PCOS or Poly Cystic Ovarian Syndrome condition develops when either one or both of your ovaries develop multiple small cysts filled with fluid. Your enlarged ovaries fail to release the egg every month at mid-cycle. Along with this, there is excess production of male hormones by the polycystic ovaries and it is then that all hell breaks loose with complete anarchy in your body’s internal hormonal system which normally has a predominantly female and only a trace amount of male hormones.
According to FOGSI; (Federation of Gynecological Society of India), about 20-30% of women suffer from PCOS problems. It is a distressing problem for women as it is associated with excess facial hair growth, scalp hair thinning, acne, obesity, dark, velvety skin or pigmentation, menstrual irregularities, and difficulty in getting pregnant due to the presence of excess male hormones Though used synonymously, PCOD is a milder form of PCOS and considered less harmful as ar as fertility, response to treatment and long term health complications like diabetes, hypertension, uterine cancer, etc. are concerned.
Difference between PCOD and PCOS
Though PCOD and PCOS are used as if they are same; there are many differences between the two:
- PCOD results when imbalance of hormones occur ; while PCOS there is total disruption of whole hormonal system affecting not only menstruation but other body functions also; like blood pressure and sugar regulation.
- PCOD is a lifestyle condition and can be managed through lifestyle and dietary changes; while in PCOS; as the whole endocrine system is affected; it can be more serious and resistant as compared to PCOD.
- In PCOD: the ovaries are filled with follicles and do not appear much larger; while in PCOS Ultrasound images show larger ovaries; 3 times larger than normal ovaries.
- PCOD can also result from emotional stress; genetic; obesity and bad dietary habits apart from hormonal disturbances; while PCOS can be due to genetic and hereditary conditions; hormonal imbalances; insulin resistance and inflammation.
- PCOD is commonly observed condition affecting upto 1/3 rd of women all over the world ; PCOS occurrence is relatively low when compared to PCOD.
- PCOD symptoms may include abdominal weight gain; irregular menses; acne; hair loss and infertility; PCOS symptoms start showing in teenage; like: loss of hair; male pattern baldness; irritability; mood swings; head ache; weight gain and infertility.
- PCOD women can become pregnant with the help of healthy lifestyle and modification of diet and with medications ; while in PCOS hormone dysregulation in women makes it very difficult to conceive due to excessive secretion of male hormones called androgen
- PCOD does not lead to major complications while PCOS women are at high risk of developing cardiovascular disorders; high blood pressure; diabetes; endometrial cancer and obesity.
There has been a lot of advancements to control PCOS problem and a number of treatments are available that can reduce or minimize the bothersome symptoms with newer medicines which restore your internal hormonal balance and also newer surgical treatments which preserve the ovarian function as well as improve the feritility outcomes and the long term health. Dr Dimple Doshi is an expert gynecologist with special interest in the polycystic ovarian syndrome. She will guide you not only for the ovarian fuction but will also take care of your cosmetic concerns.
1. Environmental factors ; risk factors include obesity, lack of physical exercise; faulty lifestyle;
PCOS may be related to or worsened by exposures to certain chemicals before birth, exposure to industrial endocrine disruptors, such as bisphenol A and certain drugs.
2. Genetic factors.: Someone born with the same condition in the family or harboring the faulty genes.
You are said to be suffering from PCO if you have 2 of these 3 conditions:
1. Irregularity of menstruation as the egg fails to release in each cycle. ;
2. High male hormone levels causing excess facial hair on the face and or chest; scalp hair thinning, acne, obesity
3. Presence of multiple tiny follicles or cysts on one or both ovaries on ultrasound.
Your PCOD doctor or gynecologist will follow a systematic protocol when you approach her for your problems.
1. HISTORY: In order to diagnose PCOS, your gynecologist will take a detailed history regarding your menstrual cycles including the interval at which your period comes; the days for which they last, and how painful they are.
2. PHYSICAL EXAMINATION: the exam is also done to visually and manually inspect the reproductive organs for masses, growths, or abnormalities.
A careful general examination is done to look for abnormal hair growth, pigmentation on the skin, or thinning of scalp hair. The presence of acne is also diagnostic if found along with the other symptoms.
3. ULTRASOUND: Ultrasound examination is done to check the appearance of your ovaries as well as the inner lining of the uterus.
4. BLOOD INVESTIGATIONS: Blood tests are done to measure hormone levels like FSH, LH, S. TSH; S testosterone, Insulin, DHEAS. Additional tests like glucose tolerance and lipid levels are also advised.
Your doctor might recommend additional tests for the complications; Like periodic checks of BP, Glucose tolerance .thyroid profile, and lipid profile.
5. Your doctor may look for the signs of depression and anxiety
6. You may be screened for a sleeping disorder called obstructive sleep apnea due to low estrogen high androgen levels and obesity.
PCOS is a lifestyle disease.
