Articles on pcod pcos

Things You Should Know About Polycystic Ovary Syndrome (Pcos)

Dr. Jyotsna Gupta, Gynecologist/Obstetrician
What is Polycystic Ovarian Disease (PCOD) or Polycystic Ovary Syndrome (PCOS)?Polycystic ovary syndrome (PCOS) is a health problem that can affect a woman's:Menstrual cycleAbility to have childrenAppearanceHormonesBlood vesselsHeartWith PCOS/PCOD women typically have:High levels of 'androgens.' These are sometimes called male hormones, though females also make them.Many small cysts (fluid-filled sacs) in their ovariesMissed or irregular periods (monthly bleeding)What causes PCOS? The cause of PCOS is unknown. But most experts think that several factors, including genetics, could play a role. Women with PCOS are more likely to have a mother or sister with PCOS.A main underlying problem with PCOS is a hormonal imbalance. In women with PCOS, the ovaries make more androgens than normal. Androgens are male hormones that females also make. High levels of these hormones affect the development and release of eggs during ovulation.High androgen levels can lead to:AcneExcessive hair growthWeight gainProblems with ovulation How many women have PCOS? Between 1 in 10 and 1 in 20 women of childbearing age has PCOS. It can occur in girls as young as 11 years old. What are the symptoms of PCOD or PCOS? The symptoms of PCOS can vary from woman to woman. Some of the polycystic ovary syndrome symptoms include:Infrequent, absent, and/or irregular menstrual periodsInfertility (not able to get pregnant) because of not ovulating. In fact, PCOS is the most common cause of female infertility.Increased hair growth on the face, chest, stomach, back, thumbs, or toesMale-pattern baldness or thinning hairCysts on the ovariesAcne, oily skin, or dandruffWeight gain or obesity, usually with extra weight around the waistSkin tags — excess flaps of skin in the armpits or neck areaPelvic painAnxiety or depressionPatches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or blackSleep apnea — when breathing stops for short periods of time while asleepHow do I know if I have PCOS? There is no single test to diagnose PCOS. Your doctor will take the following steps to find out if you have PCOS or if something else is causing your symptoms.Medical history. Your doctor will ask about your menstrual periods, weight changes, and other symptoms.Physical exam. Your doctor will want to measure your blood pressure, body mass index (BMI), and waist size. He or she also will check the areas of increased hair growth. You should try to allow the natural hair to grow for a few days before the visit.Pelvic exam. Your doctor might want to check to see if your ovaries are enlarged or swollen by the increased number of small cysts.Blood tests. Your doctor may check the androgen hormone and glucose (sugar) levels in your blood.Ultrasound (sonogram). Your doctor may perform a test that uses sound waves to take pictures of the pelvic area. It might be used to examine your ovaries for cysts and check the endometrium (lining of the womb). This lining may become thicker if your periods are not regular.How is PCOS treated?Because there is no cure for PCOS, it needs to be managed to prevent problems. Treatment goals are based on your symptoms, whether or not you want to become pregnant, and lowering your chances of getting heart disease and diabetes. Many women will need a combination of treatments to meet these goals. Some treatments for PCOS include:Lifestyle modification. Many women with PCOS are overweight or obese, which can cause health problems. You can help manage your PCOS by eating healthy and exercising to keep your weight at a healthy level. Healthy eating tips include:Limiting processed foods and foods with added sugarsAdding more whole-grain products, fruits, vegetables, and lean meats to your dietThis helps to lower blood glucose (sugar) levels, improve the body's use of insulin, and normalize hormone levels in your body. Even a 10 percent loss in body weight can restore a normal period and make your cycle more regular.Birth control pills. For women who don't want to get pregnant, birth control pills can:Control menstrual cyclesReduce male hormone levelsHelp to clear acneFertility medications. Lack of ovulation is usually the reason for fertility problems in women with PCOS. Several medications that stimulate ovulation can help women with PCOS become pregnant. Even so, other reasons for infertility in both the woman