Polycystic ovarian syndrome, also known as polycystic ovarian disease or PCOD is a very common female health complaint. PCOS is a common female endocrine disorder affecting approximately
5- 12% of women. It causes worry as it is commonly found in reproductive age; also it is thought to be one of the leading causes of female infertility.
Organs involved in Polycystic Ovary disease
- Ovary – the female gonad organ, present at the either sides of the uterus
- Adrenal glands – The glands which are placed just above the both the kidneys
- Pancreas – Gland that produces insulin in our body
- Pituitary gland – the gland just below the brain, which is responsible for all the hormonal control
Causes of PCOS
As per modern science the cause of PCOS is not fully understood. It is unknown
- Hereditary
- Hormonal imbalance
- Insulin resistance
- Mild inflammation
There is increased production of Androgen (a hormone) by the ovaries, which suppresses the maturation of ovarian follicles (ovarian follicles lead to ovum).
So, ovum does not get properly formed and released (anouvlation).
Remember that ovum meets with the sperm during intercourse leading to conception. So, in a case of PCOD, the lady usually will be having problem with conception.
How frequent is the problem of PCOD?
The incidence varies between 0.5 – 4 per cent, more common amongst infertile women. It is prevalent in young reproductive period.
What happens inside the body?
Typically, the ovaries are enlarged two to five times the normal size (PCOS – Ovarian cysts).
Ovary which is normally oval in shape will have many cysts within it.
Patient may present with features of diabetes mellitus (insulin resistance).
Careful survey concludes that the biggest lifestyle contributor to PCOS is poor diet.
Signs And Sympptoms:
- Irregular periods-This is the most common characteristic of PCOS. It includes menstrual intervals longer than 35 days, fewer than eight menstrual cycles a year.
- Amenorrhea- Absence of menstruation for four months or longer.
- Variation in menstrual bleeding- Prolonged periods that may be scanty or heavy flow with clots. Bleeding may extend to more than 9 days.
- Infertility- Not able to get pregnant because of not ovulating.
- Hirsutism- Increased male hormones causes’ excess hair growth on the face, chest, stomach, back, thumbs or toes.
- Skin changes – Includes Acne, oily skin, or dandruff.
- Obesity –Abnormal weight-gain, usually with extra weight around the waist and difficulty in reducing weight.
- Hair thinning – Increased androgen levels may cause male-pattern baldness due to excessive hair fall.
- Acanthosis nigricans- Patches of skin on the neck, arms, breasts, or thighs that are thick, velvety, dark brown or black.
- Skin tags– Excess flaps of skin in the armpits or neck area.
- Pelvic pain- Few women with PCOS experience dull aching pain in lower abdomen. This is may be due to low-grade inflammation.
- Abnormality in mental health– There may be anxiety or depression, low level of confidence due to change in their physical appearance.
- Sleep apnoea– Breathing stops for short periods of time while sleeping, which make you feel tired even after sleeping.
Long-term Health Risks of PCOS
- Infertility or Sub fertility
- Endometrial Cancer
- Diabetes
- Lipid Abnormalities
- Cardiovascular Risks
- Hypertension
Diagnosis: laboratory investigations:
The assessment and based diagnosis of PCOS is mainly based upon clinical presentation together with USG – Ultra Sonography findings and hormonal profile appropriate to mode of presentation.
Treatment of PCOD needs individualistic approach because, not all the symptoms might be seen in all the patients.
It depends on the presenting symptoms, like menstrual abnormalities, infertility, obesity, hirsutism or combined symptoms.
- Biochemical abnormalities to be corrected
- Hyper- androgenism
- Hyper secretion of LH (correction of hormonal balance)
- High levels of insulin &
- Low Follicle stimulating hormone (again related to hormone imbalance management.)
Weight reduction in obese patients is the first line of treatment. Body mass index (BMI)< 25 improves the menstrual abnormalities, hirsutism and infertility.