Dr Ankita S
MBBS, MS, DNB OBGY
PCOS (PolyCystic Ovarian Syndrome) and PCOD (PolyCystic Ovarian Disease)
We must have come across girls and ladies saying “I missed my period this month.” “I didn’t get my periods for the past 2 months.” A few are also confronted that they have PCOS and they have gotten used to it, which is sad because they are getting used to symptoms that are hurting them, used to not caring for themselves, and used to an unhealthy lifestyle.
PCOS and PCOD is a word we often encounter these days, but what do we know about it? Let’s make it clear here,
The Name clash
PCOS (PolyCystic Ovarian Syndrome) and PCOD (PolyCystic Ovarian Disease) are both addressing the same condition.
So why two terms ?
Earlier, PCOD was the term used to refer to the condition; later it has been changed to PCOS because it’s a collection of symptoms that usually occur together, not the established disease by itself.
The Physiologic clash
Despite what the name indicates, PCOS doesn’t only mean cysts in the ovaries but also includes hormonal imbalances without ovarian cysts.
Polycystic ovary syndrome (PCOS) is a complex condition characterised by elevated androgen levels, menstrual irregularities, and/or small cysts on one or both ovaries. The disorder can be morphological (polycystic ovaries) or predominantly biochemical (hyperandrogenemia). Hyperandrogenism, a clinical hallmark of PCOS, can cause inhibition of follicular development, microcysts in the ovaries, anovulation, and menstrual changes (Ndefo, 2013).
When you should be concerned
- Ovarian cysts
[Enlarged ovaries with numerous small cysts]
- Irregular menstrual cycles
[if the length of your menstrual cycle (the gap between your periods starting) keeps changing]
- Pelvic pain
[a dull ache or a jolt in your lower abdomen]
- Hirsutism
[excessive growth of dark or coarse hair on the face, chest, and back in a pattern resembling that of a man]
- Alopecia
[disease that happens when the immune system attacks hair follicles and causes hair loss]
- Acne
[Cystic acne can be large, red, painful breakouts deep in your skin]
- Acanthosis nigricans
[a skin condition that causes velvety, light-brown to black patterns on the neck, under the breasts, and in the armpits due to insulin resistance]
- Skin tags
[A small, narrow stalk of skin protrudes and erupts on various parts of your body]
These are the typical PCOS symptoms that are seen. A symptom from the list above does not necessarily indicate PCOS. As was previously said, PCOS is a collection of symptoms, therefore having a lot of them should be of worry.
Other hormones that play an important role in PCOS are insulin, sexhormone binding globulin, and FSH. Prolactin levels are also elevated in people with PCOS.
If PCOS is suspected, physical assessment; blood test and pelvic ultrasound are usually performed to diagnose the condition.
PCOS as asymptomatic
Having symptoms, being aware of them, and taking care of them is one way to manage; how can we know if there are no symptoms?
In the case where PCOS patients don’t develop symptoms but have ovarian cysts or other hormonal imbalance, it means they are at the starting stage of PCOS or at a subtle stage where they can pass it to their offspring. (Asymptomatic PCOS, 2009)
Why should PCOS be addressed ?
More than 50% of PCOS patients go on to acquire prediabetes or diabetes after receiving a diagnosis. There is also an elevated risk of myocardial infarction (MI), dyslipidemia, hypertension, anxiety, depression, endometrial cancer, and sleep apnea. Additionally, pregnant women with PCOS need to be aware of the elevated risks for preterm birth, gestational diabetes, and miscarriage (Ndefo, 2013).
What can be done ?
The cause of PCOS is still unknown, so the treatments are directed towards the symptoms. The goal should be analysed before starting the treatment-the primary focus should encounter anovulation, effects of increased androgen and insulin resistance, as these could lead to further complications.
PCOS is a lifestyle disorder that can be effectively managed with certain lifestyle changes and medical guidance from professionals like doctors and nutritionists.
There is a lot of pharmacological treatment for PCOS pertaining to the goal or symptoms like anovulation or insulin sensitivity or hormonal imbalance. Based on your assessment, your medical professional recommends which medications you should go ahead with. Taking hormone tablets or other medications without prescriptions or medical advice from doctors shouldn’t be encouraged. (Treatment of PCOS, 2013)
Since weight management is the prominent effect of PCOS, exercise with dietary intervention improves weight management and reduces cardiovascular risk factors and diabetes risk.
The dietary intervention not only helps to handle weight management but also helps to lower your symptoms like hair loss, inflammation, etc. and, to some extent, it also helps you to balance your hormone secretions if you have the right guidance and help. The hormone is severely affected by sleep deprivation and mental health. Therefore, concentrating on mental health is also important.
Conclusion
Polycystic ovary syndrome is a complex disorder for which multiple treatment approaches are required, depending on the reason a patient seeks treatment.
Naturally, there will be some uncertainty about which treatment to pursue, and we at Cysertcare are here to help with professional advice and guidance. Addressing every symptom and its triggering factors is important in the management of PCOS. CysterCare helps you understand the process, encounter possible causes of the hormonal imbalance and provides beneficial ways to effectively manage PCOS in the long run.
References
- Asymptomatic Volunteers with a Polycystic Ovary Are a Functionally Distinct but Heterogeneous Population. (2009, February 24). NCBI. Retrieved October 5, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684482/
- Clinical Practice Guideline: Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline. (2013, November 20). NCBI. Retrieved October 5, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5399492/
- Ndefo, U. A. (2013, June 6). Polycystic Ovary Syndrome – PMC. NCBI. Retrieved October 3, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3737989/
Frequently Asked Questions
PCOS (PolyCystic Ovarian Syndrome) and PCOD (PolyCystic Ovarian Disease) refer to the same condition. PCOD was the earlier term used, but it was changed to PCOS to highlight that it is a collection of symptoms, not a specific disease.
Common symptoms of PCOS include irregular menstrual cycles, ovarian cysts, hirsutism (excessive facial and body hair), acne, alopecia (hair loss), acanthosis nigricans (skin pigmentation), and skin tags.
PCOS is typically diagnosed through physical assessment, blood tests, and pelvic ultrasound. These tests help identify hormonal imbalances and other characteristic symptoms.
Yes, some individuals with PCOS may have no noticeable symptoms but still have ovarian cysts or hormonal imbalances. Identifying and managing PCOS at this stage is crucial to prevent potential complications.
PCOS can lead to an increased risk of prediabetes, diabetes, heart disease, dyslipidemia, hypertension, anxiety, depression, endometrial cancer, and sleep apnea. Pregnant women with PCOS also face elevated risks of preterm birth, gestational diabetes, and miscarriage.
Dr Ankita S
MBBS, MS, DNB OBGY
M.Sc Nutrition and Dietetics
M.Sc Nutrition and Dietetics
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