What is polycystic ovarian disease ?
Polycystic ovarian disease (PCOD) is a condition in which young girls/women develop irregular periods and hirsutism (excessive hairgrowth over face and body). Majority of these women are overweight/obese. If not properly managed, infertility is a concern.
What are the causes ?
Majority of the PCOD women are overweight/obese. Hormonal changes in PCOD are thought to be due to insulin resistance.
However, following endocrine conditions should be ruled out before branding the patient as having PCOD:
1 Cushing’s syndrome
2 Hypothyroidism
3 Prolactinoma
4 Non classical congenital adrenal hyperplasia
What are the symptoms & signs ?
- Irregular periods (Anovulatory cycles)
- Increase in facial & body hair; some may develop virilisation also (extreme degree)
- Obesity
- Features of insulin resistance (Ex: Acanthosis nigricans, skin tags)
Is there any criteria for diagnosis ?
Rotterdam criteria is generally used for the diagnosis of “PCOD”.
Any two of the following should be present for the diagnosis:
- Clinical features (hirsutism/virilisation) or documentation of high androgen/ testosterone levels
- Irregular periods (Anovulatory cycles)
- Ultrasound showing “Polycystic ovarian” morphology/pattern.
Is there any criteria for diagnosis ?
- FSH,LH,Prolactin,Testosterone,DHEAS, Dexamethasone suppressed cortisol, 17 hydroxy progesterone
- Ultrasound of pelvis to look for “Polycystic ovarian” morphology; also to rule out ovarian/adrenal tumors
How to treat ?
Weight reduction (Diet & exercise) is the cornerstone in the management of PCOD.
Even 5-10% of weight loss produces remarkable improvement.
Metformin in a dose of 500 mg – 2 gm/day is helpful in some for weight reduction/ normalization of cycles and improving fertility rates.
Clomiphene citrate and Letrozole are used to achieve fertility.
Medicines like anti-androgens (Finasteride, Spironolactone, Cyproterone acetate) and local measures (Laser therapy, electrolysis and waxing) are helpful in the treatment of hirsutism.
When to Contact a Medical Professional ?
Contact your health care provider if: