Dr.Surakshith Battina

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Dr.Surakshith Battina is an infertility specialist, laparoscopic surgeon, and cosmetic gynecologist working at Indigo Women’s Centre, Chennai. He speaks to S10 SafeCare on PCOS.

PCOD doesn’t require treatment!

Polycystic ovarian syndrome or disease is a hormonal condition that affects most modern women in their reproductive age group. Unfortunately, the number of women with PCOD has been increasing by the day. The chance of a woman having PCOD with infertility is about 60 %. An imbalance of the hormones namely FSH, LH, PR, E2, TSH is the main cause for PCOD. A chronic imbalance of these hormones caused an abnormal increase of androgens (male hormones) which causes excessive hair growth, acne, and hair loss in women. PCOD also arrests the development of follicles and stops the release of eggs causing infertility among women of reproductive age groups.

What causes PCOD?

The contributing factors are multifactorial and cannot be pinpointed to a single cause.

Lifestyle: Most individuals blame lifestyle to be a cause of PCOD. Unhealthy dietary habits, no exercise, obesity, sedentary lifestyle all contribute towards PCOD.
Hereditary: Certain genes may be carried on in PCOD mothers to their daughters, although this correlation is not well established
Hyperinsulinemia: The women’s body gets immune (resistant) to insulin thus there is a rise in the blood sugar levels which in turn causes excess insulin which is responsible for increased androgen production in the body.

What are the signs and symptoms?

Some of the more common signs and symptoms include :

Acne, skin pigmentation, thinning hair, abnormal hair growth over the cheeks, chin, and upper lips, irregular menstruation weight gain, and skin tags. The other significant finding is the presence of polycystic ovaries (multiple tiny cysts in the ovaries).

What are the complications of PCOD?

The commonest complaint of women is irregular menstruation and abnormal uterine bleeding. The patient may sometimes skip her period for months together and this makes it difficult for her to time her fertility window.

Some women may have weight gain, psychological depression and may develop certain eating disorders. Such patients should seek treatment as early as possible because early counseling is key.

Due to weight gain and irregular menstruation, a major consequence is an Infertility where the patient will be unable to conceive naturally because of a. woman not being able to time her fertility window b. no ovulation during fertility window.

What are some of the tests involved in diagnosing PCOD?

The commonest blood tests performed are glucose levels, thyroid, prolactin, cholesterol, triglyceride levels, and hormone profiles. An ultrasound is more than sufficient to diagnose polycystic ovaries an MRI or CT is not necessary.

Some additional tests for depression or sleep apnea are also performed if needed.

How is PCOD treated?

Ideally, your medical practitioner does not treat the PCOD but instead focuses on the underlying issues like obesity, excess hair growth, acne, pigmentation, or infertility.

Patients affected with acne will be treated with topical retinoids, patients with excess hair growth usually use bleaching or laser treatment.

Patients suffering from infertility take ovulation induction medication for a few months, if unhelpful they start performing follicular monitoring to assess ovulation to time the days for intercourse. When all other treatments fail, then laparoscopic ovarian drilling is the gold standard for patients with failure of ovulation induction. Patients who undergo laparoscopic ovarian drilling usually ovulate and conceive naturally within the next few months.

What lifestyle modifications are recommended for PCOD?

The most important modification is to maintain a healthy weight. Weight loss reduces insulin resistance and resolves spontaneous ovulation.
Ideal diet management is very important and women are recommended to have small meals throughout the day instead of consuming three large meals.
Women with PCOD will be given a good exercise routine to help body fat and maintain sugar levels.
For more information on PCOD and its treatments login to www.indigowomenscenter.com

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