INTRODUCTION:

A woman’s reproductive system external icon is a delicate and complex system in the body. It is important to take steps to protect it from infections, injury and prevent problems including some long-term health problems.

Taking care of self and making healthy choices can help protect self and loved ones. Protecting reproductive system also means having control of health¹

Nowadays, there is a rush to be good at everything and this has probably made people forget how important it is to eat right, exercise, sleep well, and have a good emotional balance. The increasing prevalence of PCOS in young adults can straightaway be correlated to a sedentary lifestyle and lack of nutritional food.

Polycystic Ovarian Syndrome (PCOS) or Polycystic Ovarian Disease (PCOD) is common among members of the younger generation, with almost 10 million people affected globally. Its worldwide prevalence varies from 2.2 per cent to 26 per cent and, according to latest statistics, in India one in every four young women is said to have PCOD. A study conducted by AIIMS shows that obesity is present in almost 60 per cent women who suffer from PCOS; 50 per cent have fatty liver; about 70 per cent have high insulin resistance; 60-70 per cent have high levels of male hormones; and 40 to 60 per cent have glucose intolerance²

Polycystic ovary disease (PCOD) is a common condition of infertility in females, affecting women of reproductive age with the prevalence ranging from 6 to 10%. Its major hallmark features are hyperandrogenism, hyperinsulinemia, chronic an ovulation and polycystic ovary.³ The polycystic ovarian syndrome is associated with an increased risk for metabolic conditions such as insulin independent diabetes dyslipidemia, visceral obesity, endothelial dysfunction and chronic low-grade inflammation.⁴

Women with PCOD often have many small cysts on their ovaries. Multiple cysts on the ovaries diagnosed by ultrasound⁵ If diagnosed early and managed properly with the lifestyle modification by adding natural remedy, the onset of Type2 diabetes mellitus and its resultant risk of coronary artery disease may be delayed or prevented. The disease is said to affect urban population more than rural folks, which means, as we become more educated and improve our socio-economic status, we are becoming unhealthier.

Lifestyle modifications, such as dietary pattern, exercise, and behavioral therapies, are the first line of treatment for PCOS.⁶ Diet is an important aspect that we can control for good health Since ancient times, flax has been a part of Indian cuisine. Attention to medicinal herbs has recently expanded as an alternative treatment or diseases control .Golden seeds of flax bring nutrition and therapy for (PCOS). This nature’s gift has a plenty to offer in healing from this Consumption of flax seeds help to fight against poly cystic ovarian syndrome (PCOS). Flaxseed supplementation also led to a significant reduction in insulin concentration. Phytoestrogens and hormone balancing abilities of flax seeds are beneficial in many ways .PCOS is associated with excess body weight.. High fiber and healthy omega 3 fatty acids in flax seeds will reduce body weight remarkably. flax seeds help in controlling cysts from growing and avoiding malignant ovarian/endometrial cancer. Flax lignan flushes excess androgen out and brings balance to female hormones. Menstrual and ovulatory problems is usually a result of hormonal imbalance,. Excess androgen in PCOS cause hair growth in unwanted areas. Flax seeds help to get rid of hair growth caused due to excess androgen^7,9,10

NEED FOR THE STUDY:

Polycystic ovary syndrome (PCOS) is a frequent medical condition characterized by both metabolic and reproductive disorders. PCOS is very common up to 15% of women of reproductive age have it.⁵ Different pharmaceutical treatments have been proposed for PCOS. However, side effects of long-term treatments and their probable low efficacy have made complementary and alternative treatments a valuable option. Recent reports have indicated the increased use of complementary treatments. Herbal medicine, is a part of complementary medicine. Medicinal herbs have used for a long time in the treatment of gynecological and infertility problems of PCOS patients. Some plants as natural remedies may have beneficial effects on improving different aspects of PCOS; Management of PCOS requires a multidisciplinary approach. Since common treatments for PCOS are not fully effective and have some unwanted side-effects, attempts must be made to find more advantageous therapeutic options with minimal adverse effects. A multitude of studies revealed that a wide spectrum of herbs could be used in the treatment of clinical and laboratory symptoms of PCOS, including menstrual irregularities, infertility, hormonal status, insulin resistance, lipid profile, and anthropometric indices. These herbs have been used together or in combination with conventional treatments; however, review of previous studies showed that most of these herbs were used alone.⁸

