PCOD

What is PCOS ( Polycystic Ovarian Syndrome) ?

Polycystic ovary syndrome (PCOS) is one of the most common problems today that a female faces during the reproductive age (15-45 years old). In India it’s said approximately 36% female population in reproductive age are suffering from PCOS or precisely 1 in every 4 females of reproductive age group has polycystic ovaries. Even in recent times PCOS is one of the most talked subjects on female health in any social or media fronts. This problem is very common and can happen to any of us. Here one only needs to understand what all things are important that one should know to overcome as well as to avoid the complication of PCOS which if left un-treated can lead to infertility.

Signs that helps to detect PCOS

• Acne/pimples and hirsutism/excess hair growth
• Obesity/weight gain
• Irregular menstrual periods
• Pigmentation, especially on the neck and underarms
• Polycystic ovaries (cysts develop in the ovaries) – Can be confirmed through Ultra Sonography (USG )

The sign of PCOS can begin early but in most cases sign tends to emerge during late adolescent and early adulthood. PCOS is often mis-diagnosed or precisely self-diagnosed as a cosmetological issue for visible signs like acne/pimples and hirsutism/excess hair growth.

However, the large proportions of female do not even know or realise they have landed-up in PCOS, until they have an issue with their Menstrual Cycle or they are finding it difficult to conceive.

1) Polycystic Ovaries (cysts develop in the ovaries): 

Every female has two ovaries that lie on either side of the uterus. Each ovary is about the size of a large marble. The ovaries make eggs and various hormones.
Normally, during each menstrual cycle, many small follicles grow in the ovaries and form eggs. In mid-cycle, one egg is released from one of the ovaries into the fallopian tubes. This is called as ‘Ovulation’ process. The other follicles over-ripe and break down.
In PCOS females, ovulation does not occur and an egg is not released. The follicles don’t break down, but fill with fluid and turn into cysts that appear somewhat like a bunch of grapes. The ovaries can swell, sometimes becoming two to five times larger than normal.
Your doctor may recommend an ultrasound scan to determine whether you have polycystic ovaries or not.

2) Irregular menstrual periods:
A female of reproductive age has a menstrual cycle on an average of 28 days, although it may vary from 25 to 35 days. In PCOS female, Menstrual periods usually occur at intervals >35 days (irregular menstrual period) or may be absent.
If we consider recent studies around 99% female with PCOS have menstrual irregularity.
If you have irregular menstrual cycles, take a step before it’s too late and kindly consult your doctor as soon as possible.

3) Pimples and Excess hair growth:
Acne and Hirsutism are one of the most commonly visible symptoms of PCOS. Hirsutism is nothing but excessive hair growth, usually on buttocks, backs, chest or face. Whereas Acne is a skin disease where there is papules formation similar to Pimples. Acne/pimples usually found on face, back and chest. Around 75% of PCOS female have hirsutism and around 34% of PCOS female have acne/pimples.
In PCOS female, ovarian cysts causes a hormonal imbalance therefore there is more production of male hormones (such as testosterone). The increased male hormone leads to acne/pimples and hirsutism/excess hair growth.

4) Obesity/weight gain:
Obesity or persistent weight gain is a common feature of PCOS. Around 50% of PCOS female are obese. Eating habits and changing lifestyle makes PCOS female more obese.
Obesity is a common finding in PCOS female because their body cells are resistant to sugar/glucose controlling hormone named Insulin. This Insulin Resistance prevents cells from utilizing sugar/glucose which is the stored as fat H^& thus lead to obesity or weight gain.
Obesity also causes the imbalance within hormones which affects menstrual periods. If you are obese or overweight it is recommended to lose weight and take healthy diet.

5) Pigmentation, especially on the neck and underarms:
PCOS female may suffer from pigmentation or patches of dark skin at the back of the neck, underarms, forehead, possibly some other areas of the body. This is because of too much insulin hormone in blood, Advise is to seek the consultation of a gynecologist on immediate basis.

6) Infertility:
Infertility means difficulty to conceive (Pregnancy). PCOS is one of the most common cause of infertility in current time. As irregularity or absence of menstrual periods in a PCOS female is often linked to absence of ovulation (formation and release of eggs from the ovary), which reduces the chances of conception or getting pregnant.
If you have difficulty in conceiving, ask for consultation it might be PCOS.

– Effects of untreated PCOS: The most crucial thing one needs to understand about PCOS, that it is not just a cosmetic or menstrual period problem. It can be associated with risk of developing number of long term issues. It‘s important for a PCOS female to get her health check-up done on routine basis by Gynecologist till menopause even if the symptoms disappear.

