A huge number of South Asian women suffer from low uptake of cervical cancer smear tests, Polycystic Ovaries, gestational diabetes, sexual health, endometriosis and much more. Asian Voice spoke to Dr Nitu Bajekal, a consultant obstetrician and gynaecologist for 20 years at the NHS, with over 35 years of clinical experience in women’s health.
We also reached out to her daughter, Rohini Bajekal, a nutritionist and a Board-Certified Lifestyle Medicine Professional, who provides evidence-based nutrition and lifestyle advice to her clients, focusing on a whole food plant-based approach. In an exclusive interview with Asian Voice, the mother-daughter duo spoke about their advice specific to South Asian women’s health.
Questions and answers by Rohini Bajekal:
What is the most important nutrient that BAME women suffering from PCOS need?
Fibre helps promote healthy gut bacteria, reduces inflammation and oxidative stress, normalises blood sugars and improves insulin resistance. Fibre also helps flush away excess oestrogen. Fibre is only found in plant foods.
How can BAME women with lifestyle diseases stick to a nutrition plan? What would it entail?
Add more whole plant foods to your diet. Enjoy beans, peas, lentils, vegetables, fruits, whole grains, herbs and spices. Aim to get healthy fats from nuts, seeds and avocados. Use salt, sugar and small amounts of oil for flavouring purposes rather than overusing them.
Can the food we consume trigger mental health issues or accentuate existing ones? Please explain.
This a complex issue but ultra-processed foods (such as sugar-sweetened beverages, refined grains and processed meats) may contribute to anxiety and depression through the connection between the gut and the brain - these foods are stripped of fibre and promote insulin resistance and inflammation.
What is the ideal approach to deal with Hirsutism?
Excessive hair growth means that hair follicles are being over-stimulated by testosterone or other androgen hormones. A combined approach of cosmetic treatments (laser, electrolysis) and medication (e.g. spironolactone) that decrease the levels of androgens or their impact on hair follicles can be helpful, along with lifestyle modifications.
Questions and Answers by Dr Nitu Bajekal
What is the ideal time/age for a young woman/girl to reach out to a doctor in case she hasn't started menstruating?
Answer:
Most girls start their periods around age 12 (8-16 range). Starting periods depends on a number of factors including nutrition, exercise, body weight, and family history.
Seek medical advice if periods haven't started by age 16 or earlier by age 14 if there are no other signs of puberty (hair and breast development).
What should be the immediate line of treatment for a PCOS patient?
The first line of management is to use lifestyle to manage this often distressing condition. A whole food plant based way of eating can be very helpful, especially for those who have weight to lose. Losing as little as 5% of body weight can help with all symptoms of PCOS. However, weight loss needs to be approached in a healthy and sustainable way.
What are the first signs of deteriorating reproductive health in BAME women?
Missed or irregular periods may be a sign of PCOS, the most common cause of subfertility in women while painful and/or heavy periods or painful sex may be signs of endometriosis, fibroids and adenomyosis, all of which can affect fertility.
How are PCOS and Diabetes linked? Why is every patient different from the other?
Insulin resistance, where the body does not respond to the normal levels of insulin, resulting in both higher levels of insulin but also too much glucose circulating in the blood stream, is a key feature in PCOS sufferers as well as Type 2 Diabetes.
PCOS sufferers are at higher risk as a result of developing gestational diabetes in pregnancy and Type 2 diabetes in later life. South Asians may develop Type 2 diabetes as early as in their 30s.
Every patient is unique due to the complex interplay of genetic, environmental and metabolic factors and should be managed as such.
What is the ideal time/age for a young woman/girl to reach out to a doctor in case she hasn't started menstruating?
Most girls start their periods around age 12 (8-16 range). Starting periods depends on a number of factors including nutrition, exercise, body weight, and family history.
Seek medical advice if periods haven't started by age 16 or earlier by age 14 if there are no other signs of puberty (hair and breast development).
What should be the immediate line of treatment for a PCOS patient?
The first line of management is to use lifestyle to treat and manage this often distressing condition.
For those who have weight to lose, losing as little as 5% of body weight can help with all symptoms of PCOS. However, weight loss needs to be done in a healthy sustainable way and a whole food plant based way of eating can be very helpful in this situation.
What are the first signs of deteriorating reproductive health in BAME women?
Missed or irregular periods may be a sign of PCOS, the most common cause of subfertility in women while painful and/or heavy periods or painful sex maybe signs of endometriosis, fibroids and adenomyosis, all of which can affect fertility.
How are PCOS and Diabetes linked? Why is every patient different from the other?
Insulin resistance, where the body does not respond to the normal levels of insulin, resulting in both higher levels of insulin but also too much glucose circulating in the blood stream, is a key feature in PCOS sufferers as well as Type 2 Diabetes.
Please speak about placebo treatments. How can such treatments affect a patient (especially in chronic hormonal diseases)?
I would strongly advise against empirically unproven treatments as they can often be expensive, delay effective treatment and in some cases cause harm. My advise is to always to seek effective scientific medical advice and to remember lifestyle changes can significantly benefit almost all women’s health conditions and chronic lifestyle illnesses, alongside proven western medical and surgical therapies.
