Dr Neelima Mantri's OPD -Bombay Hospital

Polycystic Ovarian Disease results from the disorder more commonly known as PCOS or Polycystic Ovary Syndrome. A syndrome is starkly different from a disease, for the former entails a set of symptoms usually occurring in concurrence, while the latter means a particular biological condition with an identifiable reason behind it. 

A syndrome solicits your concern and forethought in order to eliminate or at least control the chances of an underlying disease. Trigger to a syndrome is undetectable and hence, fighting it efficiently is fairly problematic. It is rare to find adolescent girls without hormonal problems.
 
Hormonal imbalances are just too common to be a novel topic any further. Polycystic Ovary Syndrome is faced due to imbalances in hormone secretions. It refers to the development of multiple cysts in your ovary. This condition usually affects women falling within the age group of 15 to 50. Eight among ten women, at a given point of time, are reported with PCOS. Symptoms of PCOS, when neglected, can lead to Polycystic Ovarian Disease. If you have been facing similar health issues, it is advisable to undergo a check-up and get diagnosed at the earliest possible. 

Symptoms of Polycystic Ovarian Disease:

1. A receding hairline or increased hair fall can lead to thinning of scalp hair. Such a sign should not be taken lightly as it could be indicative of Polycystic Ovarian Disease.
2. Extremely painful menstruation, irregular periods or prolonged periods with heavy bleeding might be reason enough for worrying.  
3. Development of acne could be another sign. Acne is common to girls attaining puberty, but an unprecedented growth should be a matter of concern. 
4. Patchy skin, pigmentation and discoloration of the skin are the other symptoms.
5. PCOS may also result in continual depression and anxiety.
6. Obesity is the most commonly noticed symptom. People suffering from Polycystic Ovarian Disease have lower metabolism and thus, reducing weight is an ordeal. 
7. Many women tend to grow thick facial hair or chest hair. Such a condition discourages the person to go out in public. It leads to social ostracizing which further bears severe effects on one's mental health.
8. PCOS mostly affects women belonging to the childbearing age. As a result of this syndrome, females stop ovulating. Conception becomes extremely difficult as the syndrome may lead to infertility.

Polycystic Ovarian Disease can result in Type 2 diabetes or even cardiovascular problems. If not diagnosed and treated at an early stage, it might lead to ovarian cancer. There is hardly any preventive measure to counter the chances of such a syndrome, but certain alterations in your diet under the guidance of a dietician and regular exercising can improve your health.

How is PCOD diagnosed and treated?

Your gynaecologist would be able to determine whether you have PCOD by checking your symptoms. Then she would recommend you to do a few blood tests along with a pelvic ultrasound scan to confirm whether you have PCOD. Though this disease is not reversible, its symptoms may be reduced or minimised. Most women can lead a trouble-free and healthy life if they take proper precautions at the right time.

It has been pointed in several studies that reduction in weight can help in the improvement of most PCOD symptoms because fat contributes to the production of certain hormones. Your doctor will prepare a treatment plan depending on the aspect from which you are suffering. For instance, if you are suffering from irregular periods, your doctor may prescribe you some contraceptives which can help in restoring normal menstrual cycle. But this treatment is definitely unsuitable for those who are trying to conceive. The infrequent and irregular ovulation can make it difficult to conceive and it can be artificially induced with the aid of medications.

Infertility is a condition where a couple, trying to conceive in a natural way is not able to do so even after one year of trying. It is also a matter of worry for patients who are over the age of 35 years and those who are not able to conceive naturally even after 12 months of trying constantly. So here are the causes, risks and treatment for this condition.

Causes: 

There are many causes of infertility. It may be down to a condition present in one or both partners. As per a medical study, 20% of the cases of infertility are due to males, while 40% to 50% cases are due to problems in the female partner. 30% of the cases suffer from infertility due to problems in both males and females. 

Ovulation and fertilisation are the main elements of the conception process and any condition in the female or male can upset either function, which can make it difficult to conceive. While abnormal sperm production and transport may be a common condition that leads to infertility in males, other factors like side effects of cancer treatments and too much exposure to toxins and chemicals can also play an important role in this regard. 

For females, the causes of infertility may range from ovulation disorders, uterine and fibroid tumours, uterine and cervical anomalies, damage to or blockage of the fallopian tubes, endometriosis, primary ovarian insufficiency and pelvic adhesions. Also, factors like thyroid, cancer and medication leading to temporary infertility may be at play. 

Risks: 

There are a number of factors that put a male or a female at risk of infertility. Being in your mid-30s usually has an adverse effect on the ovulation and production of well-functioning sperm. Further, smoking and tobacco are among the main causes of infertility in either partner. Excessive alcohol consumption may also lead to this problem. Being overweight or underweight can also make a person infertile. Further, not getting enough exercise and routine activities out of your day, can lead to this condition as well. 

Treatment: 

Male patients can go through treatment for any existing infections, hormonal injections and medication, surgical options like vasectomy reversal and ART or assistive reproductive technology. Female patients can turn to medication that will stimulate ovulation, Intrauterine Insemination, and surgical processes to correct a uterine septum and remove endometrial polyps, or even a hysteroscopy surgery. 

If these methods fail, the patient or the couple can always turn to methods like In Vitro Fertilisation. For other mild reasons, lifestyle changes along with a stress-free environment can help in increasing the chances of conception.

Recurrent miscarriage is a condition when there have been three or more successive pregnancy losses. It is different from infertility as infertility is the inability to conceive. For many cases, the cause of a recurrent miscarriage has not always been found. A number of factors can cause recurrent miscarriages of which some are treatable.

It may not always be possible to identify a cause for recurrent miscarriage in a couple, even after extensive research and treatment procedures. Some of the common causes of recurrent miscarriage are described below:

1. Chromosomal abnormalities: Incompatible chromosomes can result in pregnancy losses. When an egg and a sperm meet, of which one of them is faulty, they can't line up properly resulting in chromosomal abnormality. Such conditions lead to miscarriages.
2. Uterine abnormalities or Incompetent cervixes: Miscarriages occur if the uterus is abnormally shaped since the embryo is not properly implanted or even if it gets implanted, it may not get sufficient nourishment to survive. If the woman has a weak cervix, it cannot hold the developing embryo, leading to miscarriage.
3. Immunologic disorders: Under rare cases, the embryo itself is not accepted by the body. Antiphospholipid antibodies are those, which attack self-tissues, such as embryos and prevent them from building up. This leads to recurrent miscarriage.
4. Untreated thyroid problems: Conditions such as thyroid or uncontrolled diabetes result in uterine conditions which make it tough for the embryos to survive.
5. Polycystic ovary syndrome: Women with polycystic ovary syndrome tend to have high levels of male hormones which, result in irregular menstruation and ovulation. This can prevent the lining of the endometrium from maturing that is required for holding the embryo.
6. Bacterial infections: There may be the presence of a number of microorganisms inside the reproductive tract that may be harmless for the person. But there may be certain bacteria lined up in the reproductive tract, which can prevent the development of the embryo, thus leading to miscarriages.
7. Lifestyle: Smoking and drinking are harmful lifestyle habits, which may increase the chance of miscarriage to a great extent. It is always advised to avoid smoking or drinking when you wish to conceive. Other lifestyle conditions, such as working in certain environments like hospital environments, farms, laboratories, etc, may lead to miscarriages; however, the exact reason has not been identified yet.