Polycystic ovarian syndrome and Polycystic Ovarian disease (PCOD)
Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder, affecting 1 in every 10 women of reproductive age in India. It has recently been on the rise with increased incidence among teenage girls. PCOS affects a woman’s menstrual cycles, her ability to conceive, physical and mental health.
WHAT CAUSES PCOS?
Although the exact causes of PCOS are not known, it is thought to be of multifactorial in origin with a strong genetic association. It primarily arises from an imbalance of sex hormones with increased male hormones, excess insulin levels, obesity, oxidative stress, sedentary lifestyle and unhealthy eating habits leading to weight gain.
CHARACTERISTICS OF PCOS
Patients experience varied symptoms including irregular or missed periods, heavy periods , difficulty conceiving, hyper-androgenic features (like male pattern of hair growth or baldness, acne), weight gain, polycystic ovaries, insulin resistance, diabetes, metabolic syndrome, sleep apnea and depression. Many women experience a combination of symptoms, and the pattern varies greatly from woman to woman.
One must consult with a doctor if any symptoms are noticed, to make a specific diagnosis. Since many disorders involve sex hormones, distinguishing between PCOS and other related conditions can sometimes be tricky, particularly since some conditions have overlapping symptoms. Ultrasound scans, hormone tests like AMH, FSH,LH TSH,PROLACTIN , TESTOSTERONE and some blood tests like blood sugars, cholesterol help diagnose and differentiate pcos from others.
PCOS AND FERTILITY
PCOS often causes infrequent periods and anovulation leading to difficulty in conceiving. Due to hormonal imbalances, the brain may not produce hormones in correct amounts to signal egg production from the ovaries. Some women experience menstrual cycles every 2-3 months or even longer, narrowing chances of getting pregnant.
LONG-TERM CONSEQUENCES OF PCOS
PCOS maybe associated with long term health risks like insulin resistance, high cholesterol and triglycerides, type 2 diabetes, cardio-vascular disease, depression, hypertension, sleep apnea, endometrial hyperplasia or cancer. It can also cause complications during pregnancy including diabetes, hypertension, pre-eclampsia and low-birth weight of newborn .
TREATMENT OF PCOS
Exercise, weight loss, healthy dietary habits and lifestyle modifications are the mainstay of management of PCOS which help restore menstrual cycles.
Further, drugs inducing ovulation like clomiphene or letrozole are commonly used. Hormones (gonadotropins) are prescribed when there is no response to these medicines.
Laparoscopic ovarian drilling (LOD) maybe recommended if the woman fails to respond to ovulation induction drugs.
IVF (invitro-fertilization) is the last resort for couples who fail to conceive in the recommended number of ovulation induction cycles with timely intercourse or IUI. Medicines like birth control pills. metformin , antioxidants , medication for co-existing thyroid disorders, vitamin D deficiency , prolactin disorders and insulin sensitizers may also be advised.
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