Polikistik Over Sendromu Olan Kadınlara Uygulanan Beslenme ve Egzersiz Programının Semptomlara Etkisi

Yıl 2021, Cilt: 7 Sayı: 1, 85 - 96, 31.03.2021

Belma Toptaş , Hilmiye Aksu

Öz

ÖZET
Bu derlemenin amacı polikistik over sendromu olan kadınlara uygulanan beslenme ve egzersiz programının semptomlara etkisini incelemektir. Polistik over sendromu, etiyolojisinde genetik ve çevresel faktörlerin yer aldığı hormonal bir bozukluktur. Çoğunlukla peripubertal dönemden itibaren başlayan kısa ve uzun dönem riskleri bulunan bir hastalıktır. Kısa dönemde menstrual düzensizlikler, hirşutizm, alopesi, infertilite ve gebelik kayıpları bulunur. Uzun dönemde ise tip II diyabet, psikososyal sorunlar, kardiyovasküler hastalıklar ve endometrium kanseri açısından risk oluşturur.
Yapılan çalışmalarda beslenme ve egzersizin PCOS’un semptomlarında iyileşme sağladığı, PCOS’lu kadınlarda vücut ağırlığındaki azalmanın yanı sıra, beden kitle indeksinde, vücut yağlarında ve bel/kalça oranında azalma sağladığı belirlenmiştir. PCOS’lu kadınlarda diyabet, gestasyonel diyabet, kardiyovasküler hastalık riskinin azaldığı görülmüştür. Lipid metabolizmasındaki bozukluklar, menstrüel siklus bozuklukları ve ovulasyon durumunda iyileşme olduğu belirlenmiştir. Hiperandrojenizm, akne, hirşutizm gibi belirtilerde azalma olduğu ortaya çıkmıştır. Uyku düzenini sağladığı, stresi azalttığı ve metabolizma için kilitleyici rol oynayan stres hormonlarında azalma sağladığı saptanmıştır. Dengeli, sağlıklı beslenme ve egzersiz gebelik oranının artmasını, gebelik kayıplarının ve ileri gebelik haftalarında başka önemli komplikasyonların azaltılmasını sağlamıştır.
Hemşireler hastalığın yönetiminde önemli rolleri olan sağlık profesyonelleridir. PKOS’un yönetiminde hastanın yaşam tarzını değiştirmek, PKOS’dan kaynaklanan kısa ve uzun dönem sağlık sorunlarını ertelemek veya önlemek yer almalıdır.






ABSTRACT
The aim of this review is to examine the effects of the nutrition and exercise program applied to women with polycystic ovary syndrome on symptoms. Polystic ovarian syndrome is a hormonal disorder that affects women's life with short and long-term risks since the peripubertal period, and genetic and environmental factors are thought to play a role in its etiology. In the short term, menstrual irregularities, hirsutism, alopecia, infertility and pregnancy losses are found. In the long term, psychosocial problems, a risk for type II diabetes, cardiovascular diseases and cancer of the endometrium.
Studies have shown that nutrition and exercise provide improvement in the symptoms of PCOS, a decrease in body weight in women with PCOS, a decrease in body mass index, body fat and waist/hip ratio. It has been observed that the risk of diabetes, gestational diabetes and cardiovascular disease is reduced in women with PCOS. Impairments in lipid metabolism, menstrual cycle disorders and improvement in ovulation were determined. It has been found that symptoms such as hyperandrogenism, acne, hirsutism decrease, provide sleep patterns, decrease stress and decrease stress hormones that play a locking role for metabolism. Balanced, healthy diet and exercise helped increase pregnancy rate and decrease pregnancy losses and other important complications in advanced gestational weeks.
Nurses are healthcare professionals who play an important role in the management of the disease. The key point in the management of PCOS is to change the patient's lifestyle and postpone or prevent short and long term health problems caused by PCOS.

Anahtar Kelimeler

Beslenme, Egzersiz, Hemşire, Polikistik Over Sendromu.

