Polycystic Ovarian Syndrome
I am Dr. Anu Sidana, Gynaecologist. Today I am going to make you aware about polycystic ovarian syndrome. What is polycystic ovarian syndrome? Basically it is affecting all, it is a hormonal disorder which affects all the women starting from adolescent till the menopause. What is the difference between PCOD and polycystic ovarian syndrome? Basically PCOD is an ultrasound finding and when the hormonal disturbances are present in the body it present clinically in the patient then we label the patient as polycystic ovarian syndrome.
What is the main cause behind polycystic ovarian syndrome? It is not exactly known till now but most common is the sedentary lifestyle, secondly it could be because of stress and in 1-3% of the patient it is mainly because of the genetics that it that it runs in families. So how we diagnose the patient? Patient come to us with clinical symptoms as delayed cycle, periods coming at the gap of more than 35 days or patient is having less than 9 periods in a year. Then secondly weight gain. Third it may lead to acne or hair growth. Patient may present with all the symptoms altogether or may present with one symptom only. Then on the ultrasound we get the findings of polycystic ovaries, we diagnose the patient as polycystic ovarian syndrome on the help with the help of clinical as well as biochemical tests. Now, what is the main pathology behind polycystic ovary syndrome? It is basically eggs are being formed in the ovary but none of them is getting mature enough to get ruptured so it leads to formation of water-filled cysts within the ovary leading to polycystic appearance.
So, what happens if patient ignore the symptoms? If patient doesn't treat if we don't treat the patient in time in the long run as the ovulation is not effective patient may have difficulty in conception and it leads to infertility and because of the hormonal imbalance because of polycystic ovaries what happens it leads to rise in male type of hormones and decrease in female type of hormones. As a result there is metabolic changes which leads to changes in the lipid profile and patient becomes at a risk of diabetes as well as cardiac problem and in the long run abnormal uterine bleeding and patient also has an increased risk of uterine cancer. So, how to treat the patient? Before starting the treatment foremost thing to be done is the counselling of the patient regarding lifestyle modification which includes exercise. Any kind of exercise for at least 30-45 minutes either it is brisk walking, yoga, dance whatever suits the patient to be started.
Second is the weight management. Weight should be maintained according to the BMI so if there is less content of the fat in the body, lesser changes because of the polycystic ovaries and lesser complications because of the PCOS. Then what kind of treatment we have available? We have only two kind of treatment either we stress the ovaries or either we stimulate, always stimulate the ovary. Why? If patient want to conceive, we stimulate the ovaries so that effective eggs are being formed, there is ovulation and patient conceives and if patient doesn't want to conceive as she is unmarried then we stress the ovaries with the help of contraceptive pills and we have various hormonal therapies to regularise her cycle and according to her symptoms like hair growth and acne we treat the patient accordingly. So take home message is maintain a healthy diet, maintain your weight as well as be active to avoid the complications of polycystic ovarian syndrome.