PCOD (Polycystic Ovary Disorder).

     Polycystic Ovary Disorder                            (PCOD)

What is PCOD? 

PCOD (Polycystic Ovarian Disease) is a medical condition in which the woman ovaries produce immature or partially mature eggs in large numbers and over the time these become cysts in ovaries. Due to this ovaries become large and secrete large amount of male hormones (androgens) causing infertility, irregular menstrual cycles, hair loss and abnormal weight gain. PCOD can be controlled by diet and lifestyle modifications.

Common Symptoms of PCOD. 

The preliminary signs and symptoms of PCOD usually develop during the first cycle of menstruation at puberty. PCOD may also develop later due to increased weight over the years. 

There are various symptoms of PCOD. Some of the common signs are

•Increased androgen levels. Excess male sex hormones may result in various physical manifestations, such as excess facial and body hair and male-pattern baldness.

•Irregular periods. You may observe irregular periods or delayed menstrual cycle due to the abnormality in maturation of the egg.

•Difficulty in getting pregnant due to irregular and delayed or failed ovulation. The hormone imbalance in the body prevent the follicles from maturing and releasing the egg, causing delayed or failed ovulation. This heavily affects the menstrual cycle and thereby your periods. Many women are diagnosed with PCOD when they visit the doctor regarding their unsuccessful attempts at getting pregnant.

•Irregular menstruation (Oligomenorrhea)

•Skipped or absence of menstruation (Amenorrhea)

•Heavy menstrual bleeding (Menorrhagia)

•Excessive Hair growth (face, body - including on back, belly, and chest)

•Acne (face, chest, and upper back)

•Weight gain

•Hair loss (hair on the scalp gets thinner and fall out) due to the increased production of male hormones in the body

•Skin darkening (Neck, in the groin, and under the breasts)

• Interrupted breathing while sleeping also called as apnea

• Oily skin, pimples

• Mood swings

• High testosterone levels

•Severe headache

•Feeling fatigued

•Weight

Sometimes, a higher weight may worsen insulin resistance and the symptoms of polycystic ovarian syndrome. Some women with PCOD report that they had never experienced symptoms such as menstrual irregularity or excessive hair growth and are a healthy weight. However, these symptoms only appear once they gain weight.

What causes Polycystic Ovarian Disease (PCOD)?

There is a 50% possibility of getting PCOD among the women whose immediate female relatives suffer from PCOD. As you grow older, this PCOD may lead to Type 2 diabetes, as PCOD is a risk factor for developing Diabetes Till now, a single gene has not yet found to be the cause of PCOD, and it is likely to be complex and involve multiple genes.

1. Insulin resistance & Lifestyle

About 70% women with PCOD have peripheral insulin resistance. The pancreas produces insulin, which is a hormone to help the body use sugar from foods for energy. Due to insulin resistance the cells can’t use insulin properly and the body’s demand for insulin increases. To compensate, the pancreas makes more insulin.

2. Factors of Insulin Resistance:

Insulin resistance as a result of genetic factors

Insulin resistance as a result of being overweight (related to diet and inactivity)

3. A combination of both of these factors. 

What are some problems associated with PCOD?Some complications can arise from PCOD. These include various diseases and medical conditions, such as. 

•Various metabolic syndromes, including high blood pressure, cardiovascular diseases, increased cholesterol and blood glucose levels.

•Miscarriages

•Infertility

•Gestational diabetes

•Sleep apnea

•Type 2 Diabetes

•Depression and other mental disorders

•Endometrial cancer

•Abnormal uterine bleeding

•Untreatable acne, displaying hormonal problems

•Chronic Liver inflammation

•Studies also report that by the age of forty, approximately fifty per cent of women with PCOD would develop pre-diabetes or would already be diabetic, while many others would face infertility during their childbearing age.

Medications and Surgery to Treat PCOD.
Post-consultation, your doctor would recommend various medications to rectify your menstrual cycle. He may prescribe drugs such as

•Combinatorial birth control pill. These pills contain progestin and estrogen that reduce the production of the male sex hormones and regulate your hormones that let follicles release the egg, form acne and excess hair growth.

•Progestin therapy. Your doctor would advise you to take progestin for ten to fourteen days every month or two to regulate and correct your menstrual cycle in this medication.

•Immature follicles treatment. Your doctor may also recommend immature follicle aspiration PCOS treatment to improve your endocrinology and decrease the number of follicles in the ovary, thus facilitating pregnancy.

Your doctor would prescribe drugs such as clomiphene, letrozole, metformin, and Gonadotrophins to improve ovulation.

To help reduce increase hair growth, your doctor would prescribe various birth control pills, spironolactone, and eflornithine.

•Although surgery is not the immediate options of choice, your doctor, in severe cases, may perform laparoscopic ovarian drilling, which would help trigger ovulation, that is the release of the egg from the ovaries.