Dr Sunita Gupta's Clinic

Treatment, symptoms and risk factor of PCOS

I’m Dr. Sunita Gupta. I’m a consultant gynaecologist with Max Hospital Saket and Panchsheel, and I, in my first video I talked to you about the PCOS and today I’m further going to go into depth on the disease. So, third symptom is excessive facial hair on the face and the body. That is also again because of the male hormone circulating in the blood, and again, the treatment remains contraceptive pills. So most of the patients respond to contraceptive pills, but it can take up to six months to show its effect, and whatever hair is already there on the skin that will not respond and the fresh hair will stop coming with this treatment. Whatever hair is already there has to be treated by the skin specialist, so they can advise laser treatment or any beauty treatment for that, or some local creams are also there to reduce the facial hair.

And the fourth symptom is irregular cycles. Irregular cycle are also because of the male hormones in the blood. They also respond very well to contraceptive pills, but sadly not all patients need to take contraceptive pills for irregular cycles, sometimes if you correct the insulin resistance which is the basic cause in polycystic ovary, then also the cycles can become irregular also, can become regular, and so we can give them Metformin or some insulin, some medicines which can tackle the insulin resistance, which is the basic cause of obesity. And sometimes patients with polycystic ovary have excessive hair fall, which is also related to the male hormone in the blood, and if we correct the PCOD the hair fall stops, and it can take up to three months to respond.

In Polycystic ovary patients, because of the male hormone in the blood, the egg formation doesn’t occur properly and that’s why they often have infertility problem, and they may have difficulty in conceiving. If normally paints have egg formation every month, in polycystic ovary patients they may have egg formation in three months, six months, so they take all that longer to conceive. So we have medicines that induce egg formation and if we correct the PCOD, then also egg formation, if we lose weight and regular exercise by that alone so many patients start ovulating every month and they can conceive. The hormones become alright. Because it has to be a perfect cocktail of hormone in your blood, then only it becomes favorable for egg formation and for conception. So that can happen only if with regular exercise and dieting.

Sometimes you may need treatment for egg formation and infertility also occurs because the lining of the uterus is thin in these patients. Again because the progesterone hormone is less in these patients. So we may need to give them progesterone hormones in the second half of the cycle to improve their chances of conception. PCOS patients also have more chances of abortions in the first three months of pregnancy, because they have less of progesterone hormone in their blood, and that is required for so that the seed can make its roots properly in the uterus, so we need to give they progesterone supplements sometimes if they even need estrogen supplements or even some medicines to improve the blood flow in the uterus.

So even the PC or the male hormone have to be kept under control so that the baby can grow properly. For that we need to give them something to control the insulin resistance so that automatically the male hormones in the blood go down. So first three months are very crucial for PCOS patients. If the first three months can be tackled, then the rest of the pregnancy normally goes uneventful. So that is all about PCOS I wanted to share with you.

And if you want to consult me any further, you can consult me on Lybrate.com, or you can consult directly in Max Hospital Saket.

Brief knowledge about causes of PCOS

I'm Dr. Sunita Gupta. I'm Consultant Gynecologist at Max Hospitals, Saket, and Panchsheel. Today I'm going to talk about Polycystic Ovarian Syndrome.

Polycystic Ovarian Syndrome consists of three symptoms. One is Anovulation. Anovulation means there is no egg formulation in the ovary. Second is Hyperandrogenism which an is excess of male hormones in the body, and third is Cyst in the body which is visible in the ultrasound. So the main symptoms of Polycystic Ovarian Syndrome are obesity. Most of the patients of Polycystic ovary have obesity. Obesity worsens the Polycystic Ovary Syndrome and it is a vicious cycle and Polycystic Ovarian people have more obesity because what happens is that the female hormones get deposited in the fat and that's why there is deficiency of female hormone in blood of Polycystic patients and all that's why the male hormones starts dominating the system and all the male symptoms start appearing like acne, hair on the face or on he body, excessive hair on the body, irregular cycles. So, obesity is the main culprit in the patients. So, if they lose weight then all the symptoms regress because the hormone in the fat goes back to the blood and all the hormonal imbalance gets corrected and all the acne and facial hair everything will disappear.

Second thing is acne which is very common in Polycystic Ovarian patients. So many times patient go to a skin specialist for acne treatment and then they discover they have Polycystic Ovarian Syndrome. So for acne is again because of male hormones in the blood and sometimes it a response to local applications which the skin specialist gives to them. But sometimes they need to take hormonal treatment. We give the oral contraceptive pills to these patients for correcting the acne. Basically the oral contraceptive pills have perfect combination of female hormones which your body, ovary should be producing. But the in case of Polycystic ovaries the ovary is producing more of male hormones, little bit more male hormones.

So once we give pills from outside the body gets the signal that there are enough hormone in the blood and there is no need to make any more hormone. So the ovaries stops working and the male hormones also stop getting formed and all the symptom then gets regressed till the patient is on he pills. Once the patients stops the pills again the ovaries take over, again the male hormone starts getting formed by the ovaries and again the symptoms may slowly appear. So once the patient has been kept on OCPs for 6 months she may become alright for 1-2 years and again the symptoms may come back.

So Polycystic Ovary disease is a not disease which can be cured by a 6 months treatment or a one week treatment like any fever or antibiotic you give and the patient becomes alright. This is a lifestyle disease which is going to be there for the rest of your life. You can keep it under control by having a healthy lifestyle or maybe taking some medication if required or you if let it go if you allow yourself to gain weight then it can become worse and get out of hand.

If you want to know anything more about PCOS you can contact me on Librate.com or Max hospital, Sanket and Panchsheel.