Does consuming caffeine help in managing polycystic ovary syndrome (PCOS), one of the most common causes of female infertility? It may, as the latest study published in the Nature Journal suggests that caffeine can effectively improve the symptoms of PCOS – which is seeing a sharp rise in India.
The researchers who conducted tests on animals confirmed the efficacy of caffeine in treating obese PCOS rats.
According to Dr Manjula Anagani, clinical director, Women and Child Institute, CARE Hospitals, Banjara Hills, Hyderabad, the study is not without value. “Caffeine in moderation could improve PCOS management by improving insulin sensitivity and supporting metabolism, therefore benefiting obese patients,” said the Padma Shri awardee.
Dr Deepti Sharma, HOD of obstetrics and gynaecology, Amrita Hospital, Faridabad, also described the findings as promising. “Caffeine enhances lipid metabolism and reduces inflammation, which may benefit insulin-resistant PCOS patients.”
The Nature study said that the risk of PCOS increases with increasing body mass index (BMI), and weight loss is considered an important treatment to improve symptoms in PCOS patients. The study cited studies that higher coffee consumption is associated with a lower risk of polycystic ovary syndrome and may help reduce the risk of metabolic syndrome and type-2 diabetes.
Both the experts, however, said balanced consumption and more human trials are needed to confirm the safety, optimal intake, and long-term efficacy of caffeine intake in managing PCOS, which is a common hormonal condition that affects women of reproductive age and usually starts during adolescence.
“Unregulated caffeine intake can have side effects like anxiety or insomnia, so clinical guidance is essential,” stressed Dr Taruna Dua, senior consultant and unit head, obstetrics and gynaecology, Aakash Healthcare, Dwarka, New Delhi.
PCOS is a hormonal imbalance that occurs when the ovaries - the organ that produces and releases eggs - create excess hormones. If you have PCOS, your ovaries produce unusually high levels of hormones called androgens, and this causes reproductive hormones to become imbalanced.
This often results in irregular menstrual cycles, missed periods, unpredictable ovulation, an excess of androgen (male hormone), excess hair growth or hair loss, acne, weight gain or difficulty losing weight, darkening of the skin, skin tags, polycystic ovaries, miscarriages and infertility.
Also, people with PCOS may be at higher risk of certain health conditions, like diabetes, high blood pressure, high cholesterol, anxiety, depression, endometrial cancer, as well as other conditions.
Highlighting that PCOS prevalence among Indian women is relatively high compared to other countries, Dr Dua said it ranges from 9-36%, depending on diagnostic criteria and region.
“India is witnessing a rise in PCOS due to increasing urbanisation, sedentary behaviour, unhealthy diets, obesity, stress, and hormonal imbalances caused by erratic sleep cycles and environmental factors. Early onset of puberty and delayed childbearing may also play a role,” she added.
Indian studies, especially among metropolitan women, have revealed a prevalence rate of 9-22%, which is regarded as one of the highest rates worldwide. A 2021 Indian Council of Medical Research (ICMR)-funded study revealed a rising frequency among young adolescents.
Sadly, in India, PCOS is a taboo disorder, and thus gets less attention and leads to late detection.
“Indeed, in many parts of India, women’s menstrual health is a taboo topic. Usually kept private, conversations about menstruation and infertility discourage many women from getting treatment. We should aggressively encourage awareness and an open-minded mindset,” said Dr Anagani.
"This is especially due to its link with fertility and physical appearance (acne, facial hair). Women often hesitate to talk about their symptoms, leading to delayed diagnosis and treatment," added Dr Dua.
As a woman facing difficulties in conceiving may experience social pressure and judgment, the underlying PCOS might not be openly addressed, added Dr Anshumala Shukla-Kulkarni, head of minimally invasive gynaecology, gynaecology laparoscopic and robotic surgery at Kokilaben Dhirubhai Ambani Hospital, Mumbai.
According to Dr J Krithika Devi, senior fertility expert, Nova IVF Fertility, Chennai, is seeing a surge in PCOS, and one of the main reasons is menstrual and reproductive health remains stigmatised. “This results in many girls and women hesitating to seek help and suffer from fertility issues.”
Highlighting that one in five women in India suffer from PCOS, Dr Devi also pointed to consumption of processed foods as one of the reasons for the rise in PCOS.
Of course, genetics plays a significant role.
There is no cure for PCOS, but it can be effectively managed to alleviate symptoms and reduce the risk of long-term complications.
Dr Shukla-Kulkarni said lifestyle modification is the first and mainstay of treatment followed by dietary changes, regular exercise, and stress management.
She stressed the need to avoid a sedentary lifestyle, saying that those affected with the disorder should exercise every day for an hour, avoid processed food, and eat lots of fresh fruits and vegetables.
The Mumbai-based doctor also suggested avoiding foods with high glycemic index and changing to millet instead of rice. “Even 5-10 % weight loss can restore ovulation and reduce insulin resistance,” she said.
“It's important for women with PCOS to work with healthcare professionals to develop a personalised weight loss plan that takes into account their individual needs and health status,” she added.
For women with a family history of PCOS, maintaining a healthy weight and lifestyle from a young age might be particularly beneficial in potentially delaying or mitigating the onset and severity of symptoms, added Dr Shukla-Kulkarni.
Busting the myth of whether women who suffer from PCOS can conceive naturally, Dr Devi said they can if they regulate their cycle with regular exercise and diet. “They can try to conceive naturally. If cycles have become regular and you have been trying naturally for a year and still not able to conceive, then you need help from a gynaecologist.”
Stating that the treatment of PCOS is as much a psychological journey as it is a hormonal one, Dr Sharma cited an example of one of her 20-year-old patients. The college student came to her with complaints of irregular menstrual cycles, recent weight gain, and facial hair and acanthosis nigricans - a blackish discoloration at the nape of the neck, pointing to insulin resistance. But what caught the doctor’s attention was when she said she couldn’t sing now as her voice had changed.
“The emotional toll of her symptoms was undeniable. She had also started anti-anxiety medication, prescribed elsewhere, to cope with the distress,” Dr Sharma said.
After intensive lifestyle counselling, simple dietary changes, gradual physical activity, and a combination of hormonal pills, the 20-year-old lost weight, her facial hair reduced, the menstrual cycles normalised, and the timber of her voice softened. “For every young woman struggling with her body and identity, timely care, emotional support, and small clinical victories can change the narrative - from silence to song," she said.
Dr Anagani also stressed on awareness. “Timely recognition of symptoms could help early intervention. Holistic care matters. A balanced diet, exercise, and mental wellness go hand-in-hand with medication. A compassionate doctor-patient relationship can be life-changing,” she said and added that each PCOS journey is unique, and treatment plans must be personalised.