PCOD/PCOS

Overview

PCOS or polycystic ovary syndrome affects women during their reproductive years. Women with this condition have tiny sac-like structures, called cysts, lined along the outer part of their ovaries. These cysts are filled with fluid and also contain immature eggs. The structures are called follicles and they are not able to regularly release the eggs. This causes women to miss their periods.

PCOS impacts women’s hormones and causes most women to gain weight. In other women, periods may even last for days beyond the usual timeline. The condition may occur when the androgen hormone is produced in the body in high amounts.

The exact cause of PCOS is not known. Early diagnosis and treatment help affected women avoid complications in the future, including risks of heart disease and Type 2 diabetes. Women are also required to switch to a healthy diet and regulate their weight so that the medication works better.

PCOD is a similar condition to PCOS triggering irregularities with periods, but the two are different to a certain degree. For example, PCOD has fewer complications associated with it and its symptoms, treatment methods and causes differ from PCOS.

What is PCOD/PCOS?

PCOS/PCOD is caused when there is an excess of hormones produced by the ovaries. Hormonal imbalance takes place and triggers this phenomenon. Ovaries of women with PCOS produce high levels of the hormone called androgens, which triggers an imbalance of the reproductive hormones. This, in turn, causes the menstrual cycle to become irregular. Upon conducting ultrasounds, follicle cysts may be visible on the ovary linings.

On the other hand, some women may not have such ‘cysts’ despite the name of the condition. Ovarian cysts are not painful or necessarily dangerous, especially if they are treated proactively at an early stage. However, it is important to note that PCOS is a common cause of infertility in a lot of women.

Types of PCOD/PCOS

There are 4 clinically recognised types of PCOS based on how they are caused. The types are listed below:

Insulin-resistant PCOS

Considered to be the most common type, insulin-resistant PCOS is caused by overconsumption of sugar and trans fats, smoking, different pollutants, etc. They trigger high levels of insulin in the body, which obstruct the natural process of ovulation and initiate the production of testosterone in the ovaries.

Pill-induced PCOS

This type of PCOS is also common, caused by the frequent consumption of birth control pills. These pills suppress the natural process of ovulation and it only restarts once the effect of the pills wears away.

Inflammatory PCOS

Inflammatory PCOS is triggered by inflammation due to high levels of stress, environmental toxins and even gluten that prevents ovulation from occurring. Due to this, hormonal imbalance results and androgens are produced in excess.

Hidden PCOS

Hidden PCOS is a straightforward type of PCOS that can be managed effectively with 3 – 4 months of treatment. Iodine deficiency, a vegetarian diet, thyroid disease or increased intake of artificial sweeteners can trigger this type of PCOS.

Symptoms of PCOS/PCOD

Signs of PCOD and PCOS may vary from person to person, ranging from mild to severe. The symptoms are typically more severe in obese people. Some commonly recorded symptoms of PCOS include skipped periods or no period at all, darkened patches of skin, the difficulty experienced with getting pregnant owing to irregular or no ovulation, hirsutism i.e. excess hair growth on the sides of the face, neck or chest, weight gain and bloating, loss of hair from one’s head, thinning out of the hair, acne and oily skin.

One may experience all of the above-mentioned symptoms or most of them to varying degrees. Some women either face difficulties with conceiving or with their menstrual cycle; others find both to be major concerns. These symptoms become apparent once women enter their teens or their 20s. As individuals with PCOS do not ovulate periodically or at all, they run the risk of being infertile (not being able to have biological children).

Causes of PCOD/PCOS

There is no specific cause for PCOS/PCOD. However, there are certain points which have been recognised as possible causative factors. For example, a history of PCOS within the family may be a sign that one may develop the condition themselves. Other than that, high levels of androgen production also interfere with regular ovulation.

Insulin resistance may lead to the development of PCOS. The pancreas makes the insulin hormone, which lets the host use up sugar (a major energy source for the body). When said cells resist the action of insulin, blood sugar levels shoot up, causing the body to produce more insulin (in an attempt to regulate the blood sugar level). The excess insulin may trigger the body to create more androgens, which in turn, obstruct the natural ovulation process.

Finally, low-grade inflammation has been held accountable as a cause of PCOS. The white blood cells produce substances, also known as low-grade inflammation, as a response to an injury or infection. People with PCOS show signs of a low-grade inflammation that is long-term and leads to polycystic ovaries which again, produce androgens. This condition may often lead to problems with the heart and blood vessels.

PCOD/PCOS Diagnosis and Tests

To diagnose PCOS, healthcare professionals conduct a physical exam. If one experiences irregularities with their menstrual cycle and has multiple cysts along the outer edge of their ovaries, the diagnosis is prescribed. Doctors also test for higher levels of androgens by performing blood tests.

More facial and body hair may show up in a person affected by PCOS, and hair shall thin out on the head – these are some symptoms that the endocrinologist takes note of. One's doctor may ask the concerned individual about the regularity of their menstrual cycle. A pelvic ultrasound may also be necessary. Finally, frequent checks of glucose tolerance, blood pressure, triglyceride and cholesterol levels may be recommended alongside testing for obstructive sleep apnea.

PCOS/PCOD Management and Treatmen

PCOS treatment may include medication as well as mindful lifestyle changes. The treatment procedure usually focuses on the management of specific symptoms, depending on which ones particularly affect a person. For example, if obesity is triggering other complications, the doctor will recommend losing weight by switching to a healthy diet and incorporating regular exercise into one's daily routine.

Maintaining a normal weight also boosts the effectiveness of the prescribed medication. Medication may be required to regulate one’s menstrual cycle. Healthcare professionals will prescribe a combination of birth control pills and progestin therapy to protect against cancer of the endometrium.

Preventive Measures for PCOD/PCOS

There are no specific preventive measures one can undertake to prevent PCOS. However, they can manage its symptoms by making certain lifestyle tweaks. For example, one can switch to a healthy, nutritional diet instead of binge eating or indulging in junk food often. Regular exercising shall also help stay strong and full of energy while simultaneously losing a chunk of weight. Plus, it’s recommended that one avoids alcohol and other carbonated, sugary beverages.

Myths and Facts Related to PCOD/PCOS

Here are some myths associated with PCOS/PCOD and the truths behind them:

Myth 1: People with PCOD/PCOS Cannot Get Pregnant
Fact: People with PCOD/PCOS may face difficulties with conceiving but it is not true that they can never get pregnant. Most affected women can get pregnant naturally or with the help of IUI and ovulation induction.

Myth 2: Everyone with PCOD/PCOS is Overweight
Fact: While weight gain is a recognisable symptom of PCOD/PCOS, it is not always recorded. Some people may have PCOS and still not show signs of weight gain.

Myth 3: If I Have PCOD/PCOS, I Will Also Have Diabetes
Fact: With PCOD/PCOS, one is at risk of having diabetes due to insulin resistance. But it is a complication and not an assured result. The progression to Type 2 diabetes can be stopped or at least slowed down with a proper treatment regime in place.