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Overview of PCOD
Obstetrics and Gynaecology

Overview of PCOD: Understanding and Managing Polycystic Ovary Disorder

admin Sep 23, 2024

Polycystic Ovary Disorder, or PCOD, is a hormonal disorder usually reported in younger women of reproductive age. This disorder showcases various symptoms, including irregular menstrual cycles, development of ovarian cysts, elevated testosterone levels and physiological stress. If these symptoms are ignored, it can lead to many complications, such as infertility. 

Hence, it is essential to know its symptoms and consult a healthcare provider in the early stages to rule out the cause. In fact, as per WHO reports, 70% of PCOD cases go undiagnosed, with delayed diagnosis leading to various co-morbidities, making treatment complex and challenging. Hence, awareness of PCOD symptoms is crucial for early diagnosis and overall health management.

What is PCOD? 

Polycystic Ovary Disorder (PCOD) is a condition where the ovaries in a woman’s body overproduce immature eggs due to hormonal imbalance.  The word polycystic indicates the presence of several small cysts that develop in the ovaries. Although these cysts are individually benign or not harmful, they can cause hormonal disorders and fertility-related complications in the patient. 

These cysts enlarge in the ovaries and produce elevated levels of male sex hormones called androgens. Due to this hormonal imbalance, various symptoms of PCOD start to appear in women and due to lack of awareness, it often goes unnoticed, resulting in complications in later treatment. To raise awareness and to ensure knowledge of these potential symptoms, below are some of the common symptoms of PCOD:

What are some common symptoms of PCOD? 

Symptoms

Description

Irregular menstrual cycles

This can be prolonged menstrual or missed cycles, once every 3-6 months.

Growth of excess hair (hirsutism)

 

Development of more than average amounts of undesired hair on the face and body.

Acne

 

Frequent appearance of pimples that do not respond to traditional therapies.

Weight gain

 

Difficulty in losing weight, particularly in the belly area.

Thinning hair

 

Gradual hair loss from the scalp resembling male-pattern baldness.

Infertility

Difficulty in conceiving due to irregular ovulation.

Skin darkening

Dark patches under the neck, around groins or underneath breasts.

What are some causes and risk factors of PCOD?

Cause/Risk Factor

Description

Genetic predisposition

Family member with a history of PCOD or related hormonal conditions.

Obesity

Obesity increases the risk of hyperandrogenaemia (elevated levels of androgens) and metabolic disorders.

Insulin resistance

Insulin resistance, which is linked with obesity, also causes excess production of androgens, leading to PCOD.

Sedentary lifestyle

A sedentary or inactive lifestyle often leads to obesity and other mood swings, making it a critical factor for PCOD.

Food and Diet

Consuming processed foods and foods with high trans fats can lead to obesity, which in turn is a cause of PCOD.

Hormonal imbalances

Elevated levels of male sex hormones known as androgens can lead to PCOD.

What is the difference between PCOD and PCOS?

  • PCOD: In Polycystic Ovary Disorder, the ovaries contain many small, immature or partially mature eggs, eventually becoming cysts. This condition arises from junk food, being overweight, stress and hormonal disturbances. Irregular menstruation, spontaneous weight gain in the abdomen region, infertility and baldness resembling a male pattern baldness are the common symptoms. In PCOD, infertility is one of the complications which can be cured with lifestyle changes and hormonal therapies. Other than infertility, PCOD does not have a severe impact on endocrine health or cardiovascular health.
  • PCOS: Polycystic ovarian syndrome is characterised by ovarian hyperandrogenism, which means the overproduction of androgens by ovaries, resulting in improper androgen secretion. This causes ovaries to disturb the regular ovulation cycle and stop releasing eggs, leading to infertility. PCOS can lead to high-risk pregnancy cardiovascular and metabolic conditions such as diabetes and hypertension.

How is PCOD diagnosed?

The diagnostic approach for PCOD usually involves a medical history review, physical examinations, and a range of tests and imaging studies. Initially, doctors may begin by assessing the patient's complete medical history and conducting physical examinations, such as examining hair growth and checking for abdomen pain. 

They may also evaluate skin conditions like acne and darkened patches, measure body weight and body mass index (BMI), and examine patient blood pressure. The doctors may advise some investigations to check the levels of androgens and rule out the reasons for irregular periods and polycystic ovaries. A thorough assessment helps to rule out other conditions with similar symptoms.

Overview of diagnostic processes

Test/Procedure

Purpose

Blood test

To measure hormone levels, including androgens, insulin and thyroid levels.

 

Pelvic ultrasound

To visualise the ovaries and check for cysts.

 

Lipid profile

 

To assess cholesterol and triglyceride levels.

 

When to see a doctor?

It is essential to see a doctor if you experience any of the following symptoms:

  • Irregular periods
  • Excessive acne
  • Overweight and difficulty in losing weight
  • Excess hair growth
  • Difficulty conceiving
  • Unexplained weight gain
  • Family history of PCOD

How to manage PCOD?

