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Are You Suffering From PCOD?

By Dr. Kamna Nagpal in Obstetrics And Gynaecology

Jun 30 , 2016 | 9 min read

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Are you suffering from PCOD? You’re not alone. It is estimated that nearly 20% of all Indian women, that is, about 1 out of 5 women in the country, suffer from PCOD. The full form of PCOD in medical terms is Polycystic Ovarian Disease.

While relatively common, most women are not aware of the signs and symptoms of PCOD, the implications of the condition, and available treatment options. So let us take a closer look.

Understanding PCOD

PCOD (Polycystic Ovarian Disease) is a medical condition in which a woman's ovaries generate immature or partially mature eggs. These eggs develop into cysts in the ovaries over time but an increase in male hormones (androgen) causes the formation of several follicular cysts in the ovary each month. This causes anovulation and prevention of the regular release of eggs.

Common Signs of PCOD Problem

PCOD primarily affects the ovaries. The ovaries are a part of the female reproductive system. All women have two ovaries, and these release egg cells or ova. The ovaries are responsible for the production of oestrogen and progesterone. They also release the male hormone called androgen. PCOD can disrupt this process and lead to an abnormal release of male hormones.

This results in -

  1. Irregular or unpredictable menstrual periods
  2. Heavy bleeding during periods
  3. Excess body hair
  4. Acne
  5. Hair loss or male pattern baldness
  6. Difficulty in getting pregnant
  7. Obesity
  8. Darkening of skin or pigmentation around the neck
  9. Sleep disorders
  10. Depression

What causes PCOD?

The exact cause of PCOD remains unclear. Doctors believe that PCOD can have both genetic and environmental causes. PCOD is often associated with –

  1. An unhealthy diet
  2. A sedentary lifestyle
  3. Pollution
  4. Hormone altering medication
  5. Several OTC (over the counter) medications and supplements

In many cases, PCOD runs in families and is also considered hereditary.

Researchers point to several physiological causes that may increase your risks of developing PCOD/PCOS – 

  1. Excess Insulin Production - Insulin is a natural hormone produced by the pancreas. It helps regulate the metabolic functions of the body and regulate blood sugar levels. Doctors believe that a high insulin level is one of the key drivers of PCOS. Excess insulin also prompts the body to increase the production of androgen (male hormone), which inhibits ovulation.
  2. Inflammation – Several physiological reasons may cause low-grade inflammation in the body. Mild forms of autoimmune diseases can also cause inflammation in the body’s tissues. This, in turn, again increases the androgen levels in the body. 
  3. High Androgen Levels – The male hormone is associated with increased facial and body hair, acne outbreaks and skin issues, and a higher risk of developing cardiovascular diseases

How is PCOD diagnosed?

Diagnosis is crucial in finding a solution to PCOD problems. Your gynaecologist will start with a physical exam and take a history of your symptoms. The doctor may then recommend tests such as -

  1. Blood tests (to check for the hormonal levels, blood sugar, insulin, and cholesterol)
  2. Pelvic ultrasound (to look for cysts in the ovaries and measure the lining of the uterus)

What is the impact of PCOD?

The symptoms associated with PCOD often leave a lasting impact on women’s physical and mental well-being. It is estimated that about 34% of the women suffering from PCOD problems also suffer from depression, and nearly 45% suffer from anxiety. This makes it essential to diagnose and manage the symptoms early to prevent PCOD problems in future.

Many of the women diagnosed with PCOD also experience poor quality of life related to -

  1. Mood swings
  2. Negative social relationships
  3. Low self-confidence
  4. Negative self-image
  5. Disruption of eating and sleep patterns
  6. Low motivation

PCOD Problem Treatment Options

It is important to remember that solutions to the PCOD problem involve both medication and lifestyle changes. Unfortunately, there is no known cure for the condition, but managing the symptoms can improve the quality of life.