Medical intervention of polycystic ovarian syndrome includes hormonal therapies which have long term health consequences. Hence, researchers are looking for the herbal medicines for the treatment of PCOD in alternative medicine which do not cause any side effects. Effectiveness of a flax seed however does not necessarily make it acceptable to a population unless it convinces their wisdom. So, to enhance the scope of these medicines further by means of materials and methods, the present clinical study has been undertaken. A flax seed is not complete by itself by only providing a solution to a disease, without its proper knowledge. So here an attempt is made to conceptualize the disease PCOS in Ayurvedic perspective. Hence, the present study undertaken is entitled as, the effectiveness of flax seed supplement for reducing PCOD symptoms among female.

The investigator found most of female have PCOD and have lack of knowledge regarding natural remedy uses and its prevention for reducing symptoms of PCOD among females of reproductive age group. Females are neglecting to take care of themselves. Hence, the researcher is interested to reduce the symptoms regarding polycystic ovarian disease (PCOD) and its prevention through the use of natural remedy like flax seed.

OBJECTIVES:

1. To assess the pre and post assessment symptoms of PCOD among in females of reproductive age group

2. To assess the effectiveness of flax seed in symptoms of PCOD among females.

3. To compare the pre and post assessment score of symptoms of PCOD among females in reproductive age group.

4. To find out the association between the pre test symptoms of PCOD among female with their selected socio demographic variables.

HYPOTHESIS:

H1 There will be significant difference between pre test and post test assessment score of symptoms of PCOD among female of reproductive age group.

H2 There will be association between pre test symptoms of PCOD among female of reproductive age group with their selected socio demographic variables.

CONCEPTUAL FRAMEWORK:

The conceptual framework used in study is based on modified Imogene M. King “Goal Attainment Theory”. Kings conceptual systems, namely personal system, interpersonal system and social system.

The major elements of the theory are seen in the interpersonal system in which researcher and the females of reproductive age group are usually strangers come together in an organization to help and to be helped to maintain a state of health that permits functioning of roles. The main concepts of interpersonal system are interaction, perception, action and transaction.

METHODOLOGY:

RESEARCH APPROACH:

One group pre-test post-test approach.

RESEARCH DESIGN:

Pre-experimental, one group Pre-test – Post test research design

POPULATION:

Target population:

In present study the target population included were all females of reproductive age group 16 – 45 years.

Accessible population:

The population selected for this study was Females with PCOD of reproductive age group 16-45years.

Setting of the Study:

The setting for the present study was Namkum village Ranchi, Jharkhand.

Sample:

The sample of the study comprised of 60 Females of reproductive age group.

Sampling Technique:

Non probability Purposive sampling technique was used to select 60 samples.

Sample Size:

Total 60 Females of reproductive age group were taken for this study.

Variables:

According to Polit and Hungler, variable is an attribute of a person or an object that varies, that it takes an different values. Two type of variable are identified in the study. They are dependent variable and independent variables

Dependent variable:

Dependent variable was Symptoms of PCOD in females

Independent variable:

Independent variable in this study was Flax seed supplement

Sampling Criteria:

Inclusion criteria:

· Female those who are diagnosed and having symptoms of PCOD.

· Female those who are willing to participate in this study.

· Female who were in age group of 16- 45 years.

· Female who are available at the period of data collection

Exclusion criteria:

· Female those having any other gynecological disorder.

· Female who are taking any complementary

Description of The Tools:

The self-structured questionnaires were organised in two sections

Fig. 1.1 Description of tools.

Criterion Measures:

The question prepared for assessment of symptoms of PCOD on Females with PCOD of reproductive age group. The score categorized as:

· Mild- 0-10

· Moderate- 11-20

· Severe – 21-30

Method of Data Collection:

The duration of data collection was 60 days. After obtaining informed consent and willingness from the study participants the study was conducted at the Namkum village Ranchi, Jharkhand. Total of 60 samples data were collected.

