😱মেয়ে/মহিলারা সাবধান - এইরোগ লক্ষন পাল্টে শরীরে হানা দিচ্ছে

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Lean PCOS (Polycystic Ovary Syndrome in normal-weight women)

Lean PCOS refers to PCOS occurring in women who have a normal or low BMI (usually below 25). About 20–30% of PCOS patients are lean, so obesity is not required for PCOS.

Key Features of Lean PCOS

Even without obesity,
hormonal and metabolic disturbances are present.

Common symptoms
Irregular or absent periods
Difficulty conceiving (anovulation)
Acne, oily skin
Excess facial/body hair (hirsutism)
Hair thinning or hair fall
Polycystic ovaries on ultrasound

How Lean PCOS Is Different from Obese PCOS

Aspect

Lean PCOS
Obese PCOS

Body weight
Normal/low
Overweight/obese

Insulin resistance
Mild–moderate (can be hidden)
Marked

Metabolic syndrome
Less common
More common

Inflammation
Lower
Higher

Fertility issues
Common
Common

⚠️ Important: Even lean women can have insulin resistance, but it may not show in routine sugar tests.

Why Lean PCOS Happens (Scientific Explanation)
Genetic predisposition
PCOS genes affect ovarian hormone production.
Insulin resistance at cellular level
Present even without visible fat → stimulates excess androgen (male hormone) production.
High LH : FSH ratio
Leads to increased testosterone and poor ovulation.
Hyperandrogenism
Causes acne, hair issues, cycle irregularity.
Gut microbiome imbalance (new research)
Alters insulin signaling and hormone metabolism.

Diagnosis (Same Criteria as PCOS)
Based on Rotterdam criteria – any 2 of the following:
Irregular ovulation/periods
Clinical or biochemical hyperandrogenism
Polycystic ovaries on ultrasound

Useful tests
LH, FSH, LH/FSH ratio
Total & free testosterone
SHBG
Fasting insulin, HOMA-IR
OGTT (better than fasting glucose)
Lipid profile

Management of Lean PCOS (Different Approach)

1. Diet (Not weight loss–focused)
Low glycemic index foods
Adequate protein
Avoid refined sugar & ultra-processed foods
Regular meal timing (circadian rhythm matters)

2. Exercise (Very important)
Resistance training → improves insulin sensitivity
Moderate cardio (not excessive)

3. Nutritional Supplements (doctor-guided)
Myo-inositol / D-chiro inositol
Omega-3 fatty acids
Vitamin D
Magnesium

4. Stress & Sleep
Chronic stress cortisol → worsens PCOS
7–8 hours sleep essential

5. Medicines (if needed)
Ovulation induction (for fertility)

Low-dose OCPs (symptom control)
Insulin sensitizers in selected cases
Key Take-Home Message
Lean PCOS is a hormonal and metabolic disorder, not a weight disorder.
Normal weight does not mean low risk. Early diagnosis and lifestyle correction are crucial.