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Polycystic Ovarian Disease (PCOD)

What is PCOD?

The term “polycystic ovaries” refers to the many tiny cysts, or bumps, in the ovaries. These cysts
themselves are not harmful and do not need to be removed.

  • The name Polycystic Ovarian Disease refers to the enlarged ovaries that contain many very
    small cysts
  • Women with PCOD typically have high levels of androgens.
  • They also have higher levels of insulin production that can result in excess weight gain.

What causes PCOD?

  • A hormone imbalance causes the symptoms of PCOD
  • Insulin resistance: the body cannot use insulin properly
  • High testosterone: the body produces too much testosterone
  • Although the exact cause is unknown, we do know that it is a result of a hormone imbalance in
    your brain and ovaries.
  • Also, many women with PCOD have too much insulin, a hormone that turns food into energy.
  • Having too much insulin may cause your body to make too much testosterone. This high
    testosterone level would account for some of the symptoms, like excess body hair or irregular
    periods that we will talk about in later slides.
  • Insulin Resistance (Hyperinsulinemia): as a potent growth hormone, is associated with weight
    gain – makes it possible to gain weight very easily despite good nutrition and exercise.
  • It also leads to high androgens which may lead to infertility, acne, facial hair growth, and hair
    loss on head.
  • There is scientific evidence that daughters of women with PCOD are at an increased risk of
    developing PCOD.

These warning signs may indicate polycystic ovarian Disease (PCOD). Polycystic ovarian Disease symptoms are related to hormonal imbalance, lack of ovulation and insulin resistance and may include:
  • Irregular, infrequent or absent menstrual periods
  • Hirsutism (excessive growth of body and facial hair, including the chest, stomach and back)
  • Acne or oily skin
  • Enlarged and/or polycystic ovaries
  • Infertility (the inability to produce children)
  • Overweight or obesity, especially around the waist (central obesity) and abdomen

Gluttony

  • Male-pattern baldness or thinning hair
  • Skin tags (small pieces of skin on the neck or armpits)
  • Acanthosis nigricans (darkened skin areas on the back of the neck, in the armpits and under the breasts)
In addition, women with PCOD may be at increased risk for developing certain health problems. These may include:
  • Metabolic syndrome, a condition with several components, including:
  • Type 2 diabetes or insulin resistance
  • Elevated cholesterol levels
  • Hypertension (high blood pressure)
  • Excess body weight, especially around the waist and abdomen
  • Elevated levels of C-reactive protein (a marker of inflammation)
  • Elevated blood clotting factors
  • Heavy or irregular bleeding and endometrial cancer – Lack of ovulation for an extended period of time may cause excessive thickening of the endometrium (the lining of the uterus).
You may undergo these tests if your doctor thinks you have PCOD. Poly cystic ovary Disease is easiest to treat when diagnosed early, says Reproductive endocrinology specialist, Dr Suma Prasad. That’s tricky, because so many adolescents have acne and irregular periods. “If your daughter has symptoms, don’t be afraid to ask your doctor,” she says. “If the doctor isn’t familiar with PCOD, find someone who is.” Even a later-in- life diagnosis is worthwhile,says Dr. Suma Prasad. “After menopause, symptoms may ease but the underlying insulin problems remain.” These are a few methods used for poly cystic ovary Disease diagnosis:

Laboratory tests

  • Your doctor may ask for a complete blood count, also known as a CBC, or may check your hormone levels.
  • These tests involve drawing a sample of blood and checking it.
  • The information from these tests will help your doctor evaluate your health.
  • Other blood tests measure chemicals in the blood to see how certain organs are working.

Pelvic examination

  • During a pelvic examination, your health care professional will feel for lumps or changes in the shape of your vagina, cervix, uterus, fallopian tubes, ovaries and rectum.
  • The health care professional also will use a speculum to open your vagina to look at your cervix and take samples for a Pap test.