Data Analysis and Interpretation:

Descriptive statistics such as frequency, percentage, mean and standard deviation was used to compare the pre and post assessment score of symptoms of PCOD among females in reproductive age group and to assess the effectiveness of flax seed supplement on symptoms of PCOD.

Table 1.1 Analysis of pre test and post test knowledge score by using mean, mean percentage, and standard deviation

Knowledge

assessment

Total

knowledge

score

Total

mean

Total mean percentage

Pre test

1235/1800

20.58

68.61%

4.93

Post test

616/1800

10.26

34.22%

4.43

Reveals that the Pre-test and Post-test PCOD symptom score was 616 and 1235 respectively out of 1800. The total mean and mean score percentage was 20.58(68.61%) and 10.26(34.22%) respectively. The standard deviation of pre test knowledge score was 4.93 and post test score was 4.43

Table 1. 2 Analysis to assess the effectiveness of flax seed supplement on symptoms of PCOD

Assessment

Mean

Standard

deviation

Calculated

‘t’ value

Table

‘t’ value

Pre-test

20.58

4.93

22.10

2.00

Post-test

10.26

4.43

Reveals that there was highly significant difference between pre test and post test assessment score on PCOD of effectiveness of flax seed supplement as calculated ‘t’ value 22.10 (df.59) was greater than table value 2.00 at 0.05 level of significance.

Table 1.3 Criteria wise Analysis of pre test and post test assessment score of PCOD symptoms in frequency and percentage

S. No	Symptoms	Pre test		Post test
		Frequency	%	Frequency	%
1.	Mild	0	0%	42	70%
2.	Moderate	22	36.66%	18	30%
3.	Severe	38	63.33%	0	0%

Fig 1.2 Bar diagram showing Percentage of Pre-Test and Post Test assessment score of PCOD symptoms

Reveals that that in pre test assessment score, majority 63% female have severe symptoms and 31% have moderate symptoms. In post test assessment score majority 70% females shows mild symptoms, 30% have moderate symptoms and no one is having severe symptoms. Hence, consumption of flax seed is effective to improve the symptoms of PCOD.

MAJOR FINDINGS OF STUDY:

The data was collected, analysed and interpreted in term of objectives. Descriptive and inferential statistics were utilized for the data analysis. The level of significance set for testing the hypothesis was, 0.05 using ‘t’ test. The major findings of the study were presented under the following

Description of subjects according to sociodemographic variables in frequency and percentage

1. Majority 53.34% (32) females of reproductive age group belong to 16-25 years

2. Majority of females 61.66 % (37) belongs to nuclear family

3. Most of the females 36.66% (22) family monthly income was 11,000 - 25,000rs

4. Majority of Females 45% (27) were graduate

5. Most of the Females 67.5%(33) is from urban area

6. Majority of Females 51.66%(31) were non vegetarian

7. Majority of females 51.66%(31) source of information is from doctor

8. Majority of females 72.5%(41) were not having any family history of PCOD

9. Majority females 56.66%(34) were overweight

Analysis of pre test and post test knowledge score by using mean, mean percentage, and standard deviation:

Criteria wise Analysis of pre test and post test assessment score of PCOD symptoms in frequency and percentage:

Reveals that that in pre test assessment score majority 63% female have severe symptoms and 31% have moderate symptoms. In post test assessment score majority 70% females shows mild symptoms and 30% have moderate symptoms.

T-Test to assess the effectiveness of flax seed supplement on symptoms of PCOD:

Chi-square analysis for association between pre- test assessment score of females of reproductive age group with selected socio-demographic variables

Reveals that

1. Findings related to age: The present study revealed that the calculated value of chi square is 7.82, which is less than the tabulated value at 0.05 level of significance; there was no significant association between pre-test assessment score of PCOD symptoms and age of Female.

2. Findings related to family type: The present study revealed that the calculated value of chi square is 20.37, which is greater than the tabulated value at 0.05 level of significance; there was significant association between pre-test assessment score of PCOD symptoms and Family type.

3. Findings related family income: The present study revealed that the calculated value of chi square is 0.2, which is less than the tabulated value at 0.05 level of significance; there was no significant association between pre-test assessment score of PCOD symptoms and Family income.

