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.
Dr. Dimple Doshi at Vardaan Hospital; believes prevention is better than cure, and thus apart from the precise treatment guidelines; preventive measures are an essential part of our consultations with the patients who have either had it or want to know more about it.
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.
Though PCOD and PCOS are used as if they are same; there are many differences between the two:
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.
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.
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.