and man should be ruled out before fertility medications are used.Another option is in vitro fertilization (IVF). IVF offers the best chance of becoming pregnant in any given cycle. It also gives doctors better control over the chance of multiple births. But, IVF is very costly.Surgery. "Ovarian drilling" is a surgery that may increase the chance of ovulation. It’s sometimes used when a woman does not respond to fertility medicines. This surgery can lower male hormone levels and help with ovulation. But, these effects may only last a few months.Medicine for increased hair growth or extra male hormones. Medicines called anti-androgens may reduce hair growth and clear acne. Anti-androgens are often combined with birth control pills. These medications should not be taken if you are trying to become pregnant.Before taking any Medicines tell your doctor if you are pregnant or plan to become pregnant. Do not breastfeed while taking this medicine.Other options include:Cream to reduce facial hairLaser hair removal or electrolysis to remove hairHormonal treatment to keep new hair from growingDoes PCOS change at menopause?Yes and no. PCOS affects many systems in the body. So, many symptoms may persist even though ovarian function and hormone levels change as a woman nears menopause. For instance, excessive hair growth continues, and male-pattern baldness or thinning hair gets worse after menopause. Also, the risks of complications (health problems) from PCOS, such as heart attack, stroke, and diabetes, increase as a woman gets older.Polycystic ovary syndrome and pregnancy- How does PCOS affect a woman while pregnant?Women with PCOS appear to have higher rates of:MiscarriagePremature deliveryPregnancy-induced high blood pressureGestational diabetesDoes PCOS put women at risk for other health problems?Women with PCOS have greater chances of developing several serious health conditions. Recent studies found that:Women with PCOS can have diabetes or pre-diabetes at early age.Women with PCOS are at greater risk of having high blood pressure.Women with PCOS can develop sleep apnea. This is when breathing stops for short periods of time during sleep.Women with PCOS may also develop anxiety and depression. It is important to talk to your doctor about treatment for these mental health conditions.Irregular menstrual periods and the lack of ovulation cause women to produce the hormone estrogen, but not the hormone progesterone. Progesterone causes the endometrium (lining of the womb) to shed each month as a menstrual period. Without progesterone, the endometrium becomes thick, which can cause heavy or irregular bleeding. Over time, this can lead to endometrial hyperplasia, when the lining grows too much, and cancer.I have PCOS. What can I do to prevent complications?If you have PCOS, get your symptoms under control at an earlier age to help reduce your chances of having complications like diabetes and heart disease. Talk to your doctor about treating all your symptoms, rather than focusing on just one aspect of your PCOS, such as problems getting pregnant. Also, talk to your doctor about getting tested for diabetes regularly. Other steps you can take to lower your chances of health problems include:Eating rightExercisingNot smokingHow can I cope with the emotional effects of PCOS?Having PCOS can be difficult. You may feel:Embarrassed by your appearanceWorried about being able to get pregnantDepressedManaging PCOS (Diet and Exercise)Following lifestyle and diet modifications can help manage PCOS symptoms to an extent-Frequently have small meals (5-6 times a day) without fail.Drink a lot of water (8-10 glasses)Try to consume 2-3 servings of fruits and vegetables every day.Stick to a high fibre diet (wholegrains/fruits/vegetables)Give preference to home cooked meals.Add brightly colored and white vegetables to your diet. They have high anti-oxidants.Food to avoid- Fried/packaged/processed foodsFoods with high glycemic index​Exercises suggested- Work out at least 5 times every week for at least 30 minutesRunning, swimming, yogaStrengthening exercises​Even if you don't lose weight, exercise in PCOS helps to improve things like- insulin sensitivity, frequency of ovulation, cholesterol, body composition.Getting treatment for PCOS can help with these concerns and help boost your self-esteem. It is advised that you should consult gynecologist who can help you based on your symptoms and requirements to manage PCOD/PCOS. 

