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Thursday, 30 January 2014

Polycystic Ovary Disease: what is it?

Irregular ovulation is a major hurdle on the road to conception. The rule of thumb is that if periods are regular with a cycle length of twenty two to thirty five days, then ovulation is assured. The most common cause of irregular ovulation is Polycystic ovary syndrome (PCOS) or Polycystic ovary disease (PCOD). This condition occurs in 5-10% of women in the general population and up to 30% of women with subfertility. There are a lot of misconceptions around this diagnosis and women generally get very concerned when they are told that they have PCOD. 

How it is diagnosed?
Women who have PCOD may have a varying severity and types of symptoms and in order to be given a diagnosis of PCOD, there must be two of the three following criteria present: 

  • Infrequent or absent periods
  • Acne, hirsuitism (excessive hair in those parts of the body where thick, long, dark hair do not normally exist in women) or hair thinning.
  • At least one of the ovaries having more than 12 antral follicles on pelvic ultrasound scan.
Does polycystic ovaries on scan mean I have PCOD?
I come across girls and women who have had a scan and have been handed over a report saying that they have a POLYCYSTIC OVARY DISEASE! Please do not pay heed to this report as PCOD is a clinical diagnosis based on the criteria mentioned above. Ovaries may have an increased number of antral follicles in as many as one-thirds of normal women. In other words ovaries with a higher number of antral follicles can be a normal finding and in the absence of other symptoms, there is no cause for concern. Please see your doctor for clarification. 


Weight gain and PCOD
Nearly 50% of women and girls with PCOD are obese. Almost all relate their weight with the fact that they have PCOD. It is important to realise that it works the other way around and it is obesity which causes the manifestation of the symptoms of PCOD. Diet and Exercise have been shown to benefit obese PCOD women and as little as 5-10% of weight loss can result in regular menstruation and ovulation. Incorporating lifestyle changes to achieve a healthy body mass index would also decrease the risk of miscarriage and the reduction of possibility of heart disease and diabetes in later life.

Can PCOD be cured? 
The answer is no. However the problems that are faced can be overcome with expert advice. The disease is by no means the end of the road to conception. Medications such as Metformin can be given to women who have a high insulin level. Ovulation can also be induced through either tablets such as Clomiphene or injections. Women with PCOD generally have more sensitive ovaries and these ovaries therefore can mount too strong response when it is attempted to induce ovulation. None of these medications are without side-effects and it is therefore best to let the experts (either IVF specialists or endocrinologists) to treat this condition.

Do not despair if you have been handed a diagnosis of PCOD. 

Remember

                       You just need to find it!

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