Untreated PCOS female have a higher risk of developing the following conditions or diseases:

• Infertility/Inability to get pregnant
  As already discussed PCOS is a common cause of the infertility or inability to get pregnant. Thus early diagnosis of PCOS is must to avoid future risk of infertility.
• Diabetes
  Around 50% of female with PCOS will have diabetes or pre-diabetes before the age of 40. Therefore, if you have PCOS, it is recommended to do exercise and change dietary habits, in order to prevent diabetes.
• High blood cholesterol and Cardiovascular disease
  PCOS female are more prone to develop high blood cholesterol. Since cardiovascular disease is closely related to cholesterol, the risk of such disease (heart attacks) can rise in female with PCOS.
• Pregnancy complications
  PCOS female have more chances to develop complications during pregnancy. This includes having babies too early or having high blood pressure in pregnancy (pre-eclampsia) or even developing diabetes during pregnancy. If you have PCOS you should get your check-up done on routine basis.
• Endometrial Cancer/ cancer of the lining of the uterus 
  As discussed PCOS female have irregular menstrual periods or absence of menstrual periods. Thus, they may have a higher risk of developing cancer of the lining of the uterus.

Therefore, Even if you have doubt that you may have PCOS, please do not ignore your symptoms. There is an urgent need to look beyond these minor complaints, and realize the intensity of health problems which may come your way.

– Causes of PCOS: As we now know PCOS is a multi-factorial disorder. Following are the possible causes of the PCOS.

• Lifestyle Changes: Eating unhealthy foods items Junk foods and Lack of exercise leads female to gain weight. Obesity or weight gain causes imbalance of hormones which affects your menstrual periods.
• Insulin resistance: In 50-80% cases Insulin resistance is the major cause. It can also lead female putting on more weight, which makes PCOS symptoms worse.
• Hormonal Imbalance: An imbalance in certain hormones is common in female with PCOS.
• Family history: A woman is more likely to develop PCOS if her mother, aunt or sister also has/had it.

– When to reach doctor?If you are suffering from any one or more sign and symptoms of PCOS like acne/pimple, or hirsutism/excess hair growth, please Rush to nearby Consultant (Gynecologist). Because, PCOS may increase the risk of developing a number of long term problems like Infertility, diabetes, cardiovascular diseases and pregnancy complications etc.

Early diagnosis of PCOS prevents your future long term problems like infertility. So, take a step before it’s too late.

– What is the treatment of PCOS?There are several ways PCOS one can be manage. Management options may depend on the severity of the symptoms.

Life style Modification: 

For female with PCOS, making healthy lifestyle changes can be very helpful in managing the condition. Thus Lifestyle management is important for all female with PCOS, whether you are obese or even lean.

Adopting a healthy diet will ensure that you are receiving a healthy intake of nutrients, vitamins and minerals and can reduce your long-term risk of disease such as diabetes and cardiovascular disease.

Eat a low GI diet: By eating foods with a lower glycemic index (GI) one can better balance her blood sugars and improve PCOS symptoms. Low GI foods include whole grains, lean proteins, nuts and seeds, and lots of fresh fruits and non-starchy vegetables. Make sure to talk to your doctor or nutritionist to learn what the best food choices are for your specific needs. It is also advisable to take low fat diet.

Eat less at a time, more times a day: Eating smaller portions at increased intervals a day can help to keep your blood sugars balanced. You should plan to eat every 3-4 hours.

Drink more water: Because of the resistance to insulin, female with PCOS may experience water weight gain or quicker dehydration. Therefore, it is more important for you to drink at least 8 glasses of water a day.

Physical activity or exercise: It increases your energy levels, improves self esteem and reduces your stress. Government guidelines recommend 30 to 60 minutes of physical activity each day to help maintain weight. At-least 90 minutes of exercise a day is suggested everyday

Weight management can be much better achieved by combining diet with physical activity or exercise change than by simply following a diet chart.

Obese and overweight female with PCOS who lose weight and adopt a healthy lifestyle can significantly reduce their risk of long term health problems like diabetes and cardiovascular diseases.

Medications:

If you are suffering from PCOS, your doctor may ask you to take Insulin reducing medications like Myo-Inositol and Metformin, anti-male hormone medications, contraceptive pills, ovulation inducing medications, vitamin D supplementation etc. Doctor may also recommend surgery if the patient has not responded to above therapy.

Kindly consult your nearest gynecologist before taking any medications.