Polycystic Ovary Syndrome (PCOS)
I am Dr. Archana Rajesh Patil, Obstetrics & Gynaecology. I am practicing from last 20 years. Today we will talk about PCOS. I am sure many of you must have heard about this problem. PCOD is a disease which is not epidemically increasing. Many girls and newlyweds are suffering from this. Maybe because of the sedentary lifestyle, lack of exercise, unbalanced diet. What is PCOD? It is an appearance of multiple follicles in ovaries which gives a bulky ovary. Because of this, there are certain hormonal changes which represent many symptoms. First, let's talk about the incidence. 10% of the young girls today have PCOD. It is increasing. If it is a young girl then symptoms will start with irregular menses, increased weight, obesity, infertility. If it is not treated she might start getting hirsutism. Increase in facial hair, baldness, male pattern hair growth. Simultaneously there is hoarseness of voice if it is not treated.
How do we diagnose this? The first diagnosis can be done through sonography. Then we have to do little biochemical tests. When PCOS is diagnosed, normally the treatment is given for weight loss as it is a major component. Regular exercise regimen has to be given to the patient. The balanced diet needs to be followed where fatty foods need to be cut down. The best exercise is 1-hour walking which leads to regular ovulation. Every ovary has many follicles. And every month only 1 follicle will increase. And this follicle has an egg and an ovum. So, this follicle will rupture and ovum will come out. This process is called ovulation. But in PCOS, the follicle only grows in the size and ovum doesn't come out. So, there is ovulation which is failed which leads to the cystic spaces. It starts releasing different types of hormones. Again, the patient doesn't get the ovulation.
She will have breakthrough bleeding, long time of menses, loss of menses. So, there are chances that the patient may become infertile. So, there is a different protocol or the line of the management. If they are not married, we just give the insulin sensitizer, exercise, diet plan and we tend to regularize the menses, oral contraceptive pills are given so that periods are regularized. But in case, the patient is infertile, then 1st we tend to give ovulation induction drugs to them, we try to induce ovulation and help her conceive. In case, she has an advanced stage of PCOS where she got hirsutism, then there are certain laser therapies which can be given. There are some cosmetic treatments which are advised to the patient for the removal of excessive hair. In case, she is having obesity, we advise the weight loss plans to such patients. There are such situations where a patient becomes very obese, hirsutism, the patient tends to go in depression, so sometimes we need to counsel the patient.
We need to motivate the patient to lose weight. Proper treatment and regular follow up will give you a proper result for PCOS. There are chances that the patient might have diabetes mellitus in the future, there are high chances of infertility issues. So, it is better than she is treated on time. Many of the times these cosmetic problems are irreversible. There is no permanent treatment for that until and unless they go for high laser therapies. We also do ovarian drilling. This treatment is given with huge ovaries. So, this is one of the options. In PCOS, thyroid, and serum prolactin evaluation, insulin tests are necessary. Because there are chances that patient might land up in hypothyroidism and insulin resistance. Anything else, you want to know about PCOS, book an appointment through Lybrate.