Dr. Saman Ahmad, Ph.D
Polycystic Ovarian Disease (PCOD):
Background:
Polycystic Ovarian Disease, PCOD (also known as Polycystic Ovary Syndrome or PCOS) is the most common hormonal disorder in females of reproductive age. It is one of the leading causes of female infertility.
A woman has two ovaries. Their main function is to release eggs and to produce sex hormones. They usually produce one egg per month. The ovaries are filled with follicles. Follicles are fluid-filled structures in which eggs grow to maturity. After attaining puberty, every month, many follicles begin to develop and mature. However, only one follicle becomes dominant during each menstrual cycle, and reaches its fully mature state. It reaches approximately 20-25 mm in diameter. This happens about 2 weeks after the onset of the previous menstruation. The dominant follicle then ruptures and the egg is released. It is slowly sucked into the fallopian tube for fertilization. The remaining follicles wither and die. The rupturing and release of the egg is referred to as ovulation. However, in case of PCOD, many follicles start to grow each month. But none of them become fully mature to release egg. Thus, women with PCOD do not undergo ovulation.
Polycystic ovaries have a white, thick, tough outer covering, and are two to five times larger in size than normal ovaries. Polycystic means “many cysts,” and PCOD often causes clusters of small, pearl-sized cysts in the ovaries. The cysts present in the ovary are actually follicles containing eggs that have failed to grow to a mature size. They are typically 5 mm in size.
Symptoms:
– Irregular menstrual periods or amenorrhea (absence of mentruation)
– Infertility (due to the absence of ovulation)
– Increased growth of hairs on the face, chest, stomach and back
– Acne
– Obesity and trouble in losing weight
– Pelvic pain
– Thinning of hairs on the scalp (male pattern baldness)
– Dark patches of skin on back of neck, under arms, groin However, the symptoms of PCOD that one patient experiences can be very different from the symptoms of another patient. So, if one observes two or more of the above symptoms, she needs to get a thorough check up done with a gynecologist.
Diagnosis:
There is no single test to diagnose PCOD. Diagnosis will require:
– A detailed medical history of patient
– Physical examination
– Ultrasound (to look for multiple cysts on the ovaries)
– Hormone levels (male sex hormones and Leutinizing hormone)
– Blood glucose level.
Treatment:
Treatment is chosen based on a woman’s symptoms, age and future pregnancy plans. Treatment for PCOD may include:
– Birth control pills to regulate menstruation
– Anti-diabetic drugs to treat insulin resistance
– Ovulation induction to treat infertility
– Androgen-blocking medications
– Anti-hair-growth medications
– Treatments for hair loss
– Acne treatments
– Removal of other skin problems
Prevention:
Best prevention for PCOD is a healthy lifestyle. A healthy diet low in refined carbohydrates is important, as this can help regulate blood sugar levels. Exercise can also help the body regulate insulin and keep excess weight off. Losing weight is challenging with PCOD, but doing so can help reduce the male hormone levels in the body, and some women will begin to ovulate naturally. So, with a proper diagnosis, lifestyle changes and PCOD treatment, women can get relief from this condition and the other long-term health problems it can cause.
Author:
Dr. Saman Ahmad, Ph.D ( Clinical Biochemistry), J.N. Medical College, Aligarh Muslim University, India.
June 08, 2015