  1. Diet modification can go a long way in managing symptoms and offering PCOD problem solutions. Even a 5% reduction in body weight can help reduce the symptoms significantly. Eliminating sugars and fatty foods can help lower the risk of developing diabetes, high cholesterol levels, and cardiovascular diseases.
  2. Women leading a sedentary lifestyle must plan and stick to a regular exercise schedule as part of the PCOD solution.
  3. Cyclic hormonal treatment and ovulation induction medication can help regulate the menstrual cycle.
  4. Skin treatment can help reduce acne and the darkening of the skin.
  5. Infertility treatment can help with conception.
  6. Laparoscopic surgery can help destroy androgen producing tissue.
  7. Regular monitoring of health and hormone levels can help prevent PCOD problems in future.

PCOD Treatment – Medication and Surgical Options

The symptoms associated with PCOD can be treated with the help of several medicines. In rare cases, your doctor may recommend surgery as well. Some of the treatment protocols for PCOD/PCOS include - 

  1. Progestin - Progestin, a synthetic progestogen, is often recommended to correct amenorrhea or the absence of periods. 
  2. Birth control pills - Some birth control pills contain oestrogen and progestin and help reduce the Androgen levels in the body. This helps combat anovulation.
  3. Letrozole and clomiphene - Letrozole and clomiphene help induce ovulation. 
  4. Metformin - Metformin reduces insulin resistance and helps with weight reduction as well.
  5. Immature follicle aspiration - Helps reduce the number of immature follicles, improving ovulation.
  6. Laparoscopic ovarian drilling - Laparoscopic drilling is a minimally invasive surgery that helps lower testosterone levels produced by the ovaries.

Can PCOD be cured permanently?

“How to cure PCOD permanently?” This is a question researchers and doctors have been working to resolve for the past few decades, given the significant rise in the number of women suffering from the condition. As of now, there is no permanent cure, but most women can lead relatively normal and active lives. This requires an active lifestyle and health management. Each symptom, such as irregular periods, facial hair, weight gain, acne, infertility, is individually addressed. It is important to keep a positive attitude and stay connected with your doctors to avail of any new treatment options available.

PCOD Diet

Diet is an essential component of PCOD problem treatment and symptom management. Weight loss through dietary modifications can help

  1. Reduce blood glucose and HbA1C levels, lowering your diabetes risk
  2. Lower insulin
  3. Improve cholesterol levels
  4. A low carbohydrate diet is extremely helpful in losing weight and reducing BMR.
  5. Fresh foods like vegetables and fruits are low in the glycaemic index (GI) and help with weight reduction and diabetes management. 
  6. Avoid processed and packaged foods to lower the risk of hypertension.

To experience significant relief from PCOD symptoms, it is vital to pair diet modification with a regular exercise program and stress-alleviating activities such as meditation and yoga.

Getting pregnant with PCOD

Despite the hormonal imbalances and increased risk of miscarriages, several women with PCOD are successful in getting pregnant and carrying their babies to term. Patients may require regular hormone checks, medication, and treatment to stimulate ovulation. 

PCOS is a more severe condition with higher infertility rates. Women with PCOS have ovaries that are larger than normal. The ovaries, however, produce immature eggs that form cysts. Women with PCOS have higher than normal levels of the male hormone Androgen. Androgen inhibits the process by which eggs are released normally. When healthy eggs are not released, they cannot be fertilised, causing infertility issues and difficulties in getting pregnant.

The gynaecologists at Max Hospital are experienced at managing infertility issues and high-risk pregnancies, making it possible for women diagnosed with PCOD/PCOS to carry and deliver babies. If you have been diagnosed with PCOD and are planning to get pregnant, it is important to consult with your doctor and plan to manage your hormones and health accordingly.

PCOD and Mental Health

PCOD is associated with a high prevalence of anxiety and depression. PCOD/PCOS is a condition that requires active, long-term management. The role of a support system in the maintenance of treatment protocols over the long term is a major one.

