PCOD: What You Need to Know

Polycystic ovarian disease (PCOD) or polycystic ovary syndrome (PCOS) is one of the commonest causes of menstrual irregularities. It is a very common condition and a common cause of treatable infertility. According to the National Institute of Health (NIH), 4–10 % of women in reproductive age are seen to suffer from PCOS. 70% of the females suffering from PCOS are unaware of it. PCOS increases the risk of other chronic conditions like diabetes and heart disorders. Read to know about PCOS and its effect on a female’s health.

What is PCOD or PCOS?

There are majorly two types of hormones: male and female hormones. The balance between these hormones is important for the normal functioning of the reproductive tract. Stein-Leventhal syndrome commonly known as PCOS is a syndrome where a female has a higher-than-normal amount of male hormones.

Normally, male hormones (testosterone) or androgens and female hormones (estrogen and progesterone) work in sync during the menstrual cycle. Follicle-stimulating hormone (FSH) prompts the production of the follicle, which is nothing but a sac containing egg. Luteinizing hormone (LH), on another hand, triggers the release of a mature egg (ovulation). In PCOS, levels of LH are elevated, resulting in an elevated LH:FSH ratio, which is favorable for intraovarian androgen environment, impairing folliculogenesis and anovulation. Because of all these reasons, the eggs do not mature enough for ovulation. This, in turn, results in the formation of multiple cysts in the ovary and hence the name polycystic ovary syndrome. Lack of ovulation reduces the level of female hormones and increases male hormones, disrupting the normal cycle.

What are the Causes of PCOS?

The exact cause of PCOS is not yet determined and is believed to be multifactorial in origin. Genetic factors can be responsible for abnormally high androgen synthesis in the ovarian tissue. Another factor associated with PCOS is insulin resistance. Insulin is a hormone that is produced by the pancreas. This hormone is important to maintain blood glucose levels. Insulin resistance is a state where the body’s cells are unable to utilize the insulin. The body increases the secretion of insulin to compensate this state. 70% of the females suffering from PCOS suffer from insulin resistance. Inflammation is also seen to be one of the causes of high androgen levels.

Symptoms of Polycystic Ovary Syndrome

Some of the common symptoms are irregular periods, hirsutism (excess growth of hair on back, belly, chest, and face), acne, weight gain, heavy bleeding, headache, darkening of the skin, and male-pattern baldness.

PCOS is diagnosed when at least two amongst the below-mentioned three symptoms are present:

  • Multiple cysts in the ovaries
  • Irregular menses
  • High androgen levels

Ultrasonography will reveal multiple cysts in the ovaries. Moreover, hormonal studies will reveal the imbalance between male and female hormones.

Effect of PCOS on the Body

Higher-than-normal androgen levels can have the following effects on the body:

  • Infertility: Females with PCOS do not ovulate regularly. Thus, there are not enough eggs to be fertilized, making it difficult to conceive.
  • Sleep apnea: It is a condition that causes a pause in breathing at night, interrupting sleep. This is more commonly seen in obese individuals. 80% of the females with PCOS are obese, increasing the risk of sleep apnea, Depression, metabolic disorders, and endometrial cancer are also associated with PCOS.

Polycystic Ovary Syndrome Treatment

It involves medical treatment and lifestyle and dietary modifications. Medical treatment includes estrogen and progestin contraceptive pills, which restore hormonal balance, prevent excess hair growth, and aid ovulation. Metformin improves insulin sensitivity and thus treats PCOD.

Lifestyle and dietary modifications include weight loss and a low-carbohydrate diet. Losing 5–10% of the body weight regulates the menstrual cycle and improves symptoms of PCOS. A low-carbohydrate diet results in weight loss and lower insulin levels.

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