Polycystic ovarian syndrome is a syndrome which affects 10-15% of the women. It is is a multi-factorial disorder, which leads to irregular menstrual cycles and elevated levels of male hormone in a female body. These women are generally obese, have menstrual irregularities, are infertile, have excessive facial hair and acne. Their ovaries have a typical picture on sonography. It is seen that the women with PCOS have increased levels of Androgens i.e. the male hormone due to an increase in the Luteinizing Hormone(LH).
PCOS is the new epidemic worldwide. One out of every four girls suffers from it. Not only young girls but even middle aged women may be affected by the problem of PCOD. This is a problem that often runs in families and the mother and daughters may both be affected as there is a strong genetic component in its inheritance
The increased levels of male hormones can sometimes cause excessive hair growth at unwanted places over body, acne, and male-pattern hair loss.
PCOS can increase a woman's risk of other health problems like obesity, heart disease, diabetes and endometrial cancer over time.
There is no complete cure for PCOS, but a number of treatments are there that can control the progress of the disorder.
Reproductive system abnormalities — It has been proposed that there is some alteration in the pituitary hormones luteinizing hormone (LH) along with high levels of male hormones (androgens) that interfere with normal function of the ovaries.
Insulin abnormalities — PCOS is associated with:
Symptoms of PCOS usually begin around puberty and vary from woman to woman. Common symptoms are:
Menstrual irregularity — Majority of the cycles in PCOS are anovulatory, which means that ovulation doesn’t occur in all the cycles. The absence of ovulation results in thickening of the endometrial lining of the uterus, which ultimately sheds irregularly, resulting in heavy and/or prolonged bleeding. Irregular menstrual cycles if left untreated, can increase a woman's risk of endometrial cancer.
Menstrual irregularity — Majority of the cycles in PCOS are anovulatory, which means that ovulation doesn’t occur in all the cycles. The absence of ovulation results in thickening of the endometrial lining of the uterus, which ultimately sheds irregularly, resulting in heavy and/or prolonged bleeding. Irregular menstrual cycles if left untreated, can increase a woman's risk of endometrial cancer.
Weight gain and obesity — Weight gain and obesity are seen in almost half of women suffering from PCOS. It can develop at any point of time starting as early as puberty.
Hair growth and acne - Excessive hair growth (hirsutism) may be seen on unwanted areas like upper lip, chin, neck, chest, abdomen, inner thigh etc.This is due to increased levels of male hormone in the body. For the same reasons, acne is also commonly seen in women with PCOS.
Infertility — Anovulatory cycles are common in PCOS. This usually results in sub-fertility and infertility in women.
Heart disease — women with insulin resistance or diabetes have an increased risk of heart attack. PCOS can result in weight gain and insulin resistance, thus increasing the risk for heart disease.
Sleep apnea —It may occur in up to 50 percent of women with PCOS. In this condition there are brief spells of apnea during sleep, which results in daytime sleepiness fatigue.
For confirming the diagnosis of PCOS, a woman should have any two out of three of the following criteria:
Pregnancy test, prolactin level and thyroid-stimulating hormone (TSH) levels are recommended for ruling out other causes of irregular cycles.
Once PCOS is confirmed, blood glucose and cholesterol testing are usually performed. An oral glucose tolerance test (OGTT) is the preferred test for diagnosing prediabetes and/or diabetes. Blood tests for testosterone and dehydroepiandrosterone sulfate (DHEAS) are recommended in women with moderate to severe hirsutism (excess hair growth).
The treatment of PCOS is based upon the symptoms. The choice of treatment will depend on the individual patient’s symptoms and goals.
Weight loss — It is the first line of management in patients with PCOS. Losing even 5 to 10 percent of the body weight results in regular periods. Weight loss can often be achieved with a combination of both diet and exercise. In resistant cases, medicines and weight loss surgery can be of help.