Lifestyle changes include:
1. Weight loss: 5 to 10% weight reduction can help to reduce insulin resistance by 50%.
2..Nutrition and dietary changes: Changes in the meal quality, size, time, and frequency. Avoid excess sugar and sweets like chocolates, caffeine.
3. Incorporating exercise in daily routine and strictly avoiding a sedentary lifestyle.
4. Quitting alcohol, smoking, and recreational substance abuse.
5. Regularising sleep: Poor sleep quality is associated with an increased risk of obesity and insulin resistance which plays a key role in PCOS. Sleep modification is one of the important terms of lifestyle modification in PCOS.
It mainly applies to you if you are from the medical or paramedical fraternity where duty hours are not time-bound, from the aviation industry where day and night shifts keep changing, artists from glamour or film industry working at any odd hours of the day, or a student who is appearing for highly competitive exams; working day and night for the best performance… The schedules are hectic, irregular, ever-changing, and strict for them.
1 .Hormonal pills.. Improve your menstrual cycle but may increase your weight.
2. Metformin… originally an anti diabetic drug; it improves insulin resistance and helps to reduce weight and control PCOS.
3. spironolactone it is anti androgen .. reduces the effects of excess male hormones and reduces hair growth, pigmentation., acne and prevents development of muculine body structure with central obesity.
4. Other combination medicines having vitamin d3, myo and chiro inositol may be advised by your gynecologist.
6.For acne;hair growth and pigmentation problems ; you may follow the treatment as advised by your gynaecologist.
7. infertility treatment: If you are planning to get pregnant, your fertility specialist may give you medicines like clomiphene or letroz and/or injections which cause ovulation . Artificial reproductive techniques may be used for the stubborn cases.
Ovarian drilling by laparoscopy is needed when the medications have not been able to control the PCOD problem and you are planning pregnancy.
PCOD treatment involves team efforts. An expert gynecologist in collaboration with a dermatologist, endocrinologist nutritionist, psychologist, physiotherapist, cosmetic surgeon, and bariatric surgeon can help you fight your distressing problem with vengeance.
In a nutshell; Three basic tips to control PCOS:
Maintain a healthy weight. Weight loss can reduce insulin and androgen or male hormone levels; can control the bothersome symptoms caused by excess male hormones like pigmentation, scalp hair loss, acne, excess facial hair growth, and restore ovulation.
Limit carbs and foods with a high glycemic index. Opt for foods with a low glycemic index.
Be active and regularize your daily routine and your biological clock. . Exercise helps lower blood sugar levels.
DIETARY ADVICE FOR PCOS PATIENTS:
Having a high body mass index with PCOS leads to insulin resistance. Insulin is a hormone released by the pancreas and it helps keep the sugar in control. Because of insulin resistance, the body tries to prduce more and more insulin,casuing excess insulin levels which trigger the ovaries to produce excess male hormones.
A diet high in refined carbohydrates such as starchy and sugary foods can cause insulin resistance and therefore weight loss more difficult to control.
FOODS YOU SHOULD EAT ON A PCOS DIET
- All fruits and vegetables
- Whole grains like wheat, oat, quinoa, Jawar, Bajri, brown rice etc
- Plant protein sources like pulses e.g. beans, peas, gram, lentils,chickpeas,tofu,cereals etc.
- Seeds like chia seeds, flax seeds, sunflower seeds
- Unsaturated fats like almonds, walnuts, avocado, olive oils, nut butters
- Fish like salmon. Shrimp, tuna cod
- Lean paultry like skinless chicken, turkey
FOODS TO AVOID in PCOS
- White bread
- White rice
- Packed or cold pressed juices
- Sugary cold drinks aerated or non aerated
- Bottled smothies
- Cakes, candies., cookies and other sweets
- Sweetened cereals
- Yogurts with added sugar
- Ice creams witih added sugar or sugar subsitutes
- Artificial or heavily processed cheese
- Saturated fats like red processed meat like fast food ham burgers
- Trans fats like doughnuts, French fries, pizza
- Cocktails made with sugary mixers like juice or bottled mixers
- Canned cocktails
EXERCISES THAT HELP CONTROL PCOS:
Moderate exercises like brisk walking, jogging, cycling, or swimming are all great activities that help with PPCOS. They increase your body's sensitivity to insulin and control symptoms.
Long term side effects of PCOS
- Endometrial hyperplasia ( Thickening of the inner uterine lining )
- Endometrial cancer ( cancer of the uterine lining )
- High blood pressure
- Depression and anxiety
- High cholesterol levels
- Cardiovascular disease
- Weight gain
- Fatty liver
- Acanthosis nigricans ( Patches of dark skin under arms, thigh crease, neck )
We, at Vardhan hospital, under the guidance of Dr. Dimple Doshi, provide exclusive and complete gynecological management along with a nutritionist s advice. We also provide expert dermatological advice for the bothersome face hair growth problem and acne and suggest you the right treatment for the skin-related problems caused by PCOS.