Everything You Need to Know About Pcos (Polycystic Ovarian Syndrome)

Dr. Disha Sridhar, Gynecologist/Obstetrician
There are several issues becoming more prevalent with every passing day in today’s world. One such condition reaching near epidemic proportions is a dreaded and now very familiar name – PCOS. Here you will find everything you need to know about PCOS to get started.What is PCOS or PCOD?Polycystic ovary syndrome (sometimes referred to as disease depending on severity) is a problem in which a woman’s hormones are out of balance. It can cause problems with one’s periods and make it difficult to get pregnant. PCOS also may cause unwanted changes in the way you look. If it isn’t treated, over time it can lead to serious health problems, such as diabetes, heart disease and even cancers! Most women with PCOS grow many small cysts on their ovaries. That is why it is called polycystic ovary syndrome. The cysts themselves are not harmful, but lead to hormone imbalances. Did you know that symptoms of PCOS persist even when both the ovaries are removed? The root cause of the problem is not in your ovaries but in your metabolism.There is involvement of the hormone regulation centre at hypothalamus in the brain which affects multiple organs (Multi-system disease).Some of the symptoms are as follows: Acne.Weight gain and trouble losing weight.Extra hair on the face and body. Often women get thicker and darker facial hair and more hair on the chest, belly, and back.Thinning hair on the scalp.Irregular periods. Often women with PCOS have fewer than nine periods a year. Some women have no periods. Others have very heavy bleeding.Fertility problems. Many women who have PCOS have trouble getting pregnant (infertility).Depression.As if it was not bad enough, it increases your chances of developing a big disease later on in life, like full-blown diabetes, autoimmune thyroid disease and even cancers. The BioCycle study (NIH 2009) showed that untreated, hormonal imbalances increase significantly a woman's risk to diseases of inflammation - heart disease, diabetes, cancer, and premature ageing, not to mention a perpetual state of body suffering before these diseases even show up.The treatmentToday, the western medicine deals with identifying and treating the symptoms around PCOS. But these spot treatment are at best described as band-aid solutions to a much deeper problem that gets worse not only due to the ignorance of the root cause but also as side-effects of these symptomatic treatments over long periods of time. If you have been diagnosed with PCOS, chances are you have been prescribed Birth Control Pills or OC’s (oral contraceptives) for regularising hormone cycles and hence periods and metformin for elevated blood sugars or pre/diabetic conditions. All in an attempt to mask the symptoms but they come back in a worse form once synthetic hormones and pills are stopped. Lets have a look at these two so that you can get to the root of the problem and avoid potential side effects of these.Birth Control PillWhat it does: The synthetic hormones in the birth control mask your natural hormonal patterns to prevent ovulation from happening, and therefore prevent pregnancy. The menstrual period you experience on the pill is not an actual period, but rather a “break-through bleed” that occurs from the drop in estrogen. So even though it might be regulating your cycle, once you get off the pill chances are your period will return to the same state is was before and mostly it gets even worse.Side effects: Women who continually use contraceptive pills are more likely to develop circulatory problems (thrombosis and embolism), liver tumors, headaches, depression and cancer (especially breast cancer) than those who don’t use them. The risk increases with age. Metformin (Glucophage)What it does: Metformin helps with blood sugar and insulin management by suppressing glucose production by the liver. It’s commonly used for diabetes and PCOS with insulin resistance.Side effects: In a recent study, metformin was found to cause an impairment mental cognition. It’s more commonly known to cause serious digestive issues like gas, bloating, diarrhea, constipation, and more uncomfortable symptoms.If you are diagnosed with PCOS and you have been offered a prescription of birth control pills & synthetic hormones, PLEASE STOP!The advice to lose weight & exercise moreover, does not completely work either. They say that you should lose weight to be healthy but I say that you should be healthy to lose weight. I am sure you can relate to that. I am not here to criticize any system, and each kind of treatment has its own role.ConclusionVery often you'll be told that the only thing you can do is take a pill, but I hope this article has opened your eyes to the side effects of synthetic hormones and helped give you your power back when it comes to making informed decisions about treating your PCOS symptoms.There is no quick fix to treating PCOS. It is a systemic issues that needs to be managed through diet and lifestyle and holistic approach. If you’re ready to get to the bottom of your hormonal imbalances once and for all, let me help you. Your body CAN work for you. You can choose to stop suffering and start feeling good all month long.My thoughtsI believe it is my responsibility to share what I've learnt so that you and many others are not held back by PCOS & hormone imbalances, but rather use it as a way to improve your lives. I want to empower you. I want you to be the captain of your own ship because I know that if we take the necessary steps, we can improve not only our own lives, but those of our family, community & the world at large.‘The journey of a thousand miles begins with a single step’I will be glad to help you if you choose to take that first step in healing.Wishing you health & happiness!