Oral contraceptives — Combined Oral contraceptives are the most commonly used treatment for regulating menstrual periods in women with PCOS. They induce monthly periods and protect the woman from endometrial hyperplasia or cancer. These are also effective in treating hirsutism and acne along with providing protection from pregnancy. OCPs can be used in combination with anti-androgens to reduce the hair growth and acne.
Progestin — Progesterone when taken for 10 to 14 days every 1 to 3 months induces regular cycles but neither does it address the cosmetic concerns (hirsutism and acne),nor provide any contraception. It does reduce the risk of endometrial cancer.
Hair treatments — In PCOS, initially a combined contraceptive pill is prescribed for first few cycles. If the hormonal treatment results in a satisfactory reduction in excess hair growth, this therapy is continued. In cases of unsatisfactory results, antiandrogen can be added. Excess hair growth body can be removed by shaving,epilator or laser therapy.Scalp hair loss can be treated with medications, hair transplantation and wigs.
Metformin — — It is useful in PCOS with obesity and with deranged sugar levels.
There are women with PCOS in whom conceiving is the major problem . Their treatment is totally different. Infertility in an affected woman is very effectively treated with fertility enhancing drugs like Clomiphene Citrate, Letrozole, Metformin, and hormone injections like Human Menopausal Gonadotropins, Follicle Stimulating Hormone and Recombinant FSH that help in the maturation and release of the egg from the ovary. The fertility enhancing drugs are also called Ovulation inducing drugs. When the woman is on these drugs her follicular response is judged by performing serial ultrasonographies which monitors the maturation and release of the egg from the ovary. Apart from these ovulation inducing drugs, reduction of weight remarkably improves both the ovulatory and consequently the pregnancy rates.
Laparoscopic drilling of the polycystic ovaries is an option which benefits an affected woman who does not respond to ovulation inducing drugs. In laparoscopic ovarian drilling, both the ovaries are drilled with an energy source and about 4-6 punctures are made. The ovary is immediately cooled with a sterile Ringer solution. Laparoscopy also has an advantage that the fallopian tubes can be tested at the at the same sitting. Also any associated pathology like a tubal block can be corrected at the same sitting.
Laparoscopic ovarian drilling has many advantages. About 30-40% of the women will conceive naturally after this procedure. The follicular response to ovarian stimulation with drugs also improves. The dose of hormonal injections required is less. The abortion rate and the rate of hyperstimulation with hormonal injections is also less.
Many of these women become pregnant either with simple treatment or with test tube baby treatment (IVF) but there is also a high miscarriage rate in women with PCOS.
The treatment for PCOS as explained by Dr. Shweta will include birth control pills to normalize and regularize the periods, medications to control diabetes and cholesterol, and hormones to increase fertility. This disorder can occur any time in a female’s life. It should be treated well in time to avoid bigger health risks like cancer or heart diseases.
Above all patients with PCOS require a boost to their confidence as they may have serious emotional issues with their hair growth, acne and obesity. Dr Shweta Mishra provides good counseling and motivation beside the medical approach to these patients to meet their goals.She will do an in-depth assessment of your health and hormonal status for bringing you into a state of hormonal balance, including natural therapies. She will spend the time needed to answer your questions and educate you regarding what you need to do.
Dr. Shweta Mishra is the best gynaecologist for pcod/pcos Treatment in Ghaziabad. Get in touch with Dr. Shweta Mishra at her Crossings Republik, Ghaziabad (Crossings Republik Clinic Location & Direction) clinic for PCOD/PCOS Treatment in Ghaziabad, or either at Amrapali Icon Leisure Valley, Greater Noida West (Noida Extension Clinic Location & Direction) clinic for PCOD/PCOS Treatment in Noida Extension. Also, you could make a wellness appointment at any clinic location convenient to you.
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Disclaimer: The content on this website is only intended for educational purposes and to create knowledge amongst masses about women's health and obstetrics & gynaecology. Hence, no information issued on this website shall be treated as an alternative to consultation from a certified obstetrician & gynaecologist. The results can vary from women to women depending on their specific health conditions.
