PCOD (Polycystic Ovarian Disease) or PCOS (Polycystic Ovarian Syndrome) has taken the world of women by storm. It is a major ailment concerning a huge chunk of young females in India presently. PCOD strikes mostly at an early age, therefore, a substantial number of young adults go through this problem. This is a common endocrine disorder of unknown aetiology, affecting 5-10% of women of reproductive age. The average age group suffering from PCOD varies between 18 and 45 years. It is important for the youth to understand this disease at its onset, along with the causes and implications in the future.

PCOD is characterized by multiple small cysts in the ovaries. It makes the ovary enlarged and lead to excessive production of androgen and oestrogen hormones causing various bodily issues.

Causes of PCOD

The cause of PCOD is still unknown. However, the association of PCOD with low-grade inflammation, excess insulin, production of male hormones (Hyperandrogenism) in high quantity and genetics can be found. Also, early age of menarche, unhealthy lifestyle and pollution are some of the contributing factors of PCOD.

Symptoms of PCOD

Watch out for the following common symptoms of Polycystic Ovarian Disorder:

• Irregular periods, occurring every 2 to 3 months (amenorrhea)
• Heavy bleeding (Menorrhagia)
• Unusual body and facial hair growth (hirsutism)
• Stubborn acne that refuses to heal with the usual treatments. This is due to excess peripheral androgen.
• Uncontrolled weight gain around the waist area especially
• Pigmentation or darkening of the skin around the neck region (Acanthosis nigricans)
• Infertility
• Male-pattern baldness
• Headaches

You can have one or all of these symptoms.

A person may be lean or have clear skin but still suffer from PCOD.This is because it is an endocrine disorder affecting several systems in the body. However, the main pathology behind the disease is Insulin Resistance and hyperinsulinemia. Insulin regulates sugar in the body. Insulin Resistance means the inability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues. Hence pancreas produces more insulin to combat the high sugars.

Complications

Uncontrolled PCOD can lead to numerous problems such as difficulty in conceiving, increased risk for early onset of type 2 diabetes. Patients with PCOS who become pregnant are at increased risk for perinatal complications such as gestational diabetes and pre-eclampsia. In addition, they have increased long term risk of endometrial cancers. Other complications include increased cholesterol levels, high blood pressure and even breast cancer.

Treatment of PCOD

The cure is yet to be determined for PCOD. The disease is to be controlled by making lifestyle modifications. And multidisciplinary approach needs to be taken that involves the dietitian, gynaecologist, endocrinologist, dermatologist and infertility expert.

The best way to control and manage PCOD is by ensuring proper weight management. Even a 5% reduction in weight can help a lot in treating the disease. Thus, PCOD patients must exercise on a regular basis and maintain a healthy diet. The diet should be low on sugars and carbohydrates. High protein and high fibre intake are recommended for patients suffering from PCOD.

Rest of the treatment can be done based on the symptoms. Here are the different modalities:

• Medicines are available to treat insulin resistance and balance hormones to correct menstrual cycles.
• Skin treatments are available for acne, pigmentation and hair growth.
•  Fertility drugs are administered to infertile patients.
• Oral medicines and injections are available for ovulation induction and to rupture egg for enhancing fertility.
• Some cases may require Second-line therapy such as aromatase inhibitors, laparoscopic surgery or ovarian drilling.
• Usually, PCOS is treated aggressively for patients who are willing to conceive. Adolescent patients are treated with hormones and metformin to regularize the periods and insulin resistance.

It is to be noted that no medication or line of treatment will help without proper lifestyle changes.

PCOD and Pregnancy

Getting pregnant is not an issue if PCOD is under control. However, poor control of the disease would require medications or Assisted reproductive technology (ART) with infertility experts opinion.

It is also to be noted that people with PCOD have a limited ovarian capacity in order to produce healthy eggs. Thus, they are advised to opt for an early pregnancy if they want children as advancing age affects the quality of the eggs adversely.