We had the pleasure of attending the 1st International Symposium on PCOS organised by the PCOS Foundation in association with SRM Institute of Science & Technology. This 2 day conference, had an impressive line up of speakers including Dr Smita D Mahal, Director & Scientist G NIRRH, ICMR, Dr Rajapriya Ayyappan, Director of Srinivas Priya Hospital Om Fertility Clinic, Dr Srabani Mukherjee Scientist F, NIRRH, ICMR, Professor Paromita Chakraborty, SRMIST & Prof GJ Christian, Prof & Head of National Institute of Siddha.
Dr Smita D Mahale began with her address followed by the first speaker, Dr Rajapriya Ayyappan, who gave a presentation on “What is PCOS?”. Dr Ayyappan covered the role of intrauterine factors and effects of obesity in maturation of the HPG axis, the role of diet both macro & micro, the role of pro- & pre-biotics as future treatments for PCOS and the importance of good sleep quality. Dr Ayyappan also highlighted the need to raise awareness in adolescents so that complications of PCOS can be prevented. These small changes could have a huge intergenerational health impact.
Next up was Dr Srabani Mukherjee, who introduced us to some of the genetics, proteomics and epigenetics involved in PCOS. Her presentation emphasized the complexity of PCOS and how the different phenotypes make studying genetics in PCOS more difficult. Study of PCOS usually focuses on designs including Candidate gene associations involved in pathways such as insulin signalling, gonadotropin regulation, chronic inflammation & energy homeostasis and GWAS or Genome-wide Association Studies. GWAS look for associations between millions of gene variants with disease or its trait on a single platform without a predefined hypothesis. To date 6 GWAS have been performed in PCOS populations with 19 gene loci associated with a risk of PCOS. Some replications have shown conflicting results so more research is needed. Nevertheless GWAS has advanced understanding of PCOS and identified less than 10% of PCOS heritability, while twin and family studies indicate that heritability may be up to 70%. A combined approach of GWAS, candidate gene association, and family-based studies are required to fully elucidate the genetic role in the origin of PCOS.
Later, Professor Paromita Chakraborty gave her presentation on the role of environmental endocrine disruptors and BPAs as a potential cause for PCOS. Endocrine Disruptors include pesticides, organohalogens, heavy metals & plastics both phthalates and BPA. The concern for these endocrine disruptors have been linked to potential human health impacts on behaviour, cancers, diabetes, reduction in fertility rates, immunity and neurological conditions. The 2102 WHO report “State of the Science of Endocrine disrupting Chemicals” gave a detail overview of these chemicals and it is thought that there are around 1000 identified EDCs chemicals globally. It is believed that EDCs have an impact on reproductive and endocrine features of breast cancer, endometriosis, infertility, diabetes, metabolic syndrome, early puberty and obesity. Research is investigating the occurrences of EDCs in soil, water, air and food and it would seem they are everywhere including baby bottles, toys, make up, food packaging, household items and more. Marine litter is a global problem with approximately 80% of litter originating from land based activities. With particular focus on PCOS, it is thought that EDC exposure can disrupt the hormonal milieu and alter foetal development causing epigenetic changes in DNA. It has been suggested this may lead to low or high birth weights and lifelong exposure to EDCs may also contribute to PCOS by affecting androgen synthesis and increasing androgen production by ovarian theca cells. There are various ways of entry for these pollutants including conception, placental transfer, breast feeding, inhalation, dermal exposure and ingestion.
Finally, Prof GJ Christian presented on the Siddha system of medicine in treating PCOS. This work has found single herb to Herbo mineral formulations to be effective in treating symptoms of PCOS. In Siddha, PCOS may be related to other conditions like Rakta soora vayu, Soothhaga thadai, Soothhaga vayu, Soothagakatti, Garpsoolaii, Soothigavatham (mood swings) etc. Siddha deal with PCOS as a kabam disorder of Mukkutram. For PCOS, Mandagni is involved in the pathogenesis. In PCOS, the disturbance of Agni inside the ovaries, leads to the development of cysts. Agni governs several metabolic events in the body including GI, liver and tissue. PCOS may be due to deranged Vatham and Kabam. Problems also lie in Aagayam deficiency which results in the immature follicles and coupled with increased Mann (stromal tissues) follicle development arrests. Treatment in the Siddha system depends on Neekam (removal of disease), Niraivu (restoration of good health) & Kaappu (prevention with protection). Treatments are classified by body type with obesity or lean. Dr Christian explained herbs used for treating menstrual irregularities in PCOS such as Kaippu, Kalyana murungai for fertility, obesity and dysmenorrhoea. Indeed, recent studies have shown anti-lipidemic & anti-estrogenic activity of Kalyana murungai which shows great promise for PCOS.
This two day conference drew to a successful close with attendees participating in a Quiz and prize draw. With special thanks to the organisers and the eminent speakers in the field of PCOS for what was a hugely successful 1st Symposium on PCOS and hopefully the first of many more.
© PCOS Vitality, 2021