Women with PCOD/PCOS often suffer from low self-image and body image issues due to excess body hair, weight gain around the abdomen area, skin darkening and pigmentation around the neck etc. While these symptoms can be treated, friends and family must remain supportive for the woman to maintain positive mental health.

The hormonal imbalance in this condition makes the woman more prone to stress and anxiety. In addition, infertility issues and miscarriages occurring in PCOS can cause depression. Seeking therapy and help can be important in such situations.

Health Management with PCOS

Dealing with PCOS could involve long term and regular health monitoring. Apart from managing symptoms such as irregular menstruation, infertility, facial and body hair growth, and weight gain, you will need regular monitoring for diabetes, heart conditions, hypertension, and cancer of the uterus/ovaries

Management of insulin resistance is one of the key goals of PCOS treatment. In addition, early diagnosis and long term treatment help prevent diabetes-related PCOD problems in future. 

The doctor may recommend the following tests periodically to monitor your health -  

  1. Insulin levels
  2. Lipid Profile
  3. Blood Sugar levels (Fasting, PP, and HbA1C)
  4. Hormone tests
  5. Pelvic ultrasound

Apart from the support offered by doctors, you must remain aware of the causes, symptoms, risks, and management protocols for PCOD/PCOS.

PCOD/PCOS and Cancer Risk

Millions of women across the world are diagnosed with PCOD each year. However, no medical evidence establishes a link between PCOD and ovarian cancer.

Women diagnosed with PCOS are at an increased risk of developing cancer of the endometrium, which is the uterus lining. This is often a result of chronic exposure to oestrogen and exacerbated by comorbid conditions such as obesity, diabetes, and hypertension.

Women suffering from PCOS may also have a 2 to 3 times higher risk of developing ovarian cancer.

The link between PCOS and breast cancer is not very clear. Researchers have not established a link between a PCOS diagnosis and the risk of developing breast cancer. However, the hormonal imbalance caused by PCOS leads doctors to be wary.

If you suffer from PCOS, your gynaecologist may likely recommend periodic screening for breast, ovarian, and endometrial cancers. 

What is the difference between PCOD and PCOS?

The names PCOS (Polycystic Ovary Syndrome) and PCOD (Polycystic Ovarian Disease) are often used interchangeably. Let us look at how we can differentiate between the two conditions.

  1. Women suffering from PCOD can ovulate regularly and conceive naturally. While  PCOS being much severe, disrupts ovulation the menstrual cycle and causes higher infertility rates.
  2. Women suffering from PCOS often struggle with the symptoms from a younger age. Since PCOD does not release as many male hormones as PCOS, the symptoms are less frequent and rarely noticeable.
  3. PCOS is inherently a metabolic disorder. This means it is often accompanied by a greater risk of developing high blood pressure (hypertension), diabetes, cardiovascular diseases, obesity, and cancers of the uterus and breast. PCOD sufferers are not threatened with such issues.
  4. Women who suffer from PCOD experience mild to moderate symptoms. These symptoms can be managed with diet, lifestyle changes, and medication. Women suffering from PCOS may require infertility treatments and active treatment protocols to manage other health conditions that they may develop.

If you experience any of the symptoms associated with PCOD, it is important to consult an expert gynaecologist for a proper diagnosis and PCOD problem treatment. In addition, your gynaecologist may refer you to an endocrinologist or a cardiologist to help manage other health conditions that you develop due to PCOS.

PCOD and PCOS Treatment at Max Hospital

Max Hospital is one of the premier centres for treating PCOS/PCOD problems. The state-of-the-art facilities offer comprehensive diagnosis and treatment with expert gynaecologists. Max Hospital uses advanced infertility treatment protocols to help women conceive and deliver healthy babies.

The doctor will refer you to an experienced endocrinologist for sustained management of PCOS symptoms. Lifestyle and diet management counsellors are also available at the hospital.

To consult your doctor, you will need to provide detailed information regarding – 

  1. Medical history
  2. Symptoms
  3. Past treatment history
  4. Family history
  5. Medical reports (if any)

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