hence long-term holistic interest is needed to correct the reproductive health of the affected women.
4ObjectivesTo evaluate the somatic status of the obese women with PCOS.To evaluate the relationship between obesity and PCOS.Planning and evaluating the wt. management in reversal of the condition
5SELECTION OF SUBJECTS subjects having a BMI greater than 25 with the clinical manifestation of menstrual irregularities, were selected. While selecting the subjects it was found out that some of them are with or with out hirsutism, acne, dyslipidemia, hyprerinsulinemia with PCOS.
6DEVELOPMENT OF TOOLS Personal data Anthropometrical measurements Co-morbidites associated with obese PCOSDietary pattern,food preferences and food frequencyHealth practicesPhysical activitiesBehavioral pattern
7METHODOLOGYAssessment of somatic state of obesity through anthropometrics- Ht. Wt. MUAC. SFT. W&HAssessment of body composition by bio-electrical impendenceBio-chemical assessment of serum Hb, RBS, PPBS,serum insulin & lipid profile.Assessment of presence of ovarian cysts by ultra sound scanning (pelvic or TVS).
8Initially dietary counseling was given to all the subjects in the presence of their family members. Dietary modification was aimed to provide hypo caloric diet with 12 to 15 % of fat.Assessment of effective wt. reduction through anthropometrics i.e. wt, skin fold thick ness, MAC, W&H Measurements was done periodically.Assessment of presence of ovarian cysts and size of the ovaries were checked by ultra sound scanning at a specific period.
9RESULTS A loss of an average of 10 kg over a period of 5 months Reduced ovarian size and the disappearance of or reduction of cysts in both the ovaries or in a single ovary.Subjects showing on an average a reduction of 10kg body wt., were found to have regular menstrual cycles.While the subjects losing, on an average, 2 kg body wt. still continue to show menstrual irregularities.
10As assessed by bio-electrical impedance body compositions suggest reduced fat % with elevated TBW & FFM.The improvement of WHR.Three of the married subjects conceived spontaneously without any medical interventionThese findings suggest that the wt. reduction through dietary modification have a role in the improvement of reproductive health of obese women with PCOS.
11Normal uterus with bilateral polycystic ovaries. Right ovary measured 2.5x1.6x3.1 cm(volume 6.2 cc)Left ovary measured 3.1x1.7x2.9 cm(volume 7.6 cc)
12Findings are suggestive of a very early intra-uterine gestation of about 5+ weeks. Both ovaries appeared normal and Corpus-luteum was seen in the right ovary.3.1x1.2x2.0(volume 3.7 cc)3.0x2.1x3.6 cm(Corpus-luteum –1.8x1.5x1.8 cm)
13Bilateral polycystic ovaries with slight decrease in size since last scan done. Before wt. loss 3.7x2.2 cmAfter wt. loss 3.4x1.7 cmBefore wt. loss 3.8x2.0 cmAfter wt. loss 3.1x1.7 cm
14Size of the ovary before and after the dietary treatment Right ovary(cm)Left ovaryTotal loss of volume (cm)BeforeAfterAfter treatment4.0× 2.12.0 ×1.94.0× 2.33.5× 188.8.131.52 ×2.02.5× 1.73.0 ×2.22.6 ×1.65.394.8 ×1.12.6× 1.04.8× 1.11.8× 0.66.884.4 ×2.0× 2.73.4× 1.2× 1.53.4 ×1.9 ×2.11.8× 0.2× 2.06.843.0× 2.41.1× 1.62.6× 2.21.6×0.56.724.3×2.41.9× 0.55.0×2.82.9×1.319.6