Polycystic Ovary Syndrome (PCOS)

Hi,

I am Dr. Surekha P. Mathkar, Gynaecologist, Mumbai. Today I will talk about PCOS. It affects 20% of the female in the reproductive age group. It is a multispeciality problem because the patient may have a reproductive problem, psychological problem, metabolic problem. The causes aren't known but genetic factors can cause this problem. Either mother has suffered from PCOD or family has a history of diabetes. The root cause is insulin resistance. In this problem, hormones get disturbed which causes improper follicle formation. And follicle doesn't rupture and ovulation doesn't happen. This leads to irregular menstruation. So, how does the patient commonly present or when you can the patient as PCOD patient? The criteria can be anovulation, incidence, evidence of clinical or biochemically hyperandrogenism and ultrasound picture of PCOD. Any 2 out of these criteria are present, the patient is diagnosed as PCOD patient.

But in adolescence, these all 3 criteria need to be present because in them the physiological picture is different. I was worried about this topic because right from teenage ith irregular menstruation patient can come. Adolescence can have prolonged periods followed by heavy bleeding which doesn't stop with medicines. Later patient has got a fertility issue. If she conceives then the problem will be like hypertension, gestational diabetes and later part life, the patient may have dyslipidemia, obesity, diabetes, and cardiovascular complication. Once PCOD is stuck to your body, remember, it is always PCOS. Don't get scared. There are many ways to help you. There are ways to tackle the situation. Before you go for the treatment, I would like to tell you, how do we diagnose? Hormonal levels will be done, your follicles will be checked. Thyroid tests are done. Ultrasound picture has to diagnosed as I mentioned earlier of PCOS. Besides this, there are other causes of hirsutism which has to be ruled out before labeling you as PCOS. For treatment, the most important is lifestyle management.

Why the incidences have increased over the days. Because obesity has been increased, lack of exercise, junk food. So, lifestyle management is the key to success. Now Drs will prescribe you the most common medicines like oral contraceptive pills. Basically, these are hormones which your body should have taken care of. Besides this, it maintains the cycles of your periods and patients are quite comfortable with it. When you want fertility, very good medicines are available. Injections can have very good ovulation induction. If nothing is working then you may have to go for a test-tube baby. PCOD patients give an excellent number of eggs. So, you have something which is very good. For donors also we look for PCOD patients. If nothing is working then we do ovarian drilling through laparoscopy which helps in ovulation. Post reproduction as I mentioned right from the beginning, is totally in the patient's hand. Try to maintain your weight. Have good control of your diet. SO that your diabetes, hypertension, cardiovascular complications can be better resolved. And always be under the guidance of the Dr who will help you in all the aspects.

Thank You!