PCOS (Polycystic Ovary Syndrome) is a common disease of the endocrine system among women who have attained the reproductive age. Women with this condition generally have ovaries larger in size than the usual, containing small pockets of fluids, also termed follicles. These 'follicles' develop in each of the ovaries as diagnosed with the help of an ultrasound exam. Abnormal or extended menstrual cycles, unusual growth of hair and obesity are some of the common accompanying conditions associated with PCOS. This disorder can interfere with a woman's menstrual cycles, thus making pregnancy difficult. More so, this condition can also impact the way you look and if left untreated for long, can lead to underlying disorders such as diabetes and other cardio vascular diseases.

Causes of PCOS
1. Excessive Insulin secretion: Insulin is a hormone secreted by the pancreas, which allows the body cells to utilize the sugar; the most important energy store of your body. If you suffer from insulin resistance, your body's ability to utilize the insulin gets affected adversely. This forces the pancreas to secrete more insulin in order to keep up with the body's energy supply. This excess insulin might result in an increase in the production of androgen, which in turn, might interfere with the ovulation ability of the ovaries.
2. Low- level inflammation: Inflammation is the process by which your body's white blood cells fight infections. Studies reveal that women suffering from PCOS have a low level inflammation which acts as a catalyst in the production of androgens.
3. Can be hereditary: If you have someone in your family suffering from this syndrome, you might automatically be at a higher risk of developing this disorder.

Symptoms accompanying PCOS
1. Abnormal menstrual is the most commonly observed symptom. Women suffering from PCOS may have less than nine periods in an entire year and in some cases, even none. 
2. Excess secretion of male hormone, which is related to excess androgen production may result in symptoms, such as abnormal body and facial hair, acne and baldness, which is identical to that in men.
3. Unexplained increase in weight and difficulty losing it as well.
4. Another fairly noticeable symptom is depression.
5. Infertility

PCOS- Causes and Symptoms

Q1. What exactly is Laparoscopy?
Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.
Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?
Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.
Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?
Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.
Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?
Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.
Q5. Will there be much pain or discomfort after Laparoscopic Surgery?
There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.
Q6. When can I be discharged from hospital?
Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.
Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?
Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.


Know All About Gynae Laparoscopy Surgery

Polycystic ovarian syndrome or PCOS is a condition in which a woman experiences fluctuation of hormone levels, estrogen, and progesterone which causes cysts in her ovaries, dysfunctional menstrual cycle, cardiac problem, fertility and changes in appearance. Hormones are chemical messengers that can trigger a number of issues in the body. Long term problems due to PCOS can be avoided with an early diagnosis and a proper treatment.

Causes
- Genetics and hormonal imbalance have been identified as the main causes of PCOS although the exact reason has not been discovered.
- Overproduction of androgen, a male hormone in a woman can cause small lumps in the ovaries, irregular development of eggs and abnormal insulin level.

Symptoms
The severity of the symptoms depends on the constitution of the person but the most common one is irregular periods. PCOS occurs when there is a decrease in sex hormones which can lead to the development of certain male features like:

- Deeper voice
- Growth of hair on face, toes, stomach, chest and back
- Reduction in breast size
- Loss and thinning of hair

There are other symptoms as well which can help one to determine the syndrome including:
- Oily skin leading to acne
- Irregular egg formation causing fertility problems and miscarriages
- Depression, anxiety and mood swings
- Hyperinsulinemia, that refers to the presence of too much insulin in the body which can cause obesity
- Difficulty in breathing while sleeping

The severity of the symptoms varies but if you are experiencing any of these problems, it is advisable to seek a professional consultation. A healthy lifestyle, regular exercise, nutritious diets are some of the preventive measures you can take. There are hormone regulating medicines and treatments that attempt to curb the condition but there is no permanent cure.

What is Polycystic Ovarian Syndrome?

The ovaries are mainly made up of 3 kinds of cells.... Most ovarian tumors are epithelial cell tumors. Germ cell tumors start from the cells that produce the eggs (ova). Stromal tumors start from structural tissue cells that hold the ovary together and produce the female hormones estrogen and progesterone.

Types:

The ovaries are made up of three types of cells. Each cell can develop into a different type of tumor:

-Epithelial tumors form in the layer of tissue on the outside of the ovaries. About 90 percent of ovarian cancers are epithelial tumors
-Stromal tumors grow in the hormone-producing cells. Seven percent of ovarian cancers are stromal tumors.
-Germ cell tumors develop in the egg-producing cells. Germ cell tumors are rare.

Causes:

Ovarian cancer happens when cells divide and multiply in an unregulated way. However, exactly why this happens is not clear.

The following risk factors are linked to a higher chance of developing the disease:

*Family history:
Women with close relatives who have had ovarian or breast cancer have a higher risk of developing ovarian cancer, compared with other women. Genetic screening can determine whether somebody carries certain genes that are associated with an increased risk.

*Age:
Most cases of ovarian cancer occur after menopause, and especially in women aged over 63 years. It is rare before the age of 40 years.