Transvaginal ultrasound (also called ultrasonography)

  • Transvaginal ultrasound (TVU) is a procedure used to examine your vagina, uterus, Fallopian tubes and bladder.
  • It is also called Endovaginal ultrasound.
  • An ultrasound transducer (probe) is inserted into your vagina and used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes.
  • The echoes form a picture of body tissues called a sonogram.
Transabdominal Ultrasound -Pelvis imaging
  • A pelvic ultrasound uses sound waves to make a picture of the organs and structures in the lower belly (pelvis).
  • A pelvic ultrasound looks at the bladder, the ovaries, uterus, cervix, and Fallopian tubes of a woman.
  • Adolescent girls and unmarried women will be advised an abdominal ultrasound.
Individualized approach, personal attention to the health problems and nutrition needs has helped most of the women and adolescents who attended the PCOD clinic at Prasad Hospitals. Young women and for women who don't want to become pregnant, poly cystic ovarian Disease treatment is focused on correcting the abnormal hormone levels, reducing weight and managing cosmetic concerns. PCOD is not urable, but the symptoms are treatable by:
A Healthy Lifestyle

Healthy Diet & Regular Exercise

Maintaining A Healthy Weight
  • A healthy diet and increased physical activity allow more efficient use of insulin and decrease your blood glucose levels.
  • “The hands-down best strategy is diet and exercise,” Dr Suma Prasad says. “Losing just 10 percent of your body weight drastically reduces diabetes risk.”
  • For women who want to become pregnant, treatment is focused on weight reduction and promoting ovulation.
Treatment may include:
Medications Prescribed By Your Doctor

Medication

  • Metformin, a medication used in the treatment of Type 2 diabetes, often is used to decrease insulin resistance in PCOD.
  • It also may help reduce androgen levels, slow hair growth and help you ovulate more regularly.The safety of this medication in pregnancy hasn't been established.
  • You also may be prescribed medications to treat hair growth and acne.
  • “For relief of acne symptoms, a drug like spironolactone (Aldactone) may work quickly,” says our endocrinologist, with Prasad Hospitals.
  • “Hair growth and loss often take much longer to improve.” Nutraceuticals, are now most often prescribed and best planned by the Gynecologist & Dietitian.

Oral Contraceptives

Birth Control Pill Container --- Image by Beathan

  • For women above 18 years of age, our Gynaecologist may prescribe birth control pills to help your periods become more regular.
  • These pills also may improve other symptoms, such as heavy menstrual flow and the formation of ovarian cysts.
  • Regulating periods also is important to prevent endometrial cancer, which can result from cell buildup in the uterus.
  • Birth control pills stimulate the menstrual cycle and reduce male hormones.
  • Another option is progesterone-only pills.

Ovulation Induction Medications

  • These medications stimulate your ovaries to make one or more follicles (sacs that contain eggs) and release the egg for fertilization.
  • For women with PCOD, these medications also increase the risks for having a multiple birth (twins or more) and ovarian hyper stimulation, a condition of excessive stimulation of the ovaries that can cause hormone changes, abdominal bloating and pelvic pain.
  • These treatments are always individualized and discussed thoroughly with the woman before initiating.

Nutraceuticals

  • MI and DCI have been classified as insulin-sensitizers and seem to adequately counteract several InsR-related metabolic alterations with a safe nutraceutical profile.
  • Based on our analysis of selected studies that investigated MI and/or DCI, we conclude that supplementation with MI and/or DCI complement each other in their metabolic actions and act in synergy with other insulin sensitizing drugs and/or nutraceuticals.
Prasad Hospital Gynecologists carefully draft the follow up by individualizing the case.
  • Unmarried women and adolescents are given a follow up chart once in a month.the chart includes life style management, dietitian advice,weight monitoring and medication.
  • Many young women appreciate the non-hormonal approach and have achieved regular menses and weight loss.
  • Married women,who do not seek pregnancy are followed up with similar charts and a supplementary monthly ovulation check by ultrasound which is safe and simple. Those who are keen on pregnancy are treated by our Infertility specialists.
  • Hormone imbalance correction and successful ovulation induction are the key principles followed by our Infertility specialists.
  • Infertility treatment is no ordinary medical procedure. There are many emotions involved.
  • The best care blends progressive technology with honesty, empathy and caring. You have the best chance for success when you are relaxed and comfortable.
  • We offer a private setting where we treat you with respect and confidentiality.
  • We'll help you understand your options and get answers to your questions.
  • We're here to support you emotionally as you try to fulfill your dreams of becoming a parent.