Polycystic Ovarian Disease
What is PCOD?
Polycystic Ovarian Disease (PCOD), also known as Polycystic Ovary Syndrome (PCOS) is a common illness among women of conceptive age. This affects 5% to 10% of women in the age group 12 years to 45 years. Woman’s hormones become unbalanced, causing menstrual period problems and make it tough for the women to conceive. The main factors include no ovulation, irregular periods, acne, and hirsutism. If not treated, it can result in insulin-resistant diabetes, and high cholesterol leading to heart disease.
Difference between PCOS and PCOD
PCOS is an endocrine system disorder whereas, PCOD is a condition build-up by hormonal imbalance.
In girls with PCOS, the ovaries produce greater levels of androgen than usual, then this gets involved with egg development and discharge. Some of the eggs develop into cysts. Instead of releasing during ovulation, these cysts grow in the ovaries and get enlarged.
In PCOD, the hormonal imbalance leads to the gathering of mature eggs in the ovaries, as they cannot be released. These become cysts and some of the cysts further lead to more cysts and the cycle goes on.
PCOD and PCOS, are related with defective ovaries including symptoms like irregular periods, with PCOS leading to thinning of hair, and development of male hair pattern in PCOD. Both are caused due to hormonal imbalance which results in infertility. But PCOS is more serious than PCOD.
Causes of PCOD
Generally, the ovaries generate female sex hormones (estrogen) and a small number of male sex hormones (androgen). These help to manage in the development of eggs in the ovaries during each menstrual cycle.
PCOS is related to an imbalance in the sex hormones. In PCOS, they start producing more androgens which causes patients to stop ovulating, get pimples, and grow extra facial and body hair.
In polycystic ovary syndrome, the eggs in the follicles do not grow fully and are not released from the ovaries. Instead, they form very small cysts in the ovary, named polycystic ovaries.
PCOS seems to be genetic, so if other women in the family have PCOS, irregular periods, or diabetes, the chance of having it increases.
Common symptoms of PCOD and PCOS
- Acne breakouts
- Weight gain and difficulties in losing weight
- Surplus facial and body hair. Sometimes women get dense and darker facial hair, and more hair on the chest, belly, and back
- Reduction in the thickness of the hair (Hair fall)
- Irregular periods. Women suffering from PCOS have less than nine periods a year. Some women have no periods, whereas, others have heavy bleeding
- Women who have PCOS have a problem in getting pregnant (infertility)
PCOD and PCOS complications
- High risk of endometrial cancer
- Infertility (early treatment of PCOD can help to cure infertility and increase the chances of healthy pregnancy)
- Obesity-related (BMI over 30 and waist circumference greater than 35) conditions, such as high blood pressure, heart disease, and diabetes
- Possible risk of breast cancer
When to see a doctor?
Periods can happen irregular for other reasons during the first few years, it’s suggested to wait until after three years of irregular periods before consulting a doctor.
Treatment Options For Gynaecology
Gynecologic Endocrine Disorders
Hormones act as the chemical messenger in your body, which is responsible for the overall development of your body.
In women’s uterus, sometimes an abnormal growth occurs known as fibroids which are also referred to as tumors that develop with fibrous connective tissue and muscle cells.
Treatments for PCOD
To regulate your menstrual cycle, apply the following measures:
- Combined birth control pills – Pills that contain estrogen and progestin, lessen androgen production and regulate estrogen. Balancing your hormones can reduce the risk of endometrial cancer and cure abnormal bleeding, excessive hair growth, and acne. Instead of pills, you can use a skin patch or vaginal ring to release a continuous dose of estrogen and progestogen.
- Progestin therapy – This therapy decreases the odds of conception and giving birth. The Progestin shot lasts for 3 months and hence, requires 4 shots a year. The progestin-only mini pill or progestin-containing intrauterine device is a better choice if you wish to avoid pregnancy.
To help you ovulate, apply these measures:
- Letrozole (Femara) – It’s used for treating breast cancer hence, can work to stimulate the ovaries.
- Metformin – This medication treats diabetes mellitus (a condition in which the body cannot control the level of sugar in the blood). If you have prediabetes, metformin can also help in weight loss.
- Gonadotropins – These hormone medications cause the ovaries to make estrogen and progesterone.
To reduce excessive hair growth, apply the following measures:
- Birth control pills – These pills reduce androgen production which causes excessive hair growth.
- Spironolactone (Aldactone) – This medication barrier the effects of androgen on the skin. Spironolactone can cause birth defects so, it isn’t recommended if you are pregnant or planning to get pregnant.
