PCOD is female hormonal imbalance where maturing egg fail to be expelled from ovary, creating an ovary filled with immature follicles. The cysts will cause hormonal imbalance, which causes more cysts and enlarged ovaries. It is characterized by anovulation (no formation of egg) irrespective of periods (regular or irregular or absent) and hyperandrogenism (elevated level of testosterone and androgen). Women with PCOD who conceive has high rate of fetal loss.

Women with PCOD have fewer chances to conceive, compared to normal women who ovulate every month.

Normal women get 12 chances in a year to get pregnant, while women with PCOD get 3-4 chances in a year to get pregnant due to delayed periods.

Causes of PCOD:

• Family history of PCOD.
• Genetic predisposition.
• Young diabetic women treated with insulin.
  

Symptoms of PCOD:

• Irregular and infrequent menstrual periods or no menstrual periods at all.
• Infrequent or no ovulation with increased serum levels of male hormones like testosterone.
• Inability to get pregnant with one year of unprotected intercourse.
• Weight gain or obesity.
• Excess growth of hair on face, chest, stomach and male pattern baldness or thinning of hair.
• Acne, oily skin, dandruff.
• Patches of thickened and dark brown or black skin on neck, groin, under arms and skin folds.
• Skin tags, or tiny excess flaps of skin in the arm pits or neck area.
• Male fat storage pattern like abdominal storage rather than female standard fat storage pattern on thighs, hips, waist.
• Mid cycle pain indicating painful ovulation due to enlarged and blockage of the surface of ovaries.
  

Consequences of PCOD:

• Menstrual irregularities.
• Miscarriage.
• Impaired fertility.
• Hyperinsulinemia, causing high blood pressure and increased clot formation leading to heart disease, stroke and type-2 diabetes.
• Hair and skin problems like acne, excessive hair growth (hirsutism).
• Obesity.
• Increased risk of endometrial or breast cancer due to less estrogen.
  

Diagnosis of PCOD:

• Medical history.
• Physical examination.
• Pelvic examination.
• Ultrasound scan: The signs of PCOD are enlarged ovaries with 10 or more cysts located at the periphery of the ovary. The size of cyst is generally less than 8mm.
• Blood tests to measure hormones, insulin, lipids.
  

Treatment:

Medical treatment:

• Birth control pills: To regulate menstrual irregularities, to reduce androgen levels, to decrease acne.
• Fertility drugs.
• Surgery.
  

Complications of PCOD:

• Type 2 diabetes mellitus.
• High blood pressure.
• Increased triglycerides.
• Decreased high density lipoprotein (HDL) cholesterol, good cholesterol.
• Cardiovascular disease.
• Metabolic syndrome.
• Abnormal uterine bleeding.
• Endometrial cancer.
  

Life style modifications:

• Eating balanced diet low in carbohydrates, fat and maintain healthy weight reduces the symptoms of PCOD.
• Regular exercises to decrease the weight.