Kaynakça

• Aşçı, Ö ve Kocaöz, S (2019). Üreme Organları Tümörleri. HA. Özkan (Ed.), Kadın Sağlığı ve Hastalıkları içinde (s.675-720). Ankara: Akademisyen Kitapevi.
• Aherna, S.A. Polycystic ovary syndrome. (2004). Nursing Standard, 18(26), 40–44.
• Chavarro, J.E., Rich-Edwards, J.W., Rosner, B.A. (2007). Dietary fatty acids intakes and the risk of ovulatory infertility. The American Journal of Clinical Nutrition, 85(3), 652-662.
• Church, T.S., Blair, S.N., Cocreham, S., Johannsen, N., Johnson, W., Kramer K, Mikus, MS, Myers, V., Nauta, M., Rodarte R.Q., Sparks, L., Thompson, A., Earnest, C.P. (2010). Effect of aerobic and resistance training on HbA1c levels in patients with type 2 diabetes. JAMA, 304(20):2253-2262.
• Clapauch, R., & Mattos, T. M. (2008). Triplet pregnancy after metformin in a woman with polycystic ovary syndrome. Fertility and Sterility, 89(5), 1260-1262.
• Crete, J., Adamshick, P. (2011). Managing polycystic ovary syndrome. Journal of Holistic Nursing, 29(4), 256-266.
• Durant, M. E., Leslie, N. S., Critch, E. A. (2009). Managing polycystic ovary syndrome: A cognitive behavioral strategy. Nursing ForWomen’s Health, 13(4), 294–300.
• Eisenhardt, S., Schwarzmann, N., Henschel, V., Germeyer, A., von Wolff, M., Hamann, A., Strowitzki, T. (2006). Early effects of metformin in women with polycystic ovary syndrome (PCOS): A prospective randomized double-blind placebo-controlled trial. Journal of Clinical Endocrinology & Metabolism, 91, 946-952.
• Evliyaoğlu, O. Polycystic ovary syndrome and hirsutism. (2011). Türk Pediatri Arşivi, 46, 97-102.
• Franks, H., Mason, H., Willis, D. (2000). Follicular dynamics in the policystic ovary syndrome. Molecular and Cellular Endocrinology , 163(1-2), 49-52.
• Glintborg, D., Mumm, H., Ravn, P., Andersen, M. (2012). Age associated differences in prevalence of individual rotterdam criteria and metabolic risk factors during reproductive age in 446 Caucasian women with polycystic ovary syndrome. Hormone and Metabolic Research, 44(9), 694-698.
• Hamdy, O., Goodyear, L.J., Horton, E.S. (2001). Diet and exercise in type 2 diabetes mellitus. Endocrinology Metabolism Clinics of North America, 30, 883-907.
• Hutchison, S.K., Stepto, N.K., Harrison, C.L., Moran, L.J., Strauss, B.J., Teede, H. J. (2011). Effects of exercise on insulin resistance and body composition in overweight and obese women with and without polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism, 96(1), 48-56.
• Kalgaonkar, S., Almario, R.U, Gurusinghe, D., Garamendi, E.M , Buchan, W., Kim, K., Karakas, S.E. (2011). Differential effects of walnuts vs almonds on improving metabolic and endocrine parameters in PCOS. European Journal of Clinical Nutrition, 65(3), 386-393.
• Kaya, A. (2009). Polistik over sendromu ve beslenme. Turkiye Klinikleri Endocrinology-Special Topics, 2(2), 81-89.
• Kelley, L. (2003). Polycystic ovarian syndrom: A challenge for occupational health nursing. Official Journal of the American Association of Occupational Health Nurses, 51(1), 23–27.
• Krystock A. (2014). Role of Lifestyle and Diet in the Management of Polycystic Ovarian Syndrome. Pal L (ed). İn: Polycystic Ovary Syndrome. (pp. 147-64). New York NY: Springer.
• Lim AJ, Huang Z, Chua SE, Kramer MS, Yong EL. (2016). Sleep duration, exercise, shift work and polycystic ovarian syndrome-related outcomes in a healthy population: a cross-sectional study. PLOS ONE: Accelerating the Publication of Peer-Reviewed Science, 11(11), 7016-7048.