PCOS Is More Than a Hormonal Disorder

Dr. Neelam Nath Bhatia, General Physician
PCOS-Poly Cystic Ovarian Syndrome or POCD-Polycystic Ovarian Disease means presence of tiny water filled balloons on the ovaries. Ovaries have developing follicles in women from puberty to menopause. A baby girl is borne with a numbers of them but they start maturing at puberty, few per cycle. Not every egg she is carrying gets ripe in each cycle & this is the way the capability of reproducing is protected in a woman.Few follicles develop & rupture per cycle, egg is released which travels towards uterus for implantation. Uterus has made arrangements to receive the mature egg for conception. In case no conception takes place, the lining is shed for 5 days in the form of periods.The size of follicles in Indian women is about 20 mm or 2 cms but some women may do have a size larger than this but it is never more than 2.5 cms.What is a Cyst? Cyst is a balloon with clear water like transparent substance.If Cysts are present in ovaries , it is a disease or a Lifestyle Disorder?Cyst in ovaries can be a big follicle that did not rupture on day 14- Ovulation time or it can be due to other reasons not known to us,  but the affected woman gets diagnosed by an Ultrasound.She has symptoms of irregular periods, delayed cycles with less blood and obesity, acne on face, black patches here and there, hair loss, hirsutism (hair on face), risk of getting type 2 diabetes and heart disease, thyroid disease being on the low side and infertility / and if she conceives risk of a complicated pregnancy with high BP, swellings and pre eclamptic changes.Her blood levels are high  for SteroidsTestosterone hormoneFollicle stimulating hormoneFasting blood sugar is high but herHDL-the good cholesterol is low CRP-C reactive protein is high-it is an indicator of inflammation and infection Anywhere in the body.Doctors usually prescribe a 21 day course of low hormone oral contraceptive pills, even to young girls who do not need it to prevent conception. Metformin medicine given to Type 2 Diabetics is also prescribed.But OCs / Hormone therapy does carry side effects like making periods more irregular than before, break through bleeding, weight gain, nausea, mood swings among others. PCOS can also be considered a lifestyle disorder:Correct it by modifying lifestyle byReduce the weight by taking no sugar, minimal salt, no bad fats like burgers, pizzas and street food, packed food rich in salt and fats as salt is a preservative and fats add to the taste.Do yoga and meditation Reduce stress but do enjoy the fruitful result oriented stress as it boosts the good cholesterol, Exercise regularly but according to constitution and tolerance.Eat as much as possible-every seasonalfruits and vegetables, at least 5 types with 5 different colours.Even borderline low thyroid becomes normal without giving extra thyroid hormones as tablets (eltroxin has lots of side effects like palpitations and high end personality who wants to be always on the go!)Take a glass of warm water with juice oflemon + a spoon of honey added to it, every day in the morning on emptystomach. This helps to reduce weight, bring down levels of blood sugar andcholesterol.Apple cider vinegar if taken with juice/water /honey helps also.Treat PCOD minus hormones & sugar lowering medicine metformin

Missed Periods-Is It Because of PCOS or Unwanted Pregnancy

Dr. Himani Gupta, Gynecologist/Obstetrician
For most women , getting her menses (period ) on time in regularity and flow is a very important matter. This holds true regardless of marital status. Whether she is married or unmarried, she does not want to miss her chums.Many times the management of missed periods rely on correct diagnosis.Two most important reasons for delay in getting periods are PCOS (Polycystic Ovarian Syndrome-A hormonal imbalance disorder) and Unwanted pregnancyDifferentiating correctly between theses two will make timely treatment available in both the cases.Problem of irregular menses and PCOS is rampant these days. Changing lifestyle, dietary patterns are environmental factors responsible for it.Education and career demands on women will make them move out of their family domain and stay on their own managing everything about themselves. This will add further to their stress levels. Relationship status in new social paradigm is ever changing.Knowingly or unknowingly this is another stress factor.It becomes imperative to them that periods (menses)  come on time.If they put missed periods on PCOS,  at times their self-diagnosis is incorrect.On the face of unprotected sex and having taken an emergency contraceptive pill ( Over The Counter emergency unwanted pregnancy protection tablet)  sometimes they find themselves facing an unwanted pregnancy.Away from home and family and at times short of money too, they may look for quick fixes with local doc/ family doctors instead of qualified Gynaecologist. This will further complicate the clinical pictureThe first step towards resolving the issue is to seek the consultation of an expert Gynaecologist in your area. For those who are in a relationship , a pregnancy test should be done. Depending on the test results the treatment is offered.If the pregnancy test is positive, and the woman wants to discontinue, it is best to do so at the earliest as newer methods of abortion like abortion tablets work well in those pregnancies which are of shorter duration. In early cases, the complications rate is also less.If a pregnancy test is negative, hormonal tests and sonography are advised to arrive at a correct diagnosis.In either case scenario, your Gynaecologist will help you in getting the correct treatment.

