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Poly-Cystic Ovarian Disease

The pleasure of being a mother and bringing a new life into existence is the greatest bliss of every woman’s life. There are certain problems which influence the fertility of women, and PCOD (Poly-Cystic Ovarian Disease) is one of them. It is a common diagnosis in women presenting with infertility. It changes the hormonal pathways of body that produce eggs and prepare the uterus for pregnancy. It affects approximately 10% women of reproductive age group and is mainly caused by imbalance of body hormones.

“PCOS/PCOD is a disease characterized by multiple cysts or small sacs filled with fluid in the ovary. Patients with PCOD have abnormal levels of hormones. It is the most frequent cause of anovulatory infertility and can also bring terrible physical changes in the appearance of woman if not treated at an initial stage. Over the advanced stage, it can lead to serious ailments, such as diabetes and heart disease.”

Most women with PCOD have some or all of the following features :

  • Abnormal uterine bleeding and lack of normal menstrual bleeding
  • Obesity, usually carrying extra weight around the waist can also be a factor for PCOD but it accounts for only 50% chances of obese women developing PCOD.
  • Acne, oily skin, excess Hair on face, chest, stomach, back, thumb or toes body or male pattern baldness may be one of the signs associated with PCOD which is very rare.
  • Polycystic ovaries, with or without ovarian enlargement
  • Insulin resistance
  • Infrequency in menstrual period
  • Excessive thickening of the lining of the uterus caused by an increase in the number of endometrial glands.

Dr. Nandita Palshetkar, Gynecologist & Infertility Expert, explains, "Both males and females produce hormones called androgens, referred to as male hormones, which play a role in sexual functioning of the body. In girls with PCOS, the ovaries produce higher levels of androgens than normal, and this interferes with egg development and release. Some of the eggs develop into cysts which are little sacs filled with liquid and instead of being released during ovulation, these cysts build up in the ovaries and even get enlarged. This condition is called Poly-Cystic Ovarian Syndrome."

Stressing on the importance of early diagnosis Dr. Pai emphasizes, "If PCOD is not diagnosed early and treated properly it can lead to problems like Type 2 Diabetes , High Cholesterol, High Blood Pressure, Abnormal Bleeding from the Uterus, and very occasionally Cancer too. The most important step is screening the condition and PCOS can be easily diagnosed through Blood tests and Ultrasound and therefore the chances of having serious side effects are reduced."

Treatment of PCOS/PCOD

Fortunately today PCOS/PCOD can be treated using various medications: Birth control pills for women who don't want to become pregnant is used in regulating the menstrual cycles, reduce male hormone levels, and help to clear acne.

Anti - diabetic drugs, normally used to treat type 2 diabetes is also prescribed for controlling the PCOD symptoms. It affects the way insulin regulates glucose and decreases the testosterone production. Abnormal hair growth gets slowed down and ovulation may return after a few months of use.

Fertility Medications: The main fertility problem for women with PCOD is the lack of ovulation. Pills and injections are used to stimulate the ovary to ovulate. PCOD patients are at increased risk for multiple births when using these medications. In vitro Fertilization (IVF) is sometimes recommended to control the chance of having triplets or more.

A surgery called Ovarian Drilling is another option of treatment for PCOD, though it is not recommended as the first course of treatment. It is performed at advanced stage in order to induce ovulation. This is done via laparoscopy or key-hole surgery. The ovaries are punctured with a small needle carrying an electric current or using laser to voluntarily breech the ovarian capsule. This surgery can lower male hormone levels and help with ovulation.

Otherwise the natural way of managing the PCOS is to maintain a healthy weight. Since obesity is common with PCOS, a healthy diet and physical activity helps in maintaining the healthy weight. This in turn helps the body to lower glucose levels, use insulin more efficiently, and help restore a normal period. Loss of even 10% of body weight can help make a woman's cycle more regular and increase the chances of ovulation by 25%.

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