Polycystic ovary syndrome (pcos) and infertility are considered synonymous by most. However, the truth is that they are not and there are a lot of treatment options that can lead to pregnancy, even in a lady who is suffering from pcos.

Reasons pcos leads to infertility
Women with pcos have different hormonal pathways than a normal woman without pcos. It changes the system of how your body produces the eggs and prepares your uterus for pregnancy. Three reasons why women with pcos do not get pregnant or why it is difficult for them to maintain pregnancy are:
1. Women who are suffering with pcos do not ovulate normally.
2. They have irregular periods and thus their monthly cycles are not predictable.
3. As they have irregular periods, their endometrium may not be prepared when the egg is released. Thus, it does not help in sustaining the pregnancy.

Symptoms of pcos
There are a lot of symptoms that show the hormonal imbalance due to pcos.
1. Ovarian cysts
2. Excessive amounts of male hormones
3. High levels of insulin
4. Fertility problems
5. Weight gain
6. Ovulation and menstrual problems
7. Excess body and facial hair
8. Acne
9. Anxiety and depression

As there is hormonal imbalance in a woman with pcos, the eggs may not develop properly and at the same time, they may not be ready to get fertilized, thus leading to infertility.

Pcos infertility treatment
The good news is that even if you are one of them with pcos, there are treatments that can help you to get pregnant.

Here are the drugs that help patients with pcos.

Metformin (glucophage)
It helps in reducing the insulin levels and stabilizes the hormones. Thus, doctors often prescribe metformin that will help in making the ovulation cycles regular.

Clomid (clomiphene citrate)
Another fertility drug that helps in conceiving is clomid. It may be prescribed with or without metformin. When women with pcos take these two drugs together, their chances of getting treated for pcos and getting fertile become more. Many women may need a high dose of clomid so that they can retain fertility.

Gonadotropins
This medication is necessary for helping you with ovulation as gonadotropins are hormones that stimulate your ovaries to release eggs. When someone is not responding to clomid then this medication may be tried.
If you too are trying to conceive and yet have not succeeded and can find the symptoms mentioned above, visit your doctor and start the treatment.

How to Get Pregnant Even if You Have Polycystic Ovary Syndrome (PCOS)?

Why do you get PCOS?

Polycystic ovarian syndrome is the condition when a woman's sex hormone levels get imbalanced. This can cause women to have irregular periods and may also have an impact on their fertility. Women suffering from PCOS also tend to grow small cysts in their ovaries which can also lead to severe health problems like diabetes and heart disease, if left untreated.

What causes PCOS?

The exact cause of PCOS is not known. However, the condition may be triggered by hormonal imbalances and genetic factors. Women are more susceptible to developing this condition if their mother or a female family member also has the condition. Excessive production of androgen, which is a male sex hormone, may also lead to this condition. Women suffering from PCOS tend to have high levels of androgen. The formation of eggs and their release during ovulation can be delayed by high levels of androgen. High androgen levels may result from excess insulin present in the blood. Poor lifestyle and irregular eating habits contribute to obesity which intern leads to increased insulin resistance and hence delayed ovulation and irregular cycles leading to infertility.

What are the symptoms of PCOS?


The type of symptom in case of PCOS varies from person to person. Since PCOS is characterized by low levels of sex hormones, this condition may lead to symptoms such as:

- Excessive hair growth on stomach, face, chest, toes and thumbs
- The breast size starts to shrink
- There is a change in voice, making it deeper
- There is excessive loss of hair from your scalp
- Sometimes the face is filled with acne and the skin turns oily
- There are fertility problems like having trouble in ovulating or recurring miscarriages
- Frequent depression or mood swings
- Facing breathings problems while sleeping
- Obesity

Why do you get PCOS?

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

Why every 1 in 5 Women in India suffers from PCOS? (And what they need to know)

Polycystic ovarian syndrome (PCOS) is a medical condition related to a woman’s endocrine system. Generally, this disorder is characterised by an imbalance of the sex hormones (oestrogen and progesterone), which leads to the development of multiple small cysts in the ovaries. Symptoms of PCOS include acne, irregular menstrual cycle and depression to name a few.
The causes of PCOS have not been accurately identified so far, but researchers suggest that the following factors might contribute to the onset of the condition.

1. Increased amount of insulin secretion- Women suffering from insulin resistance may get PCOS as their body is not able to effectively use this insulin, which results in increased insulin secretion by the pancreas. This, in turn, triggers more androgen (male sex hormone) production in the ovaries, making it difficult for the ovaries to ovulate.

2. Lower inflammation levels- The white blood cells present in your body form resistance against infections through a response termed as inflammation. Women with lower inflammation levels are likelier to get PCOS as the decreased levels stimulate polycystic ovaries, thereby producing more androgens.