PCOS Has Become as Common as Common Cold These Days

Dr. Geetanjali, Dietitian/Nutritionist
Polycystic Ovary Syndrome (PCOS) has become as common as common cold these days. It affects at least one in every ten women ageing towards puberty. PCOS is an aftermath of a hormonal imbalance in women wherein the testosterone levels shoots up in the body causing an array of symptomatic reactions.A woman with PCOS is prone to weight gain, pelvic pain, acne, depression and irregular menstrual cycles. But that’s only as far as the horror factors go. Firstly, like I have mentioned before, PCOS has become indescribably common among women of a certain age these days. Secondly, with a treatment, proper diet and exercise schedule, PCOS is quite curable.Here are a few tips and tricks for you to keep in mind and compile them with your treatment to stay several steps ahead of PCOS.PCOS and Weight gain Between PCOS and body weight, it’s a long, enticing affair that takes place. PCOS makes it difficult for the body to use insulin; a hormone that is responsible for converting food starch into energy. As a result, your body becomes insulin resistant, and stores up the energy as fat instead of burning it out. High insulin levels make it a troublesome affair to maintain a manageable weight.Diet tips that work wonders with PCOS Carbohydrates are one of those food components that really make your insulin levels tick. But not all carbs are the bad guys. It’s the simple carbs that you need to watch out for. Even if you gulp down foods with the same amount of carbohydrate, the effect they will have on your insulin level will vary depending on the type of carb that you have consumed. So, it helps to stay wide awake every time you go grocery shopping. Make a few necessary tweaks to your grocery list and consumption pattern, and before you know your PCOS will be an ancient thing in the past. Next time you go to the departmental store, make sure you pick whole grains over multi-grains. You could switch from cornflakes to wheat flakes or oatmeal as far as breakfast is concerned. Here’s another small fix you can pull. Swap your white bread with its brown counterpart and do the same with your rice. It’s always more advisable (and beneficial) to eat whole fruits instead of drinking canned juices. And, most importantly let not those ‘fat-free’ levels laugh it off at you; they are secretly loaded with a truck full of sugar.To further fine tune your PCOS diet; build up on smart snacking habits. Open a packet of unsalted peanuts rather than salted potato chips. Having a tantrum with the sweet tooth? Smoothen it out with tidbits of dark chocolate.  Rely on water (and water alone) to quench your thirst.  Choose this essential and harmless liquid to curb down your soda and soft drink pangs entirely. Eating a little consciously can take you a long way to get rid of PCOS. Top up your dietary efforts with your regular exercise alongside your treatment, and there’s no reason why your hormones won’t fall into place along with your life

Weight Gain & Polycystic Ovarian Syndrome (Pcos)

Ms. Swati Kapoor, Dietitian/Nutritionist
Women with PCOS due to the increase in weight and general insulin resistance in the body are more prone to diseases like diabetes and heart. All these conditions can be avoided by simply following a  exercise and healthy eating routine specific to this medical condition. The most common mistake made by people with this condition is that they go on fad diets or start starving themselves. All this will do nothing to the condition but only make it worse, making you more susceptible to additional nutrition deficiencies like osteoporosis etc. Here are three simple steps to lose weight with PCOS:Step 1- Eat Right:- Limit Carbohydrate Intake: Limit the intake of carbohydrate to 40-50 percent of the total diet per day.- Avoid Refined Carbohydrates: refined carbohydrates like Maida-based or sugar, shoots up insulin levels which worsen the symptoms associated with PCOS and promote abdominal fat storage.-  Include Low Glycemic Index (GI) foods: Foods with a low GI release sugar into the blood more slowly, resulting in a slow and steady release of insulin preventing insulin resistance. Low GI foods include those high in fiber, fresh vegetables and some fruits and protein-rich.- Incorporate Soya: Soya and its products have phytoestrogen properties which mimic female hormone –estrogen bringing about beneficial effects.- Eat at Regular Intervals: Any variation in meal timings puts pressure on the glands to release more of contra-PCOS hormones.- Salt Restriction: Is another major aspect to prevent water retention and to relieve the symptom of bloating.Step 2- Exercise:Regular exercise helps controls insulin levels and reduces depression. The best forms of exercises for women with PCOS are:- Cardiovascular Exercise- Interval Training- Strength TrainingStep 3- Sleep:Regular and adequate sleep pattern has an effect on blood glucose management. One study showed that otherwise normal people who were deprived of just one night's sleep had impaired glucose/insulin systems. A good night sleep of 7-8 hrs/day is therefore essential to mitigate symptoms of PCOS arising out of insulin resistance. Lifestyle modifications including stress reduction, exercise, and balanced diet have positive effects for PCOS women planning to conceive.

