PCOD (Polycystic Ovarian Disease)

PCOD, or Polycystic Ovarian Disease, is a common hormonal disorder affecting women of reproductive age. It is characterized by the presence of multiple immature eggs (follicles) in the ovaries, which can lead to a range of symptoms and long-term health risks.

Key Features and Symptoms

• Irregular periods: Due to disrupted or absent ovulation, leading to unpredictable menstrual cycles.


• Excess androgen: Higher levels of male hormones can cause symptoms such as excessive facial/body hair (hirsutism), acne, and scalp hair thinning.


• Polycystic ovaries: Ovaries may appear enlarged with many small, fluid-filled follicles on ultrasound, though not all women have visible cysts.


• Infertility: Difficulty conceiving is common due to irregular or absent ovulation and poor egg quality.


• Weight gain or obesity: Many women with PCOD experience weight gain or have trouble losing weight.


• Other symptoms: Skin pigmentation changes, oily skin, and male-pattern baldness.

Causes and Risk Factors

• Genetics: Family history increases risk; about 50% of women with PCOD have a close female relative with the condition.


• Insulin resistance: Seen in up to 70% of women with PCOD, leading to increased insulin and androgen production, worsening symptoms and increasing risk for type 2 diabetes.


• Lifestyle factors: Obesity, poor diet, and lack of exercise can exacerbate symptoms.


• Inflammation: Higher levels of inflammation are often found in women with PCOD and may worsen hormonal imbalances.

Diagnosis

Diagnosis is based on clinical symptoms, blood tests (for hormone levels and insulin resistance), and ultrasound findings of polycystic ovaries. A diagnosis is usually made if at least two of the following are present: irregular periods, signs of excess androgen, or polycystic ovaries on ultrasound.

Impact on Fertility

PCOD is a leading cause of infertility in women due to infrequent or absent ovulation and poor egg quality. Insulin resistance and elevated androgens further disrupt ovulation and can affect the course of pregnancy, increasing the risk of complications.

Treatment Options

Treatment is individualized based on symptoms and fertility goals:

• Lifestyle modifications: Weight loss through diet and exercise is the first-line approach and can restore ovulation in many women. Even a 5–10% reduction in weight can significantly improve symptoms and fertility.


• Medications:
  • Hormonal contraceptives: Birth control pills regulate periods and reduce androgen-related symptoms.
  
  
  • Insulin sensitizers: Metformin may improve insulin resistance and help regulate cycles.
  
  
  • Ovulation induction agents: Clomiphene, letrozole, or gonadotropins are used to stimulate ovulation in women trying to conceive.
  
  
  • Anti-androgens: Medications like spironolactone may reduce excessive hair growth and acne.


• Surgical options: Laparoscopic ovarian drilling may be considered for women who do not respond to medication.


• Dietary management: Low-glycemic, nutrient-dense diets are recommended. Avoiding processed sugars, high-carb foods, and unhealthy fats is important.


• Supplements: Omega-3 fatty acids, vitamin D, magnesium, and inositol may help manage symptoms.

Long-Term Health Risks

Untreated PCOD increases the risk of type 2 diabetes, obesity, high cholesterol, hypertension, heart disease, and endometrial cancer.

When to Seek Help

Consult a healthcare provider if you have skipped periods, excessive hair growth, acne, weight gain, or have been trying to conceive for 12 months or more without success.