21 Jul Understanding Polycystic Ovarian Disease
Poly Cystic Ovarian Disease is also known as Poly Cystic Ovary Syndrome, PCOD, or PCOS in short. It is globally prevalent in 4%-8% of women in the reproductive age group. The condition affects the endocrine system of the female which eventually impacts metabolic as well as cardiovascular health.
The clinical representation of PCOD varies individually for most women. Menstrual disturbances, clinical manifestations of hyperandrogenism and infertility are the common reasons for seeking medical assistance. Although 30% of women with Poly Cystic Ovarian Disease will have normal menses most complain of scanty or lack of menstruation.
It is observed that about 70% of women with PCOD have Hirsutism. This is a common clinical presentation where hair growth is observed at seven sites: upper lip, chin/face, chest, back, abdomen, arms, and thighs.
The major health concern of OCOD is infertility which affects 40% of women with PCOS.
What are the reasons for developing PCOD?
A family history of PCOS is a risk factor and a high prevalence of PCOD is observed in daughters if a mother has the same.
Obesity is also marked as one of the primary causes of Poly Cystic Ovarian Disease.
Type 1, Type 2, and gestational diabetes have been associated with an increased prevalence of PCOS.
In adolescent girls, there are few contributing factors associated with increased risk of PCOD. One of the main factors includes high birth weight in girls born to overweight mothers. Also, congenital virilization, low birth weight, premature pubarche, atypical central precocious puberty, obesity syndromes, acanthosis nigricans, and metabolic syndrome are all risk factors found in teenage girls.
It is observed that women with PCOS are also at increased risk of a number of mental health disorders including depression, bipolar disorder, anxiety, and eating disorders.
Hirsutism is associated with PCOD. Physical manifestations include acne, hair growth at unwanted areas, and alopecia. Generally, oral contraceptive pills (OCPs) are first-line for pharmacologic management of hirsutism in premenopausal women. Today, women can opt for laser hair removal and other mechanical hair removal options to improve cosmetic appearance.
PCOD is marked with increased insulin resistance or insulin sensitivity. Metformin and thiazolidinediones have insulin-lowering effects by improving insulin sensitivity. There is a decrease in circulating androgen levels by taking these medications under guided prescription.
Experts advise that weight loss can also improve circulating androgen levels providing numerous other metabolic benefits for patients with PCOD.
Regular exercise to reduce insulin resistance, high fiber, and moderate protein, a low-fat diet is recommended to treat symptoms associated with PCOD.
Proper diagnosis and management are essential as PCOD has several potential metabolic and cardiovascular risks if not managed appropriately. It is observed that the treatment is focused on individual symptoms but not the syndrome itself. It is suggested that the understanding of the pathophysiology of PCOD by the patient will help them comply with all treatment suggestions.
Gynecologist in Delhi, diet educator, as well as alternative therapy experts, are required to improve the overall well being of women with PCOD.