PCOD and Diet

Ms. Silky Mahajan, Dietitian/Nutritionist
Polycystic ovarian disease (PCOD) have multiple small cysts in their ovaries. These cysts occur when the regular changes of a normal menstrual cycle are disrupted. The ovary is enlarged; and produces excessive amounts of androgen and estrogenic hormones. This excess, along with the absence of ovulation, may cause infertility. Other names for PCOD are Polycystic Ovarian Syndrome (PCOS) or the Stein-Leventhal syndrome.Causes of PCOD:We don't really understand what causes PCOD, though we do know that it has a significant hereditary component, and is often transmitted from mother to daughter . We also know that the characteristic polycystic ovary emerges when a state of an ovulation persists for a length of time. Patients with PCO have persistently elevated levels of androgens and estrogens, which set up a vicious cycle. Obesity can aggravate PCOD because fatty tissues are hormonally active and they produce estrogen which disrupts ovulation . Overactive adrenal glands can also produce excess androgens, and these may also contribute to PCOD. These women also have insulin resistance ( high levels of insulin in their blood, because their cells do not respond normally to insulin).Treatment:Weight Loss Diet for PCODIn case of PCod,Carbohydrate loading is very important to improve insulin sensitivity.Whey protein Avoid High Glycemic Index foodsInclude Green Leafy Vegetables & FruitsEssential Fats:Not all fat is bad and healthy fats are essential for your PCOS diet.Essential fatty acids are really important for maintaining the cell wall, which allows nutrients in, and toxins out. They are also vital for hormone balance, weight management and fertility.These healthy fats are found in nuts and seeds, oily fish, avocado and olive oil so be sure to incorporate those into your  diet.            6. Adequate Quantity of Vitamin B and MagnesiumPhysical ActivityWhilst diet is hugely important aspect to tackling PCOS, we must not forget other lifestyle changes that will help to overcome PCOS and it’s symptoms.Exercise regularlyManage stress levelsShare the burden and get good support from your family and friends.Look after yourself and pamper yourself. We need to reclaim our womanhood and femininity so a little bit of TLC is definitely in order.There is no magical formula that’s going to make us all better. However, by making these diet and lifestyle changes now, we can manage our symptoms and improve our health.

Pcod: Is It a Disease?

Dr. Radhika Wagh, Gynecologist/Obstetrician
“Poly Cystic Ovarian Disease” is a hormonal disorder where instead of one mature follicle; multiple immature follicles are formed in the ovaries. These are seen as small collections of fluid (follicles or cysts) in an ultrasound examination. The term definitely has the word Disease but this is not a Disease, it is an alteration in the body. It’s a body that is functioning in a different pattern.It is seen in the Reproductive age of a female common between the age group of 16-34.What causes PCOD?   The exact cause of this condition is unknown. But its presence is usually seen in obese constitutions, having lifestyles & habits that tend to cause weight gain. It also has genetic association.How to identify?It mainly deranges ovulation, causes either late ovulation or no ovulation. Whichever the case, leads to Irregularity of Periods. There is a difficulty to conceive for those who want to. So, it’s one of the main causes of Infertility. It also causes Obesity & Insulin resistance which may lead to Diabetes. We usually find the Waist to Hip ratio of such females equal to or more than 1.How to deal with it??Now, this is the important part. Management of this condition differs from person to person.Ovulation is deranged which means conceiving a pregnancy is tough. But if you’re an unmarried girl who has nothing to do with pregnancy, why bother. What difference is it going to make in your life if you skip a period or two (provided you are sure that you aren’t pregnant). Course of hormonal medicines will regularize your periods but this condition repeats itself once these medicines are stopped. Just prevent weight gain as that worsens this condition,or if you already are overweight then losing weight should reverse this condition.Yes, for someone who wants to plan a pregnancy treatment will really help. But the treatment should be aimed towards getting pregnant & not regularize periods. Ideally pregnancy itself is the best treatment of this condition. Post child birth this condition gets self-corrected in many of the females.To sum it up, PCOD is not a disease it’s a different type of body. Different not abnormal.

