PCOD: Polycystic ovarian disease, in which there are multiple small cysts in ovaries. These sacs are actually follicles,each one containing an immature egg. The eggs never mature enough to trigger ovulation.

PCOS: Polycystic ovarian syndrome is a constellation of clinical features. Doctors typically diagnose PCOS in women who have at least two of these three symptoms:

  • High androgen levels
  • Irregular menstrual cycles
  • Cysts in the ovaries. USG: should have at least one of the following: increased ovarian area (>5.5cm2) or volume (>11 mL)and/or presence of ≥12 follicles measuring 2 to 9 mm in diameter. 

ETIOLOGY 

  • MULTIFACTORIAL: Mixture of Genetic and environmental factors. 
  • INSULIN RESISTANCE: Hence is common in obese women. Hypersecretion of insulin results in ovarian secretions of androgen. 
  • INCREASED MALE HORMONES: Leadingto hirsutism, acne, baldness and menstrual disturbance.
  • AGE: Women between 15-44 years. The symptoms frequently begin at puberty although in many women the syndrome is not fully expressed until later in their reproductive years. 

CLINICAL FEATURES 

  • MENSTRUAL IRREGULARITIES: Oligomenorrhea,amenorrhea, irregular periods 
  • DIFFICULTY GETTING PREGNANT 
  • RECURRENT MISCARRIAGE 
  • INCREASED MALE HORMONES: Hirsutism, acne and alopecia 
  • DARKENING OF THE SKIN: Dark patches of skin canform in body creases like those on the neck, in the groin, and under the breasts.
  • HEADACHES: Hormone changes can trigger headaches 

TREATMENT OF PCOS

  • Weight loss: It improves ovarian function and reverses some of the associated hormonal abnormalities. 
  • Diet: Healthy home food, no packaged or processed food.Plenty of fruits and vegetables 
  • Exercise: Physical and mental fitness and well being 
  • Life Style Modification: Reduction of stress, proper sleep,quality “me” time, 
  • Cigarette and alcohol cessation

This lifestyle modification is put into practice for 6 months.  

If disorder persists medical treatment is done:

  • METFORMIN: To decrease insulin resistance, may also cause weight loss 
  • INFERTILITY: Clomiphene citrate for induction of ovulation.Ovulation occurred in 70-80% of cases and pregnancy resulted in 30-40% cases 
  • HIRSUTISM: Anti-male hormone therapy for symptoms of hirsutism including acne. 
  • IRREGULAR MENSTRUATION: Low dose contraceptives 
  • SURGERY: Ovarian drilling is a procedure that makes tiny holes in the ovary with a laser or thin heated needle to restore normal ovulation.