To manage the impact of PCOD, affected individuals need to make certain lifestyle changes, take medication, and eventually turn to other remedies. The management of PCOD includes relief of symptoms, prevention and control of complications and enhancement of the quality of life.

Lifestyle changes and diet tips

Recommended Foods

Foods to Avoid

Fruits and vegetables

Processed foods

Whole grains

Sugary drinks

Lean protein

High-fat dairy products

Healthy fats

Fried foods

Fiber-rich foods

Excessive salt and sugar

Focus on:

  • Weight management: Losing excess weight can help alleviate symptoms and minimise future tendencies.
  • Healthy diet: Incorporating fruits, vegetables, whole grains, and lean protein helps control hormones and enhance insulin sensitivity.
  • Low-glycemic-index foods: These foods are complex in nature, digest slowly, do not spike blood sugar, and are suitable for combating insulin resistance. Examples include sweet corn, broken wheat, raw bananas, and whole grains.
  • Limited saturated and trans fats: These fats can cause inflammation and have negative effects on insulin sensitivity, so they should be limited in the diet.

Exercise and physical activity recommendations

Regular physical activity is essential for managing PCOD. It helps improve insulin sensitivity, reduce weight, and improve mood.

Recommendations:

  • Adapt at least 150 minutes of moderate aerobic activity, such as cycling, jogging, running, or brisk walking, in a week.
  • It is also advisable for women to add strength exercises to their exercise regime at least twice a week to build muscle mass.
  • Select the suitable exercise activity as per the body type, as the performed action should give a body a feel of freshness and joy. For instance, if an individual feels difficulty in performing stretching exercise, then a simple walk for 30 minutes will work. Swimming is an excellent alternative for those with joint issues. 

Medications and treatments for PCOD

Treatment Option

Benefits

Potential Side Effects

Oral Contraceptives or birth control pills

Regularise periods, control the excess production of androgens and reduce acne.

Increased risk of blood clots, headaches, mood swings and nausea.

Metformin

Improves insulin sensitivity, reduces androgen levels, and may aid in weight loss.

Gastrointestinal discomfort, nausea, and diarrhoea.

Clomiphene Citrate

Stimulates ovulation and promotes fertility.

Multiple births, ovarian hyperstimulation syndrome, and vision problems.

Hormonal therapy

Hormonal therapy works well, when it comes to the treatment of the symptoms related to PCOD. Oral contraceptives can be used to regulate the menstrual cycle, controlling hormonal fluctuation and thereby managing acne relating to androgen excess. Hormonal therapy is not only used to improve quality of life but also used to reduce complications of PCOD in future. Although the treatment is effective, it is important to discuss the potential benefits, risks, and side effects with the doctor.

Natural Remedies and Alternative Therapies

Apart from pharmacological treatment, many women opt for natural and alternate therapies in order to reduce the side effects of medications. Numerous dietary and lifestyle therapies have demonstrated counteractive effects on PCOD. The synergistic activity of these substances has reduced the prevalence of PCOS in many countries. Here are some effective natural approaches: 

Dietary changes

Balanced diet: Based on certain changes in the diet, consumption of low glycaemic index such as fruits, vegetables, lean proteins and whole grains has been reported to control the blood glucose levels.

Anti-inflammatory Foods: Foods that help in minimizing inflammations are commonly witnessed in reducing the insulin resistance in PCOD patients, and hence one should incorporate foods such as berries, fatty fish and leafy green veggies.

Herbal remedies

Spearmint Tea: Spearmint tea, if consumed twice a day, helps reduce androgen levels, and one will also be relieved of hirsutism.

Cinnamon: Cinnamon works like insulin in the body and therefore helps in the strengthening of insulin sensitivity. Including it in your diet is healthy for those people who are suffering from PCOD problems.

Fenugreek: Fenugreek seeds act as an insulin optimiser and are effective in balancing hormonal levels.

Supplements: Adding certain supplements enhances our endurance and performance. Here are some of them

Inositol: Many clinical studies have shown that inositol and its derivatives, especially Myo-inositol and D-chiro-inositol, have beneficial effects on insulin sensitivity and reduce PCOD symptoms.

Vitamin D: Vitamin D deficiency is a critical factor frequently reported in individuals with PCOD. As vitamin D is linked to improve insulin resistance and hormonal status and its deficiency may be the contributing factor to PCOD. 

Omega-3 Fatty Acids: It is evidenced that the anti-inflammatory effects of Omega-3 fatty acid supplements may also reduce menstrual irregularities.

Alternate therapies

While not a substitute for conventional treatment, some natural remedies and alternative therapies may provide additional support in managing PCOD symptoms.

  • Acupuncture and herbal remedies: Some studies suggest that acupuncture and certain herbal remedies might help regulate hormones and improve insulin sensitivity. However, more research is needed.
  • Stress management techniques: Stress can exacerbate PCOD symptoms. Techniques like yoga, meditation, and deep breathing exercises can help manage stress levels, improve hormonal balance and enhance overall well-being.

