𝐔𝐧𝐝𝐞𝐫𝐬𝐭𝐚𝐧𝐝𝐢𝐧𝐠 𝐏𝐨𝐥𝐲𝐜𝐲𝐬𝐭𝐢𝐜 𝐎𝐯𝐚𝐫𝐢𝐚𝐧 𝐃𝐢𝐬𝐞𝐚𝐬𝐞/𝐒𝐲𝐧𝐝𝐫𝐨𝐦𝐞 (𝐏𝐂𝐎𝐃 𝐨𝐫 𝐏𝐂𝐎𝐒)

Anjali has been trying to conceive over six months. After all attempts and best-intended advice from buddies failed to succeed, she consulted a Gynecologist. Erratic menstruation, continuous weight gain, and lethargy were the first things the doctor noticed.  Investigations revealed that Anjali had PCOD and it was necessary for her to understand what it is and take appropriate measures to relieve the symptoms and conceive.

Poly Cystic Ovarian Disease is also known as Poly Cystic Ovary Syndrome, PCOD or PCOS in short. It is globally prevalent in 5%-10% of women in the reproductive age group globally. The condition affects the endocrine system of the female which eventually impacts metabolic as well as cardiovascular health.

It is the commonest hormone imbalance observed (very commonly these days) in women particularly in adolescent or reproductive age. The conformation of PCOS is done by Gynecologists on evaluation of clinical (menstrual irregularities or other concerns like facial hair, acne, excessive weight gain or difficulty in conception), biochemical and ultrasound parameters. Dr. Nupur Gupta shares her concerns about long term effect of PCOS on women that include diabetes, hypertension, heart disease, deranged lipid profile, endometrial hyperplasia and hence an early treatment plan is advised.

The factors that cause PCOS are yet to be ascertained and could vary from genetics (A family history of PCOS is a risk factor and a high prevalence of PCOD is observed in daughters if a mother has the same), environment or lifestyle (Obesity is also marked as one of the primary causes of Poly Cystic Ovarian Disease).  Type 1, Type 2, and gestational diabetes have been associated with an increased prevalence of PCOS.

The prime goal is to manage symptoms associated with PCOS that are inclusive of dietary modifications, regular physical activity and relaxation therapy. A multidisciplinary approach inclusive of a team of dietitians, Endocrinologists and Gynecologists work together in providing recommendations for treatment plan for PCOS.

The essence of this knowledge sharing is that PCOS can be managed with a positive mindset and Dr. Nupur Gupta reaffirms that “there is no need to be embarrassed upon discovering that you have PCOS. Confidently, talk to your health care providers and learn the approach that is best for you.”

The clinical representation of PCOD varies individually for most women. Menstrual disturbances, clinical manifestations of hyperandrogenism and infertility are the common reasons for seeking medical assistance. Although 30% of women with Poly Cystic Ovarian Disease will have normal menses most complain of scanty or lack of menstruation.

It is observed that about 70% of women with PCOD have Hirsutism. This is a common clinical presentation where hair growth is observed at seven sites: upper lip, chin/face, chest, back, abdomen, arms, and thighs.

The major health concern of PCOD is infertility which affects 40% of women with PCOS.

In adolescent girls, there are few contributing factors associated with increased risk of PCOD.  One of the main factors includes high birth weight in girls born to overweight mothers. Also, congenital virilization, low birth weight, premature pubarche, atypical central precocious puberty, obesity syndromes, acanthosis nigricans, and metabolic syndrome are all risk factors found in teenage girls.

It is observed that women with PCOS are also at increased risk of a number of mental health disorders including depression, bipolar disorder, anxiety, and eating disorders.

Treatment:

Hirsutism is associated with PCOD. Physical manifestations include acne, hair growth at unwanted areas and alopecia. Generally, oral contraceptive pills (OCPs) are first-line for pharmacologic management of hirsutism in premenopausal women. Today, women can opt for laser hair removal and other mechanical hair removal options to improve cosmetic appearance..

PCOD is marked with increased insulin resistance or insulin sensitivity. Metformin and thiazolidinediones have insulin-lowering effects by improving insulin sensitivity. There is a decrease in circulating androgen levels by taking these medications under guided prescription.

Experts advise that weight loss can also improve circulating androgen levels providing numerous other metabolic benefits for patients with PCOD.

Regular exercise to reduce insulin resistance, high fiber and moderate protein, a low-fat diet is recommended to treat symptoms associated with PCOD.

Conclusion

Proper diagnosis and management are essential as PCOD has several potential metabolic and cardiovascular risks if not managed appropriately. It is observed that the treatment is focused on individual symptoms but not the syndrome itself. It is suggested that the understanding of the pathophysiology of PCOD by the patient will help them comply with all treatment suggestions.

Gynecologist in Gurgaon, diet educator, as well as alternative therapy experts, are required to improve the overall well being of women with PCOD.

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To watch video, click What is PCOS?