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Polycystic Ovarian Disease (PCOD) Test


Overview

Polycystic Ovarian Disease (PCOD) also known as Polycystic Ovary Syndrome (PCOS) is a hormonal disorder among women in which ovaries develop multiple small collections of fluid (follicles) and fail to regularly release eggs

Ovary(ies) get enlarged and produce excessive amounts of androgenic and estrogenic hormones which leads to infrequent or prolonged menstrual periods

Around 20% of females in India suffer from PCOD and the number rises to 25% amongst the East Indian women

PCOD is one of the most common and underdiagnosed causes or irregular menstruation and infertility amongst younger women in India

While most of the cases of PCOD are due to hereditary or genetic factors which are difficulty to describe, it can be due to one or more of the following factors:

  • Hereditary / genetic factors (passes on from mother to daughter)
  • Persistently high levels of estrogen and androgen
  • Obesity (as fatty tissues are active hormonally and they produce estrogen which can disrupt ovulation)
  • Excessive androgens produced by overactive adrenal glands
  • Excess insulin production by pancreas

Signs and symptoms are very mild initially and a female might experience only 2 or 3 symptoms, from the following list:

  • Irregular menstrual cycle
  • Weight gain and trouble losing weight
  • Hirsutism (excess hair on face)
  • Acne on face, chest and upper back
  • Thinning hair or hair loss on scalp, male pattern baldness
  • Darkening of skin, particularly along neck creases and underneath breasts
  • Skin tags (small excess flaps of skin in the armpits or neck area)
  • Infertility and difficulty in getting pregnant
  • Depression

Besides fertility problems, complications include risk of developing:

  • Insulin resistance and Pre-diabetes / Diabetes
  • Abnormal cholesterol and triglyceride levels
  • Heart diseases
  • Stroke
  • Endometrial cancer (cancer of the inner lining of the uterus)
  • Obesity
  • Sleep apnea
  • Nonalcoholic steatohepatitis (a severe liver inflammation caused by fat accumulation in the liver)
  • Abnormal uterine bleeding
  • Physical examination (blood pressure, body mass index (BMI), waist size, skin check for extra hair on face, chest or back, acne, or skin discoloration)
  • Basic screening tests like Thyroid function tests, Serum prolactin level, Total and free testosterone levels, Free androgen index, Serum hCG level, Cosyntropin stimulation test, Serum 17-hydroxyprogesterone (17-OHPG) level, Urinary free cortisol (UFC) and creatinine levels, Low-dose dexamethasone suppression test, Serum insulin-like growth factor (IGF)–1 level, Andostenedione level, FSH and LH levels, GnRH stimulation testing, Glucose level, Insulin level and Lipid panel
  • Diagnosis is confirmed by vaginal ultrasound, which shows that both the ovaries are enlarged; the bright central stroma is increased ; and there are multiple small cysts in the ovaries

Apart from medical management, lifestyle modification has a significant role to play in management of PCOD:

  • Weight loss through a low-calorie diet combined with moderate exercise activities (even a modest reduction in weight improves the condition)
  • Eat healthy food that includes lot of vegetables, fruits, nuts, beans, and whole grains
  • Avoid food that are high in saturated fats like red meat, cheese and fried foods
  • Quit smoking

Polycystic Ovarian Disease (PCOD)

i.What are the main causes of Polycystic Ovarian Disease?+
ii.What does the doctor check to confirm the diagnosis of PCOD?+
iii. Can polycystic ovarian disease be treated?+
iv.Is natural conceiving possible with PCOD?+

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