PCOS/PCOD

PCOD or PCOS affects women’s ovaries, the reproductive organs that produce progesterone and estrogen hormones that regulate the menstrual cycle along with small amounts of inhibin, relaxin, and male hormones called androgens.Around 10% of women around the world suffer from PCOD. Women with PCOS produce more male hormones than women with PCOD. Their hormone imbalance causes them to skip menstrual periods and makes it harder for them to become pregnant.

A woman with PCOD (Polycystic Ovarian Disease) develops cysts in her ovaries over time as a result of her ovaries producing immature or partially mature eggs in large numbers. Consequently, the ovaries become large and secrete a large amount of male hormones (androgens), causing infertility, irregular menstrual cycles, hair loss, and abnormal weight gain. Diet and lifestyle modifications can help control PCOD.

PCOS (Polycystic Ovary Syndrome) is a metabolic disorder in which a woman experiences hormonal imbalance during her reproductive years (between ages 12 to 51). Increased male hormones can cause females to skip menstrual periods, have irregular ovulation, have difficulty getting pregnant, and experience abnormal hair growth on the body and face at the same time. This can lead to cardiovascular disease and diabetes. PCOS is a serious, medical condition that requires appropriate medical care or surgical treatment.

Facts

• Women with PCOS are more likely to require a cesarean delivery because their babies are likely to be larger than expected for their gestational age.
• They have higher rates of anxiety and depression than women without the syndrome.
• High level of testosterone can build muscle easier in PCOS Women than women without the syndrome.
• Sleep disturbances have been found to be twice as common in women with PCOS compared with those without.

PCOS symptoms differ with age in women. While younger women suffer from mood swings and irregular, light, or missing menstrual cycles, elderly women suffer from metabolic disorders such as weight gain and insulin resistance. Depending on one’s health, the severity of the symptoms varies as well. Some women notice symptoms around the time of their first period, while others don’t until they’ve gained a lot of weight or are having problems getting pregnant.

Following are the most common  symptoms of PCOD or PCOS in women:

• Hirsutism (Excessive Hair growth on the face, and body – including on the back, belly, and chest)
• Infertility
• Skin darkening (Neck, the groin, and under the breasts)
• Acne (face, chest, and upper back)
• Irregular Periods
• Weight gain
• Fatigue
• Pelvic Pain
• Hair loss (Male-pattern baldness or thinning hair )

Sometimes we take PCOS/PCOD symptoms from something else because its symptoms are similar to those of many other medical conditions. Some of the False conditions include:

• Hyperprolactinemia
• Thyroid disorder
• Endocrine disorders
• Ovarian cancer
• Adrenal hyperplasia

If you’ve missed periods or have similar PCOD / PCOS symptoms including hair growth on your face or body, or if you’ve been trying to conceive for 12 months or more without success, please consult a doctor.

Lab tests are a complete analysis of your whole body. Blood tests are done:

• To diagnose any kind of symptoms.
• To find out how well our organs are working.
• It can monitor chronic health conditions and diseases and find out problems in their early stages.

To Diagnose and monitor PCOS/PCOD some of the following tests are :

• Insulin fasting
• Glucose-Fasting Blood (FBG) Test
• Luteinising hormone (LH)
• Thyroid stimulating hormone (TSH)
• Follicle stimulating hormone (FSH)
• Prolactin
• Total and free testosterone levels
• Beta HCG

Although the exact cause of PCOS in women is unknown, the following are some important aspects to consider :

Hormonal imbalances

Hormonal imbalance is thought to be one of the leading causes of PCOS. PCOS can affect women in their reproductive years if they have any of the hormonal disorders listed below.

• Increased Prolactin levels
• Increased Testosterone levels
• Increased Luteinizing hormone (LH) levels
• Decreased Sex hormone-binding globulin (SHBG) levels

Genes

Because PCOS has been found in women with a family history of the disease, it is thought that it may be passed on from generation to generation. The actual genes that cause PCOS have yet to be discovered by researchers. However, one of the possible causes is the role of genes.

Low-grade inflammation

According to research, Women with PCOS have a form of low-grade inflammation that causes their polycystic ovaries to produce androgens, which can cause heart and blood vessel problems.

Here are some factors that may contribute to or increase your risk for the syndrome:

Family history

Because no single gene has been identified as causing PCOS, the relationship is most likely complex and involves numerous genes. Women with PCOS are 50% more likely to have a female relative with PCOS, such as their mother, aunt, sister, or daughter. Families with PCOS are more likely to have type 2 diabetes.

