PCOD-THE DISEASE THAT WORRIES A WOMAN

PCOD-THE DISEASE THAT WORRIES A WOMAN

A woman having delayed periods with excessive hair growth on face and body must think of Polycystic Ovarian Disease (PCOD).It is the most common harmonal reproducive problem that affects 5-10 % women of child bearing age. It is a leading cause of infertility. The disorder is increased especially in young women due to changed life style & eating habits leading to obesity.

Anatomy of the ovary :-

The ovaries are two small organs, one on each side of a women’s uterus. A woman’s ovaries have follicles, which are tiny sacs filled with liquid that hold the eggs. Each month about 20 eggs start to grow, but usually only one becomes mature. When that egg matures, the follicle breaks open to release the egg so it can travel through the fallopian tube for fertilization.

Fig.1: A comparision of a Polycystic Ovary with narmal Overy.


Development of the PCOD :-
In women with PCOD, the ovary doesn’t make all the of the harmones it needs for any of the eggs to fully mature. They may start to grow and accumalate fluid. But no one egg becomes large enough. Instead, some may remain as cysts. Since no egg matures or is realeased , ovulation does not occur & the harmone progesterone is not made. Without progesterone, menstrual cycle becomes irregular or absent. Also,cysts produce male harmones(androgens).

Fig. 2: Laproscopic picture showing Polycystic Ovary


Signs & Symptoms:-
Ovaries are enlarged, they have smooth & whitish outer surface. the ratio of
LH (Luteinizing harmone) to FSH (Follicle stimulating harmone) is greater than 1:1, as tested onDay 3 of the menstrual cycle. There will be harmone imbalance. Testosterone & insulin levels are rised.

The lady may have excess hair on face, chest (Hirsutism). Her cycles will be irregular ,scanty & sometimes there may be no periods at all. She may become obese, diabetic& infertile. She may also have hair loss, pimples & decreased sex drive.

Diagnosis of Polycystic Ovarian Syndrome :-
PCOD can be diagnosed by Physical examination, Pelvic ultrasound, Laproscopy, MRI, CT scans, Harmone levels, & measurement of Sugar levels in the blood.

Fig 3: Vaginal scan showing PCOD

Vaginal ultrasound scan
Vaginal ultrasound shows that the ovaries are enlarged; & there are multiple small cysts in the ovaries. These cysts are usually arranged in the form of a necklace along the periphery of the ovary.

Treatment of PCOD :-
PCOD is a common readily treatable disorder. Some of the treatment options are:-
1.Using Birth control pills : Low-dose oral contraceptive pills can regulate menstrual cycles, reduce male harmone levels.
2. Weight loss : Maintaining a healthy weight by exercise can help to cure PCOD. Metformins helps in loosing weight & also controls insulin level.
3.Fertility Medications : clomiphene(tablets) & Gonadotropins(injections) can be
used to stimulate the ovulation
.
Fig 4: Overian drilling by laproscopy

4. Medicine for increased hair growth: Spironolactone is a blood pressure medicine leads to decrease the abnormal hair growth (hirsutism).


5. Surgery: Ovarian drilling is done by Laproscopy. Cysts are punctured by electric
current This helps in ovulation & reducing male harmone.
Conclusion :-
PCOD is one of the commonest problems faced by women. Luckily it is curable. Women with PCOD must reduce the weight by strict diet & exercise. Early diagnosis and prompt proper treatment can cure the disease.