• Lydic, M., Juturu, V. (2008). Dietary approaches and alternative therapies for polycystic ovary syndrome. Current Nutrition & Food Science, 4(4), 265-281.
• Marsh, K. A., Steinbeck, K. S., Atkinson, F. S., Petocz, P., Brand-Miller, J. C. (2010). Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome. The American journal of clinical nutrition, 92(1), 83-92.
• Mehrabani, H.H, Salehpour, S., Amiri, Z., Farahani, S.J., Meyer, B.J., Tahbaz, F. (2012). Beneficial effects of a high-protein, low glycemic-load hypocaloric diet in overweight and obese woman with polycystic ovary syndrome: a randomized controlled intervention study. Journal of the American College of Nutrition, 31(2), 117-125.
• Mehta, R., Varma, H. (2019). Prevalence of Metabolic Syndrome in Indian Women with Polycystic Ovarian Syndrome (PCOS) and the Correlation of Dietary Nutrient Composition and Physical Activity on Components of the PCOS—A Pilot Study. American Diabetes Association, 68(1), 787.
• Moran, L.J., Hutchison, S.K., Norman, R.J, Teede, H.J. (2011). Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews, 16(2).
• Moran, L.J., Ko, H., Misso, M., Marsh, K., Noakes, M., Talbot, M. (2013). Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines. Journal of the Academy of Nutrition and Dietetics, 113 (4), 520- 545.
• Norman, R.J., Davies, M.J., Lord, J., Moran, L.J. (2002). The role of lifestyle modification in polycystic ovary syndrome. Trends in Endocrinology&Metabolism, 13(6), 458-460.
• Smith, J.W., Taylor, J. S. (2011). Polycystic ovary syndrome: Evidence‐based strategies for managing symptoms and preventing long‐term sequelae. Nursing for women's health, 15(5), 402-411.
• Sorensen, L.B., Soe, M., Halkier, K.H, Stigsby, B., Astrup, A. (2012). Effects of increased dietary protein-to-carbonhydrate ratios in women with polycystic ovary syndrome. The American journal of clinical nutrition, 95(1), 39-48.
• Şahin, NH ve Bal, MD (2015). Üreme Organ Tümörleri. NH. Beji (Ed.), Kadın Sağlığı ve Hastalıkları içinde (s.143-159). İstanbul: Nobel Tıp Kitabevleri.
• Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. (2008). Human Reproduction, 23(3), 462-477.
• Tiwari, N., Pasrija, S., Jain, S. (2019). Randomised controlled trial to study the efficacy of exercise with and without metformin on women with polycystic ovary syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology, 234, 149-154.
• Tomlinson, J., Millward, A., Stenhouse, E., Pinkney, J. (2010). Type 2 diabetes and cardiovascular disease in polycystic ovary syndrome: What are the risks and can they be reduced? Journal Compilation Diabetes UK. Diabetic Medicine, 27, 498–451.
• Uludağ, E.Ü, Gözükara, İ., Kucur, S.K., Keskin, H., Kılıç, H., Kamalak, Z., Durmaz, Ş.A. (2013). Polikistik over sendromunda kardiyovasküler hastalık risk faktörü olarak C-reaktif protein düzeyi ve obezite. Dicle Medical Journal/Dicle Tip Dergisi, 40(3), 426-431.
• Vigorito, C., Giallauria, F., Palomba, S., Cascella, T., Manguso, F., Lucci, R., De Lorenzo, A., Tafuri, D., Lombardi, G., Colao, A., Orio, F. (2007). Beneficial Effects of a Three-Month Structured Exercise Training Program on Cardiopulmonary Functional Capacity in Young Women with Polycystic Ovary Syndrome. The Journal of Clinical Endocrinology & Metabolism, 92, 1379-1384.
• Witchel SF. (2007). Hirsutism and Polycystic Ovary Syndrome. In F. Lifshitz, (ed), İn : Pediatric Endocrinology. (pp. 325-48). New York: Informa Healthcare USA Inc.