Polycystic ovary syndrome (PCOS)


Polycystic Ovary Syndrome or PCOS or PCOD has come to epidemic proportions in young women nowadays.

It is present in 5-10% women. It basically means a hormonal imbalance, a shift towards more male type of hormones. It mainly has Insulin resistance which causes obesity. There is Ovulation failure and infertility.

It can also predispose to Gestational diabetes, type II Diabetes High BP, endometrial hyperplasia and cholesterol later in life.


What are the Symptoms?



  • Irregular cycles-delayed(6-8/yr), less bleeding
  • Acne, male pattern hair growth(upper lip, chin, neck, sideburn area, chest, upper or lower abdomen, upper arm, and inner thigh Weight gain(50%)
  • Type II Diabetes (10%) High BP and cholesterol,Heart disease
  • Obstructive sleep apnoea(50%)
  • Anxiety, depression

    It may lead to problems related to pregnancy like

  • Infertility
  • Ovulation problems-30%PCOS
  • Miscarriage
  • Pre eclampsia
  • Gestational diabetes
  • Preterm birth
  • Large for age baby

How to Diagnose?

PCOD is a combination of symptoms, it is diagnosed if there are 2 out of these 3 features

  • Irregular menstrual periods caused by anovulation or irregular ovulation.
  • Evidence of elevated androgen levels. The evidence can be based upon signs (excess hair growth, acne, or male-pattern balding) or blood tests (high androgen levels).
  • Polycystic ovaries on pelvic ultrasound.

What are the Treatment options?

PCOD is a lifestyle problem, it can be best controlled with



  • Lifestyle modification
  • Low carbohydrate diet
  • Exercise and weight loss (5% to 10%)
    • 18 – 64 yrs- 150 min/week of moderate intensity or 75 min/week of vigorous intensities including muscle strengthening activities on 2 non-consecutive days/week
    • Adolescents- 60 min moderate to vigorous intensity/ day, including strengthening muscle and bone at least 3 times weekly prevention of weight-regain ,minimised sedentary, screen or sitting time
    • Physical activity includes leisure time physical activity, transportation (walking or cycling), occupational work, household chores, games, sports or planned exercise
    • Daily, 10000 steps is ideal, including activities of daily living and 30 minutes of structured physical activity or around 3000 steps.
    • SMART (Specific, Measureable, Achievable, Relevant, Time limited) goals could include 10 minute bouts, progressively increasing physical activity 5% weekly
  • Healthy eating
  • Focus on Whole Plant Based Food
    • Complex carbohydrates
    • Are packed with Nutrients
    • Give long lasting energy
    • Leave you full and satisfied
  • Simple carbohydrates
    • Provide short lived energy
    • Are mostly empty calories
    • Leave you hungry for more
  • Eat the right type of protein
    • Eggs
    • Chicken & fish
    • Milk & milk Products
    • Soybean & Legumes
    • Mix Dals
    • Nuts

Medication

When lifestyle changes are not helping, some medication may be needed to improve the symptoms, like

  • Insulin sensitisers like metformin
  • Myo Inositol
  • Oral contraceptive pills to regulate cycles
  • Ovulation induction for pregnancy
  • Anti testosterones

The dose, duration and combination of medication depends on the problems that one is facing. It is advisable to continue lifestyle changes to be less dependent on medication.

Surgery-This is almost never needed to treat PCOD. In some very resistant cases of infertility with PCOD, laparoscopic ovarian drilling may be suggested but it is controversial.


Dr. Astha Dayal one of the most experienced Gynecologist and Obstetrician in Gurgaon Haryana specialised in PCOD & PCOS treatment

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