3. Genetic factor-  If you have a family history of PCOS, it’s highly probable that you may also get it as the disease is linked with your genes.

How To  Live with PCOS

PCOS comes with numerous side effects like acne, obesity, infertility, excessive facial or body hair among others. There are certain lifestyle changes, which you may consider to manage PCOS and minimise its side effects.

1. Change your diet - Opt for a low carbohydrate, low sugar diet to keep your insulin levels in control, as insulin is responsible for increasing the severity of PCOS symptoms. 

2. Try to maintain an ideal body weight - Obesity is known for worsening insulin resistance, and you can prevent this by regularly keeping your weight in check. You can practice some easy at-home exercise to reduce weight besides having a balanced diet.

3. Get yourself checked regularly - Visit a doctor and get yourself checked regularly for potential health risks as PCOS is often associated with increased chances of diabetes, heart diseases, certain forms of cancer, hypertension, and high LDL (bad) cholesterol levels.

4. Join a support group - Joining a PCOS support group will help you cope with your emotional difficulties, while helping you to live a better life by cultivating an optimistic outlook.

If you would like to consult with me privately, please click on 'Consult'.

Every 1 in 5 Women in India suffers from PCOS! Why? (And what they need to know)

What is an ovarian cyst?
If a follicle present in the ovaries grows beyond 2cm in size, it is called an ovarian cyst. In an ovarian cyst, fluid accumulates inside a thin wall in the ovaries. The size of the ovarian cyst varies in size from person to person. It is most common in women during their fertile period, but it can happen anytime.

What is the cause of an ovarian cyst?
Follicles are produced in the ovaries under normal conditions. One of these follicles matures into an egg every month. It is a very normal process and happens spontaneously in most cases. However, under certain circumstances and conditions, these follicles fail to rupture and turn into a fluid filled cyst. In rare cases, dermoid reactions caused by entrapment of sebum follicle or hair follicle can cause ovarian cysts as well. It is common for most women to have at least one cyst in their lifetime.

What are the symptoms of an ovarian cyst?
Sometimes, an ovarian cyst does not present many symptoms. The most common symptoms include:

Increase in weight
Painful intercourse
Headache and fatigue
Pain in the abdomen
Heaviness and fullness in the stomach
An increase in the frequency of urination
Increase in bowel movements as a result of pressure
Back pain
Ayurvedic treatment for ovarian cyst

Shilajit: It is the most common herb for enhancing male libido and induces strength and vigour. Hence, this herb is indicated in women to increase agility so that they are able to get on with their daily schedule without much interference due to the fatigue.
Commiphora mukul: It is a very potent drug and has immense rejuvenating properties. The cells of the body are revitalised and rejuvenated by these. It is also effective in people who are anaemic or have low haemoglobin levels in the blood.
Emblica Officalis (Amlaki): Amlaki  is known for its rejuvenating properties as well. It has great anti oxidant properties and helps to neutralise the free radicals in the body. It is also effective in increasing immunity in the body and enhancing metabolism.

Ovarian Cysts - Ways Ayurveda Can Help You Treat It!

Vaginal cysts are closed packets of fluid, air or pus which develop along the vaginal lining. Vaginal cysts are of many types, and they are usually caused by accumulation of fluids, childbirth-related injuries or non-malignant tumors in the vagina. Usually these cysts do not yield many symptoms, but may cause a little discomfort.

Treatment might not be needed in case of cysts which are tiny. However, larger cysts would definitely warrant medical attention.

Types of Cysts-

The commonly occurring cysts are:

Gartner s Duct Cysts: This duct forms around a woman s reproductive canal during pregnancy and it disappears post childbirth. If the duct remains even after the delivery, it may lead to fluid accumulation, thus resulting in a cyst.

Vaginal Inclusion Cysts: Any injury to the vaginal walls, especially during childbirth or surgery, can lead to vaginal inclusion cysts.

Bartholin s Cyst: Bartholin s gland is situated near the vaginal opening. A flap of skin covering this gland may lead to accumulation of fluid. This fluid accumulation usually leads to a cyst which is called a Bartholin s cyst.

Treatment-

Usually, cysts in the vagina do not require any treatment. Most of the cysts do not grow in size and thus do not cause major problems. A biopsy of the cyst may require in order to rule out chances of cancer. A common treatment for vaginal cysts would be to sit inside a bathtub filled with warm water so that the cyst is allowed to soak in the water. If there are symptoms of infection in the vagina, then antibiotics are required.

If the size of the cyst is large and filled with fluids, then a catheter needs to be inserted into it to drain out the cyst. Usually, the catheter is kept in place for a few weeks before it is removed. A surgical procedure called marsupialization is used in some cases, wherein an incision is made around the affected area and into the cyst in order to drain out its contents.

Surgery to remove the entire cyst may also be recommended to prevent its recurrence.

Vaginal Cysts - Types and Treatment

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