4. Findings related area of residence: The present study revealed that the calculated value of chi square is 0.52, which is less than the tabulated value at 0.05 level of significance; there was no significant association between pre-test assessment score of PCOD symptoms and residential area.

5. Findings related educational qualification:

The present study revealed that the calculated value of chi square is 2.52, which is less than the tabulated value at 0.05 level of significance; there was no significant association between pre-test assessment score of PCOD symptoms and educational qualification.

6. Findings related dietary pattern:

The present study revealed that the calculated value of chi square is 12.36, which is greater than the tabulated value at 0.05 level of significance; there was significant association between pre-test assessment score of PCOD symptoms and Dietary pattern.

7. Findings related source of information:

The present study revealed that the calculated value of chi square is 13.63, which is greater than the tabulated value at 0.05 level of significance; there was significant association between pre-test assessment score of PCOD symptoms and source of information.

8: Findings related family history of PCOD:

The present study revealed that the calculated value of chi square is 8.08, which is greater than the tabulated value at 0.05 level of significance; there was significant association between pre-test assessment score of PCOD symptoms and age of Family history of PCOD.

9. Findings related BMI:

The present study revealed that the calculated value of chi square is 14.9, which is greater than the tabulated value at 0.05 level of significance; there was significant association between pre-test assessment score of PCOD symptoms and BMI.

Findings reveals that there is significant association between the pre-test assessment score of PCOD symptoms among females of reproductive age group with their selected socio- demographic variables such as BMI, family history, dietary pattern, family type and source of information.

Hence Hypothesis H2 is accepted:

CONCLUSION:

PCOS is definitely a lifestyle disorder. Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. It affect ability to have a children and leads to infertility . It affects 1 in 10 women of childbearing age. Women with PCOS have a hormonal imbalance and metabolism problems that may affect their overall health and appearance. Women of all races and ethnicities are at risk of PCOS. One should try to control and prevent it as the disease can lead to a lot of long-term health problems, like diabetes, heart diseases, infertility, gynaecological cancers, hypertension, depression and gestational diabetes. Lack of exercise, weight gain and obesity lead to metabolic imbalances, such as insulin resistance, which is high in urban Indian population. Insulin resistance leads to deranged hormones and increases the chances of diabetes and other metabolic disorders.

Treatment tends to be symptom based, Evidence based medical management emphasises a multidisciplinary approach for PCOS, as conventional pharmaceutical treatment, may be contra-indicated, is often associated with side effects and not effective in some cases. Conventional therapy is effective in the treatment of PCOD but it may cause some side effects after prolonged usage. Women with PCOD can approach an alternative therapy to manage the symptoms. Hence the current scientific research focused on herbal medicines in polycystic ovarian syndrome.. Several natural products have been used in traditional medicine for PCOD,. Among numerous agent s advocated, flax seeds have been used for treating menstrual irregularities since ancient times. As hyperandrogenemia is an important contributory factor for PCOD, any compound that can reduce androgens will be useful in PCOD. Based on this assumption the present study was conducted to find out the effect of flax seeds in PCOD

REFERENCE:

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2. Shikha Prakash, PCOS: A lifestyle disorder, The Telegraph online 1/12/18 https://www.telegraphindia.com/health/pcos-a-lifestyle-disorder/cid/1677239

3. Fauser BCJM, Tarlatzis BC, Rebar RW, et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-sponsored 3rd PCOS consensus workshop group. Fertility and Sterility. 2012;97(1):28.e25–38.e25.

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7. Poornima Malagi, Tata Digital Health, Flax seeds – 5-way defence against PCOS https://www.tatahealth.com/article/5-way-defence-against-pcos-flax-seeds

8. Moini Jazani A, Nasimi Doost Azgomi H, Nasimi Doost Azgomi A, Nasimi Doost Azgomi R. A comprehensive review of clinical studies with herbal medicine on polycystic ovary syndrome (PCOS). Daru. 2019 Dec;27(2):863-877. doi: 10.1007/s40199-019-00312-0. Epub 2019 Nov 18.

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Received on 21.06.2022 Modified on 10.07.2022

Int. J. of Advances in Nur. Management. 2022; 10(4):379-384.

DOI: 10.52711/2454-2652.2022.00083