Polycysticovarian Disease (Pcod) Part 1

Dr. Hema Jajoo, Gynecologist/Obstetrician
Polycystic ovary syndrome (PCOS) is a hormonal disorder with over production of male harmone (Androgen) and insulin resistance (Insulin resistance is a condition in which the body produces insulin but does not use it effectively which again lead to horm onal imbalance) that causes verities of symptoms like irregular menstrual periods, overweight ,obesity, hirsuitism (excessive hair growth all over body), acne etc. Incidence-  The condition occurs in about 5 to 10 percent of female population of developed countries .Much higher incidence is reportedin india 3.7 to 22.5% and In Indian adolescents it is 9.13 to 36%..Cause of PCOD- The cause of polycystic ovary syndrome (PCOS)is not fully understood, but genetics may be a factor. PCOS can be passed down from either your mother's or father's side. PCOS problems are caused by hormonal changes. One hormone change triggers another,which changes another.How PCOS patients presents-Menstrual irregularities- is the commonest problem PCOD patients present with. This can be in the form of scanty menses, prolonged menstrual cycles, prolonged and heavy menses or absent menses.Weight gain and obesity- Because of hormonal imbalances most women gradually gain weight. There are few women or adolescents who do not gain weight. They are known as Lean PCOS.Male-pattern hair growth ( hirsutism is the excessive growth of thick,dark terminal hair in women where hair growth is normally absent) may be seen on the upper lip, chin, neck, side burn area, chest, upper or lower abdomen, upper arm, and inner thigh.Pimples- (Acne) is a skin condition that causes oily skin and blockages in hair follicles.Mostly occurs on face, but sometimes may be seen on back and upper chestInfertility - Many women with PCOS do not ovulate regularly, and it may take these women longer to become pregnant. An infertility evaluation is often recommended after 6 to 12 months of trying to become pregnant.Metabolic syndrome- Many patients with polycystic ovary syndrome (PCOS) also have features of the metabolic syndrome,including insulin resistance, Diabetes, obesity, and dyslipidemia (abnorma lLipid profile), suggesting an increased risk for cardiovascular disease( CVD ).Risk Factors for PCOSEarly or late Menarche- age of first menses.Obesity.Family History of PCOS ,irregular periods or Diabetes.Sedentary and improper life style.Long term sequel of PCOD-They are at high risk of developing Diabetes.High blood pressure, high cholesterol and heart diseases.Obesity.High risk of developing uterine cancer (endometrial cancer) due to unopposed action of Oestrogen harmone.Thyroid Disorders( Hypothyroidism)Sleep apnea — Sleep apnea is a condition that causes brief spells where breathing stops (apnea )during sleep. Patients with this problem often experience fatigue and daytime sleepiness.Depression and Anxiety.PCOS DIAGNOSISWhen patient goes to a doctor with any of the above mentioned symptoms then doctor takes full history, ask for other symptoms and examines thoroughly and then may advice certain tests to confirm the diagnosis.There is no single test for diagnosing polycystic ovary syndrome (PCOS). You may be diagnosed with PCOS based upon your symptoms, blood tests, and a physical examination. Expert groups have determined that a woman must have two out ofthree ( Rotterdam criteria ) of the following to be diagnosed with PCOS:Irregular menstrual periods caused by anovulation or irregular ovulation.Evidence of elevated male harmone (Testesterone) levels. The evidence can be based upon signs (excess hair growth, acne, or male-pattern balding) .Polycystic ovaries on pelvic ultrasound.- it shows enlarged ovary with multiple cysts. This is seen in almost 30% of cases.In women with moderate to severe hirsutism (excess hair growth), blood tests for testosterone and Indehydroepiandrosterone sulfate (DHEA-S) may be recommended.TSH and Prolactin harmones should also bed one as Hypothyroidism and or Hyperprolactinimia  may be associated with PCOS.If PCOS is confirmed, blood glucose and cholesterol testing are usually performed. Anoral glucose tolerance test is the best way to diagnose prediabetes and/or diabetes.Adolescent PCOS In adolescents, presence of oligomenorrhea (scanty menses) or amenorrhea (absent menses) beyond two years of menarche should be considered an early clinical sign of PCOS, followed by (Rotterdam criteria ) of adults for diagnosis of PCOS as mentioned above.Minimal diagnosis of PCOS in adolescents should include 5 tests- Serum total testosterone (cut off 60 ng/dL) Oral glucose tolerance test (OGTT) zero, two hours after 75 gm glucose load.Serum 17– hydroxy progesterone (assessed at 8 am)Serum TSH Serum and prolactin levels MANAGEMENT OF PATIENTS WITH PCOSBoth pharmacological and non-pharmacological management strategies are crucial in the overall management of PCOS. Usually treatment depends upon the symptoms for which patient comes. As PCOS can not be cured permanently, long term treatment plans should be given to manage her bothering symptoms and also to prevent long term sequeli. Treatment- usually depend upon the symptoms for which patient has come. But life style modification forms the main stay of treatment. Regular exercise,a healthy diet ,weight control, and not smoking are all important parts of treatment for polycystic ovary syndrome (PCOS)Physical activity- In adults and adolescents with PCOS, daily strict physical activity sessions for at least 30min/day or 150min/ week are recommended.Weight loss — Weight loss is one of the most effective approaches for managing insulinabnormalities, irregular menstrual periods, and other symptoms of PCOS. Forexample, many overweight women with PCOS who lose 5 to 10 percent of their bodyweight notice that their periods become more regular. Weight loss can often beachieved with a program of diet and exercise.Diet -it is recommended to follow calorie restricted diet (low carbohydrate and fat,high protein diet)There are a number of options available to treat obesity. These options are identical to those recommended for women without PCOS and include diet and exercise, weight loss medications (although their use is limited), and weight loss surgery. Weight loss surgery may be an option for severely obese women with PCOS. Women can lose significant of weight after surgery, which can restore normal menstrual cycles, reduce high androgen levels and hirsutism, and reduce the risk of type 2 diabetes. Oral contraceptives — Oral contraceptives (OCs; with combined estrogen and progestin) are the most commonly used treatment for regulating menstrual periods in women with polycystic ovary syndrome (PCOS). OCs protect the woman from endometrial (uterine) hyperplasia or cancer by inducing a monthly menstrual period. OCs are also effective for treating hirsutism and acne. Women with PCOS occasionally ovulate, and oral contraceptives are useful in providing protection from pregnancy. Although an OC allows for bleeding once per month, this does not mean that the PCOS is“cured,  irregular cycles generally return when the OC is stopped. Oral contraceptives decrease the body's production of male harmone ( androgens). Anti-androgen drugs (such as spironolactone) decrease the effect of androgens. These treatments can be used in combination to reduce and slow hair growth. Oral contraceptives and anti-androgens can alsoreduce acne. Metformin — Metformin is used to decrease insulin resistance in these patients. It improves the effectiveness of insulin produced by the body. It was developed as a treatmentfor type 2 diabetes but may be recommended for women with PCOS with obesity and insulin resistance.If a woman does not have regular menstrual cycles, the first-line treatment is a hormonal method of birth control, such as birth control pills. If the woman can not take birth control pills, one alternative is to take metformin; a progestinis usually recommended periodically to have withdrawal bleeding in addition to metformin, for six months or until menstrual cycles are regular.Metformin may help with weight loss. Although metformin is not a weight-loss drug, some studies have shown that women with PCOS who are on a low-calorie diet lose more weight when metformin is added. If metformin is used, it is essential that diet and exercise are also part of the recommended regimen because the weight that is lost in the early phase of metformin treatment may be regained over time.Treatment of infertility — If tests determine that lack of ovulation is the cause of infertility, several treatment options are available.These treatments work best in women who are not obese.The primary treatment for women who are unable to become pregnant and who have PCOS is weight loss. Even a modest amount of weight loss may allow the woman to begin ovulating normally. In addition, weight loss can improve the effectiveness of other infertility treatments. Ovulation inducing drugs (like clomiphene etc)  are also used in conjunction with Matformin. Your doctor will discuss with you about it.Prevention-  (PCOS) cannot be prevented. But early diagnosis and treatment helps prevent long-term complications, such as infertility, metabolic syndrome, obesity, diabetes, and heart disease.