*Reproductive history:
Women who have had one or more full-term pregnancies, especially before the age of 26 years, have a lower risk. The more pregnancies they have, the lower the risk.

*Breastfeeding may also decrease the risk.

-Birth control:
Using the contraceptive pill for at least 3 to 6 months appears to reduce the risk. The longer the pill is used, the lower the risk appears to be. Using an injectible contraceptive hormone, depot medroxyprogesterone acetate (DMPA or Depo-Provera CI), especially for 3 years or more, reduces the risk further.

-Infertility or fertility treatment:
Fertility drugs have been linked to a higher risk of ovarian cancer, especially in women who used them for more than one year without becoming pregnant. Those who are infertile may also have a higher risk than those who are not, possible due to not carrying a pregnancy.

-Breast cancer:
Women who have received a diagnosis of breast cancer have a higher chance of being diagnosed with ovarian cancer.

For this reason, women who are diagnosed with breast cancer and who test positive for the BRCA1 or BRCA2 gene may opt to have an oophorectomy as preventive therapy.

Symptoms:

It s easy to overlook the early symptoms of ovarian cancer because they re similar to other common illnesses or they tend to come and go. The early symptoms include:

-abdominal bloating, pressure, and pain
-abnormal fullness after eating
-difficulty eating
-an increase in urination
-an increased urge to urinate

*Ovarian cancer can also cause other symptoms, such as:

-fatigue
-indigestion
-heartburn
-constipation
-back pain
-menstrual irregularities
-painful intercourse
-dermatomyositis (a rare inflammatory disease that can cause skin rash, muscle weakness, and inflamed muscles)

These symptoms may occur for any number of reasons. They aren t necessarily due to ovarian cancer. Many women have some of these problems at one time or another. These types of symptoms are often temporary and respond to simple treatments in most cases.

Again, cancers are best treated when detected early. Please consult with your doctor if you experience new and unusual symptoms.

The symptoms will persist if they re due to ovarian cancer. Symptoms usually become more severe as the tumor grows. By this time, the cancer has usually spread outside of the ovaries, making it much harder to treat effectively.

Diagnosis:

A doctor will carry out a pelvic examination and check for any palpable abnormalities in the uterus or ovaries. They will also check the patient's medical history and family history.

The following tests are used to help diagnose ovarian cancer:

-Blood tests: Checking for elevated levels of a marker called CA-125.

-Imaging tests: Transvaginal ultrasound, MRI, or a CT scan might be used.

-Laparoscopy: A laparoscope, a thin viewing tube with a camera at the end, is inserted through a small incision in the lower abdomen. This will allow the doctor to see the ovaries and, if necessary, to take a tissue sample

-Colonoscopy: If there is constipation or bleeding from the rectum, a colonoscopy may be needed, to examine the large intestine, or colon.

-Abdominal fluid aspiration: If the patient's abdomen is swollen, there may be a buildup of fluid, which can be examined by using a fine needle to remove some fluid through the abdomen.

-Biopsy: The usual way to diagnose ovarian cancer is to remove the tumor or part of the tumor to examine for the presence of cancer cells.

Role of Homeopathy In Ovarian:

Treatment of ovarian cancer has to be multi-way therapy. Its not either Homeopathy or conventional treatment. The best long-term results are achieved by combination therapy depending on age, stage of ovarian cancer and general health condition of patient. While conventional treatments like chemotherapy or radiation therapy helps in faster removal of cancer, Homeopathy Treatment for ovarian cancer can help in:

-Regression of ovarian cancer
-Prevention of recurrence of ovarian cancer,
-Removing side-effects of chemo and radiation therapy,
-Relieving cancer pains
-Improving general quality of life and hence, a better reaction to other treatments.

The speciality Homeopathic treatment for ovarian cancer, developed at Welling Clinics can be very helpful for those suffering from ovarian cancer.

Diet and non-diet:

There is no proven evidence regarding the cause of PCOD though gynaecologists are of the opinion that some females possess a predisposition to this disease, and it may run hereditarily in the family. You can alleviate your PCOD symptoms to a considerable extent by regulating your diet properly.

Have loads of fruits and green leafy vegetables and try to abstain from dairy products as many experts believe that dairy products are a direct cause of an increase in insulin levels, which can aggravate skin troubles along with other PCOD symptoms. Avoiding red meat and eating lean meat instead will help the condition and reduce the chances of infertility. It is always recommended to avoid hydrogenated and saturated fats, which are normally found in animal and dairy-based food. Try to put a stop to cheese, cottage cheese, clarified butter, pork, lamb, beef, etc. and certain baked products like cookies, cakes and fudges as they will trigger a rise in your blood sugar and cholesterol levels.

What Is Ovarian Cancer?

Ovarian cysts and fertility: Is there a connection?

Having a child is one of the most profound experiences in a woman s life. The joy of being a mother and welcoming a new life is unparalleled. In the midst of such expectation, an inability to conceive can take a serious toll on any woman s health. The mental scars from such an event can never be obliterated.

