Polycystic Ovarian Disease
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Polycystic ovarian disease (PCOS) is a hormonal disorder affecting 5-10% of women. It causes irregular menstrual cycles, difficulty conceiving, weight gain, unwanted hair growth and acne. PCOS is caused by an imbalance of reproductive hormones like insulin, and has genetic links. Diagnosis involves clinical exams, ultrasounds showing ovarian cysts, and hormone blood tests. Long term risks include metabolic syndrome, diabetes, heart disease, and certain cancers. Treatment focuses on lifestyle changes like diet and exercise to lose weight and lower hormone levels, along with medication to manage symptoms and fertility issues. Early diagnosis and treatment can help prevent serious health complications. While there is no cure, managing the condition prevents long-
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Polycystic Ovarian Disease
- 1. POLYCYSTIC OVARIAN DISEASE:THE RISINGTREND Dr Nupur Gupta Consultant & Unit Head, Dept of Obstetrics & Gynecology
- 2. WHAT IS PCOS? A health problem that can affect a woman’s • Menstrual cycle, • Ability to have children • Hormones • Heart • Blood Vessels & • Appearance
- 3. INCIDENCE • Affects 5 to 10% of females • 20 to 30% have ultrasound appearance Most common hormonal disorder in women of reproductive age
- 4. AGE GROUP • Adolescent age (pubertal) • Reproductive age
- 5. CAUSE: HORMONAL IMBALANCE • Not completely understood • Family History (genetic – 50%, 40% if sister, 10% if mother) • Hyperinsulinaemia • The ovaries make more androgens than normal
- 6. SYMPTOMS Vary from woman to woman • Irregular menstrual cycles (amenorrhoea 25%, oligomenorrhoea 85%, hypomenorrhoea) • Difficulty in conception 50% • Weight gain 40% • Unwanted hair growth • Acne
- 7. DIAGNOSIS • CLINICAL • ULTRASOUND – multiple tiny ovarian cysts (STRING OF PEARLS) • BIOCHEMICAL (blood tests) – hormones (LH FSH, Testosterone, DHEAS, Glucose tolerance test) • ASSOCIATED TESTS - thyroid, prolactin, lipid profile
- 8. PCOD & INSULIN RESISTANCE • High insulin levels – high androgens • Hyperinsulinemia • Insulin resistance
- 9. PCOD & HYPERANDROGENISM SERUM TESTOSTERONE & DHEAS • Acne, oily skin, seborrhoea • Hirsutism – upper lip, side bran, chin, chest, abdomen, back & inner thigh • Thinning of hair, Male pattern baldness • Irregular or absent ovulation • Dark patches of skin (neck, armpit & groin)
- 10. PCOD & WEIGHT GAIN • Increase in abdominal fat as in males • Apple figure (waist hip ratio) • Rise in BMI
- 11. LONGTERM SIDE EFFECTS • Metabolic Syndrome (risk of type 2 diabetes, hypertension, hyperlipidaemia, heart disease) • Increased risk of sleep apnoea • Increased risk of endometrial hyperplasia & uterine cancer • Increased risk of depression
- 12. MANAGEMENT • Lifestyle modification • Drug therapy – hormones, insulin sensitisers • Symptomatic treatment for acne, hair growth, menstrual dysfunction • Surgical management
- 13. COUNSELING IN PCOD • Regarding endocrine problems • Metabolic problems • Fertility • Risk of multiple pregnancy & its complications • Long term sequealae
- 14. TREATMENT GOALS Depends on age & need • Adolescent • Newly married, not planning conception • Married planning conception • Secondary infertility • Family complete • Perimenopausal & Menopausal
- 15. LIFESTYLE MANAGEMENT • Weight control • Healthy Diet • Regular exercise & physical activity
- 16. PCOS DIETARY GOALS Consume More Foods • Rich in carbohydrates (50%) • MUFA • Fiber • Omega 3 • Low Glycemic Index Reduce • Total Caloric intake • Saturated Fats (<10%) • Cholesterol
- 17. HAIR TREATMENT • Temporary – epilation, electrolysis, waxing, shaving • Permanent - Laser
- 18. WEIGHT LOSS & MENSTRUAL CYCLES If 7% weight loss & 30 to 60 min of moderate physical activity • Spontaneous menses Free androgen Free insulin Free testosterone SHBG
- 19. WEIGHT LOSS & FERTILITY • In overweight anovulatory women • Weight loss 6 Kg • Resumption of ovulation 92% • Pregnancy rate 85% • Decrease in insulin & testosterone levels
- 20. HOW TO COPE WITH EMOTIONAL ASPECTS OF PCOS? Don’t feel embarrassed Don’t be depressed
- 21. Early diagnosis and treatment helps prevent long- term complications, such as infertility, metabolic syndrome, obesity, diabetes & heart disease. IS THERE A CURE FOR PCOS? CAN IT BE PREVENTED?
- 22. ThanksThanks NEVER LOSE HOPENEVER LOSE HOPE To consult Dr Nupur Gupta Consultant & Unit Head, Dept of Obstetrics & Gynecology Call 0124-4585555 You can also view her profile on :