What are the complications and long-term effects associated with PCOD?  

If the symptoms of PCOD are not treated in time, then the following health problems are most likely to occur in the near future.

  • Impact of PCOD on fertility 

If PCOD is left untreated, it can result in fertility problems due to ovulation, hormonal dysfunctions and high levels of androgens. Although the condition is reversible, as many women with PCOD conceive naturally, some may need help with ovulation induction in the form of medication or even assisted reproductive technologies (ART), like in vitro fertilisation (IVF).

  • Managing weight and insulin resistance 

A healthy diet plan is necessary to lower the PCOD signs and early indications. Weight reduction, with at least 5-10 per cent loss of initial weight, enhances insulin response and menstrual cycling and lessens the probability of developing type 2 diabetes.

Lifestyle Changes

Benefits

Regular exercise

Improves insulin sensitivity, aids weight management

Balanced diet

Helps regulate blood sugar levels, reduces inflammation

Weight loss (if overweight)

Lowers insulin levels, improves ovulation

Reducing refined carbs and sugars

Stabilises blood glucose levels

Risk of type 2 diabetes and cardiovascular diseases 

Women suffering from PCOD will have an increased risk of developing type II diabetes and cardiovascular diseases because of increased insulin resistance and obesity. 

Strategies for Prevention:

  • Maintaining a healthy weight is essential for managing insulin resistance and reducing the risk of type 2 diabetes.
  • Physical activity improves insulin sensitivity and helps prevent cardiovascular disease.
  • A balanced diet low in saturated and trans fats, cholesterol, and added sugars can reduce the risk of cardiovascular disease.
  • Regular blood sugar checks are crucial for early detection of diabetes.
  • Regular blood pressure checks can help identify high blood pressure, another risk factor for cardiovascular disease.

Mental health and emotional well-being 

Living with PCOD can affect mental health, leading to feelings of anxiety, depression, and frustration.

Coping strategies:

  • Seek support: Discuss your emotions with your doctor, friends, family, or other people in the support group you belong to.
  • Practice self-care: If stressed, it is advised to participate in exciting activities to help manage the stress and elevate your spirit.
  • Seek therapy: Cognitive behaviour therapy helps to treat negative thoughts and feelings.
  • Connect with others: Using social media or online platforms, seek out other people that have suffered and overcome the same experience.

What are some measures to prevent PCOD? 

While there is no foolproof way to prevent PCOD, certain lifestyle choices can significantly reduce the risk.

Tips for Reducing the Risk of Developing PCOD

Preventive Strategy

Description

Maintain a healthy weight

Excess weight increases the risk of developing PCOD and its complications.

Engage in regular physical activity

Exercise helps regulate hormones, improve insulin sensitivity, and manage weight.

Follow a balanced diet

Choose nutrient-rich foods like fruits, vegetables, whole grains, and lean protein.

Limit processed foods, sugary drinks, and saturated fats

These contribute to weight gain, insulin resistance, and inflammation.

Manage stress levels

Chronic stress can disrupt hormone balance and increase the risk of PCOD.

Early Intervention Strategies 

  • Seek medical advice if you have any of the identifiable symptoms
  • Discuss potential lifestyle changes, including weight loss and exercise.
  • Regular follow-up with your doctor to monitor your health.
  • Consider appropriate medications and treatments as recommended by your doctor.
  • Be proactive by learning habits that are healthy and take responsibility for your own sickness

Frequently Asked Questions (FAQs) 

  1. What are the early signs of PCOD that I should be aware of?

Avoid junk foods, focus on eating healthy food with a low glycaemic index, exercise regularly, and practice yoga or mindfulness. 

  1. Are there any natural remedies that can help with PCOD? 

Some natural remedies, like acupuncture and herbal supplements, may provide additional support, but it's crucial to consult a doctor before trying them. 

  1. How do I deal with the emotional impact of living with PCOD? 

Living with PCOS can be emotionally challenging. It's important to remember that you're not alone. It is okay to feel anxious or frustrated; however, one can practice some strategies like focusing on progress, not perfection, taking ups and downs as a part of life, and replacing negative thoughts with positive ones. 

  1. What should I expect during a doctor’s appointment for PCOD? 

  The doctor may ask about medical history and perform physical examinations. Further, they may advise certain diagnostic tests to confirm the presence of PCOD.

  1. Is weight loss really important in managing PCOD?

Losing a small amount of weight (5-10%) can improve insulin sensitivity, regulate menstrual cycles, and minimise the risk of other health-related conditions associated with PCOS.

  1. Can PCOD lead to other health problems if left untreated? 

If left untreated, PCOD can lead to infertility, metabolic syndrome, depression or sometimes can lead to endometrial cancer.

  1. What support is available for women with PCOD?

It is important to visit a gynaecologist regularly and schedule time with other healthcare providers, such as an endocrinologist or a nutritionist. Living healthily, performing regular activities, and eating a healthy diet can greatly improve PCOS symptoms.

 

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