- Eflornithine (Vaniqa) – This medication can slow down facial hair growth in women.
- Electrolysis – A tiny needle is injected into each hair follicle. The needle release vibration of electric current to destroy the follicle. You might need multiple treatments.
Common medical treatments
Some common medical treatments used for treating some of the problems associated with PCOS, including weight-loss medication, such as Xenical (orlistat) which decreases the amount of dietary fat absorbed in your intestines; cholesterol-reducing medication (statins) which blocks the substance your body needs to make cholesterol in your blood; and acne treatments.
Surgery can also be an alternative way to treat PCOS by an open operation done through a large incision called wedge resection. In this operation, a segment of the ovaries gets cut out to repair the ovary. It helps to improve fertility hence, starting ovulation and creating pregnancies. Ovarian drilling is a surgical technique in which tiny holes are made in the membrane surrounding the ovary with a laser or a surgical needle to restore regular ovulation cycle.
PCOS and Pregnancy tests
1. Pregnancy test false positives
There are possible for any person to get a false positive on a pregnancy test. However, PCOS is not responsible if you get a false report.
Pregnancy tests depend on the presence of human chorionic gonadotropin (HCG) to decide whether you are pregnant or not. And it’s not a hormone that directly gets affected with PCOS.
In case you are undergoing fertility treatments that require taking some medications, you may discover HCG (from the medication) that can show the false positive pregnancy test result.
Other common reasons for a false positive can be – using an expired pregnancy test kit or not following the test instructions properly.
2. Pregnancy test false negatives
When you have PCOS your hormone levels are uneven, so false negatives are possible.
Some women with PCOS may not know that they are pregnant until many weeks after conception.
3. PCOD pregnancy success rate
Women suffering from PCOS have a 20 to 40 % chance of getting pregnant with IVF treatment. Women who are 35 years of age or above, or are overweight, have less chance of getting pregnant.
How PCOD is diagnosed?
To get an image (picture) of the uterus, ovaries, and pelvis an ultrasound is done. The image will show whether there are any cysts on your ovaries or whether an ovary has enlarged. It is also helpful for assessing the lining of the womb (endometrium), which may become thick due to irregular periods and become a risk factor for womb cancer.
Transvaginal Ultrasound– Transvaginal ultrasounds are carried out only on women who have been sexually active, or else an abdominal scan is done. A transvaginal ultrasound is a pain-free test with no radiation. A pen-shaped probe with an ultrasound sensor on the tip is used to insert into the vagina. This gives a clearer picture than an abdominal ultrasound.
Abdominal Ultrasound– In an abdominal ultrasound, the ovaries get checked from the outside through the stomach wall.
Diet and lifestyle tips to treat PCOD
Some changes in lifestyle like diet and exercise will help you to lose weight, hence can be some precautions for the treatment for PCOS.
1. Doing exercise is good for PCOS patients. Losing about 5 to 10% of your body weight can help to improve your menstrual cycle and overcome PCOS symptoms. Weight loss can also control your cholesterol levels, lower insulin, and reduce heart problems and diabetes. So, moderate half an hour exercise for at least three days a week can help women with PCOS, lose weight.
2. PCOS diet means that you need to consume whole grains, fruits and vegetables, and plant-based proteins and reduce the consumption of sugar, processed food, and tranz fat. Depending on your overall health, you may need to add nutritional supplements.
3. Instead of elevators, use stairs. Make sure that you do more physical activities to makes changes in your static lifestyle.
4. The condition of your PCOS can become worse if you do not get proper sleep. Make sure that you get eight hours of sleep every day. Reduce your stress levels by engaging yourself in some fun activities.
5. Green tea and spearmint tea can have a positive impact on PCOS symptoms. Hence, you can opt for drinking herbal tea or spearmint tea twice a day. Avoid consuming alcohol as it can raise insulin levels and cause hormone imbalance.
There is some acupuncture, which can help with improving PCOS, but more research is required on them.
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Yes. PCOS impact on your pregnancy. Keep reading to find out how PCOS can impact your chances of getting pregnant.
PCOS is caused by an imbalance of hormones whereas PCOD is caused by an overproduction of testosterone.
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Dr. Jay Mehta
Fertility and IVF Specialist
Dr. Jay Mehta is the Scientific Director of Shree IVF Clinic. He is a well-known Fertility and IVF Specialist and also among few doctors in the country who specializes in Embryology and Andrology.