Androgens

The ovaries are unable to release eggs (ovulation) due to high androgen levels, resulting in irregular menstruation periods. Small, fluid-filled sacs can form in the ovaries as a result of irregular ovulation. Acne and excessive hair growth are also symptoms of high androgen levels in women.

Insulin resistance

Insulin is a hormone the pancreas produces to help the body use sugar from foods for energy. If your cells become resistant to insulin, your blood sugar levels may rise, and your body may create more insulin to compensate. Although not all people with insulin resistance have high blood sugar or diabetes,  insulin resistance can lead to diabetes. Excess insulin stimulates the production of androgen hormones in the ovaries.

PCOS cannot be diagnosed just based on symptoms. PCOS is a complicated endocrine disease. Before a PCOS diagnosis is verified, blood tests to determine hormone levels, an ultrasound to look at the reproductive organs, and a complete personal and family history will be required.
Your doctor may ask you to get the Polycystic Ovarian Disease Panel done. This includes the following tests to determine whether or not a medical issue exists :

• Fasting glucose level: A blood sample is taken for this test after an overnight fast (12 hours). A test result of less than 100 mg/dL is considered normal, while readings of 100 to 125 mg/dL indicate that the person is prediabetic, and 126 mg/dL or higher indicates that the person has diabetes. If you have PCOS, you’re more likely to have high glucose levels.
• Insulin fasting: This test measures the level of insulin in the body and determines whether or not the person is insulin resistant. This test also necessitates a 12-hour fast before sample collection. Insulin resistance is common among PCOS women.
• Luteinising hormone (LH): In men and women, this hormone regulates the function of the testes and ovaries. It measures the amount of luteinizing hormone in a woman’s blood to determine if her menstrual cycle is normal. Ovulation increases the level of luteinizing hormone in the body. A higher level of luteinizing hormone may indicate PCOS.
• Testosterone Total: This test allows your doctor to determine the level of testosterone in your blood, which is the major sex hormone in men. PCOS can be diagnosed by high testosterone levels.
• Thyroid stimulating hormone (TSH): Thyroid-stimulating hormone (TSH) is measured in the blood in this blood test. Patients with PCOS are more likely to suffer from hypothyroidism, including the autoimmune disease Hashimoto’s thyroiditis. Hashimoto’s disease is an autoimmune condition in which the body attacks and damages the thyroid gland, resulting in hypothyroidism.
• Follicle stimulating hormone (FSH): This test measures the amount of FSH in your blood, which is important for controlling menstruation and egg growth in women. PCOS may affect your FSH levels.
• Prolactin: Prolactin is a pituitary hormone that stimulates and sustains milk production in nursing mothers. Prolactin levels are usually normal in women with PCOS, generally less than 25 ng/mL. However, it is important to check for high prolactin levels to rule out other problems, such as a pituitary tumor, that might be causing PCOS-related symptoms. Some women with PCOS do have elevated prolactin levels, typically falling within the 25–40 ng/ml range.
• DHEAS (dehydroepiandrosterone sulfate): DHEAS (dehydroepiandrosterone sulfate) levels in the blood are measured using a DHEAS test. DHEA sulfate, a steroid hormone produced by your adrenal glands, is found in both men and women. Most women with PCOS tend to have high DHEA-S levels.

Treatment for PCOS is determined by a variety of circumstances, including your symptoms, medical family history, other health concerns, and whether or not you want to become pregnant. PCOS is not curable, however it can be managed with drugs and lifestyle improvements.

• Medications to regulate ovulation: Anemia, hirsutism, and menstrual abnormalities are among the conditions for which pharmacological therapies are used. The most common first-line medical treatment is an oral contraceptive to produce regular menses..
• Ovarian drilling: A laparoscopic procedure called ovarian drilling involves destroying the androgen-producing tissue within the ovaries with a laser or electrocautery. It is considered the last option for PCOS patients who have failed to respond to hormonal therapy.
• Weight control and healthy diet: Doctors recommend dietary and lifestyle changes before using hormonal birth control pills to promote overall health. Dietary modifications can help you maintain a healthy weight and glucose levels, which can help you control your menstruation.
• Supplements: Inositol, for example, is frequently recommended to help increase ovarian function and regulate periods, making it easier to conceive. Citrus fruits, legumes, brown rice, and wheat bran all contain inositol, a vitamin-like compound. Supplementing with omega-3 fatty acids can also help to minimize the risk of inflammatory illnesses and depression. Supplementing with chromium can help lower blood sugar levels and increase insulin sensitivity.