Ovaries are the reproductive organs of a female that control the menstrual cycle and the production of hormones like estrogen, progesterone, inhibin, relaxin etc.

The accumulation of the eggs, swells the ovary and makes it release large quantities of male hormone thus causing infertility. 

PCOD is a hormonal condition that affects approximately 5- 10% of women their childbearing ages of 12 – 45 years.

While the prevalence of PCOD differs, it affects around 9% – 22% of Indian women.

In this condition, the hormones of a woman go out of balance, which creates various symptoms, including the absence of ovulation, irregular menstrual cycle, difficulty conceiving, weight gain, acne, and hirsutism.

PCOD, also known as PCOS, which is Polycystic Ovarian Syndrome, if left untreated, can lead to further health complications, like diabetes, obesity, heart diseases, and high cholesterol.

The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may lower the risk of long-term complications such as type 2 diabetes and heart disease.

Symptoms of PCOD/PCOS

Symptoms of PCOS often start around the time of the first menstrual period. Sometimes symptoms develop later after you have had periods for a while.

The symptoms of PCOS vary. A diagnosis of PCOS is made when you have at least two of these symptoms:

  • Irregular periods – Having few menstrual periods or having periods that aren’t regular are common signs of PCOS. So is having periods that last for many days or longer than is typical for a period. For example, you might have fewer than nine periods a year. And those periods may occur more than 35 days apart. You may have trouble getting pregnant.
  • Too much androgen – High levels of the hormone androgen may result in excess facial and body hair. This is called hirsutism. Sometimes, severe acne and male-pattern baldness can happen, too.
  • Polycystic ovaries – Your ovaries might be bigger. Many follicles containing immature eggs may develop around the edge of the ovary. The ovaries might not work the way they should.

Cause of PCOD/PCOS

The exact cause of PCOS isn’t known. Factors that might lead to PCOD/PCOS:

  • Insulin resistance – Insulin is a hormone that the pancreas makes. It allows cells to use sugar, your body’s primary energy supply. If cells become resistant to the action of insulin, then blood sugar levels can go up. This can cause your body to make more insulin to try to bring down the blood sugar level.Too much insulin might cause your body to make too much of the male hormone androgen. You could have trouble with ovulation, the process where eggs are released from the ovary. One sign of insulin resistance is dark, velvety patches of skin on the lower part of the neck, armpits or under the breasts. A bigger appetite and weight gain may be other signs.
  • Low-grade inflammation – White blood cells make substances in response to infection or injury. This response is called low-grade inflammation. Research shows that people with PCOS have a type of long-term, low-grade inflammation that leads polycystic ovaries to produce androgens. This can lead to heart and blood vessel problems.
  • Heredity – Research suggests that certain genes might be linked to PCOS. Having a family history of PCOS may play a role in developing the condition.
  • Excess androgen – With PCOS, the ovaries may produce high levels of androgen. Having too much androgen interferes with ovulation. This means that eggs don’t develop on a regular basis and aren’t released from the follicles where they develop. Excess androgen also can result in hirsutism and acne.

Complications of PCOD/PCOS

Complications of PCOS can include:

  • Infertility
  • Gestational diabetes or pregnancy-induced high blood pressure
  • Miscarriage or premature birth
  • Nonalcoholic steatohepatitis
  • Metabolic syndrome
  • Type 2 diabetes or prediabetes
  • Sleep apnea
  • Depression, anxiety and eating disorders
  • Cancer of the uterine lining (endometrial cancer). 
  • Endometrial cancer
  • Abnormal uterine bleeding
  • Untreatable acne, displaying hormonal problems
  • Chronic Liver inflammation

It is found that by the age of forty, approximately fifty per cent of women with PCOD would develop pre-diabetes or would already be diabetic, while many others would face infertility during their childbearing age.

Treatment of PCOD/PCOS

Post-consultation, your doctor would recommend various medications to rectify your menstrual cycle. He may prescribe drugs such as

  • Combinatorial birth control pill – These pills contain progestin and estrogen that reduce the production of the male sex hormones and regulate your hormones that let follicles release the egg, form acne and excess hair growth.
  • Progestin therapy – Your doctor would advise you to take progestin for ten to fourteen days every month or two to regulate and correct your menstrual cycle in this medication.
  • Immature follicles treatment – Your doctor may also recommend immature follicle aspiration PCOS treatment to improve your endocrinology and decrease the number of follicles in the ovary, thus facilitating pregnancy.
  • Your doctor would prescribe drugs such as clomiphene, letrozole, metformin, and gonadotrophins to improve ovulation.
  • To help reduce increase hair growth, your doctor would prescribe various birth control pills, spironolactone, and eflornithine.
  • Although surgery is not the immediate options of choice, your doctor, in severe cases, may perform laparoscopic ovarian drilling, which would help trigger ovulation,  that is the release of the egg from the ovaries.