This does not mean you should give up. Consult a doctor to find the cause and rectify it. With advances in medical science and technologies like IVF in the market, no fertility challenge is insurmountable.

One of the most common cause of infertility is ovarian cysts. According to research conducted by the American Society For Reproductive Medicine, ovarian cysts resulting in ovulation abnormality and infertility has been recorded among 25% of women.

There are two types of cysts that are produced as byproducts of ovulation-

1. Follicular Cysts which does not break open to release the eggs. Rather the follicle stays as a whole while the cyst continues to grow.

2. Corpus Cysts or luteal cysts is a condition when after the egg has bronek free, the follicles seal itself rather than shrinking and the fluid builds up inside.

Causes-

Ovarian cysts are mainly caused due to hormonal imbalance, abnormal cell growth where the cells overgrow and develop into cysts, pelvic infections that spread to the ovaries and fallopian tubes and causes severe harm to them, and endometriosis when the tissue attaches to an ovary and forms cell growth.

Which ovarian cyst affects fertility?

Ovarian cysts that generate complications during pregnancy include-

1. Endometriomas - This is the condition when the tissues lining your uterus or endometrium grows outside the uterus or the fallopian tubes and is largely associated with fertility problems. Endometriomas can differ in sizes from the range of less than an inch to over 6 inches. They are filled with dark coloured blood.

Some studies have demonstrated that women suffering from mild endometriosis develop a lower (2%-4%) chance of getting pregnant each month when compared to women who are healthy and have a 15%-20% chance. Another research states that 40% of unexplained infertility results from endometriosis through anatomical distortion or inflammation.

2. Polycystic Ovary Syndrome - PCOS is the condition where small cysts form inside your ovaries which prompts irregular periods, excessive stomach cramps and large hormonal imbalance. Connected to immature ovaries, they do not assist in ovulation and thus produces complications infertility. The immature follicles with an immature egg cause the ovary to be politic.

This chronic lack of ovulation also alters the hormonal levels in your body that assists in ovulation. Women with PCOS develop high levels of androgen or male hormones in your body, which gets converted to estrogen. As a result, they do not ovulate.

Does the treatment of ovarian cysts also affect fertility?

This usually depends on the kind of treatment you receive. Hormonal birth control doesn t have a long-term effect on fertility. Although surgeries can invariably damage some healthy eggs inside your body, the doctors recommend that the ovaries be removed before you have more complications. However, in both the situations, the egg count in your body decreases significantly.

Ovarian Cysts & Fertility - Is There A Connection?

Ovarian cysts are fluid-filled sacs that develop on a woman's ovary. A patient might experience abdominal and pelvic pain, abnormal bleeding, menstrual irregularities, pain during intercourse or irregular bowel movements. These symptoms indicate an ovarian cyst developing inside you. Ovarian cysts are common in women and may develop during menstruation. In many cases, symptoms are not observed, and you may get ovarian cysts without knowing. Usually being harmless, ovarian cysts may sometimes lead to severe health conditions.

Here are 7 important things you should know about ovarian cysts:
1. You should know the reason behind the formation of ovarian cysts. When the follicle does not release the egg, it may grow bigger in size and take the form of a follicular cyst. A corpus luteum cyst may also develop, which is a cavity that gets formed after the egg is ruptured and released from the follicle. The cysts may bleed and cause pelvic pain.

2. It is important for you to know if you have an ovarian cyst. Many ovarian cysts do not show symptoms and go away by themselves. Follicular cysts do not change your menstrual cycle, but corpus luteum cysts may cause bleeding.  

3. You should know how to detect an ovarian cyst. You should visit a gynecologist regularly for diagnosis. Bigger cysts can be diagnosed via a pelvic examination. Ultrasound is also used for detection.  

4. You should have an idea about all the symptoms associated with ovarian cysts. These include fever, nausea and vomiting. These symptoms indicate that you have an infection. Sometimes, a cyst might twist an ovary, which may cut off blood supply to the ovary, causing permanent damage.

5. In case you are at a risk of twisting of the ovaries, you have to undergo a surgery. Surgery is also considered when the cyst lasts longer than three menstrual cycles and it is bigger than four inches in size. The cyst may also pose the risk of being a tumor. The common surgical procedures for ovarian cysts are laparoscopy and laparotomy.  

6. You can prevent ovarian cysts be taking birth control pills, which help in suppressing ovulation and prevent the formation of a cyst. Birth control pills may help only if you are not pregnant.

7. Ovarian cysts are more common in premenopausal women. However, these are possible in postmenopausal women as well, especially in the early postmenopausal stage.  

Sometimes, there might be chances of an ovarian cyst being cancerous in nature, which may lead to ovarian cancer. The risk of cancerous ovarian cysts increases with age. It is recommended to consult a gynecologist for the proper diagnosis and treatment of ovarian cysts in women. Pain medications and heating pads are used as alternative treatment methods for less serious ovarian cysts.

7 Things You Should Know About Ovarian Cysts

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