Polycystic Ovarian Disease (PCOD) is a prevalent illness that affects 5% to 10% of women between the ages of 12 and 45. It is a condition in which there is hormonal balance in a woman’s body. Normally, each of a woman’s ovaries releases one egg alternately, every month. PCOD is a disorder in which the ovaries produce a large number of immature or partially-mature eggs that develop into cysts. Androgens or male hormones are also produced in minute amounts by the ovaries, however, in this condition, the ovaries swell up and secrete high levels of androgen, which can create havoc on a woman’s fertility and her body.
PCOD is a disease that affects a large number of young adults since it may begin at an early age. It is a common condition that affects teens and young women, affecting 1 out of 10 women of reproductive or childbearing age. PCOD can make it difficult for women to conceive and complications may arise with regards to menstrual periods. No ovulation, acne, irregular periods, and hirusitism are common. Abdominal weight gain, irregular periods, male pattern hair loss, and infertility are prevalent symptoms of PCOD. It is critical for young people to understand the disease’s development, as well as the causes and long-term consequences. If not treated, it can lead to insulin-resistant diabetes, obesity, high cholesterol leading to cardiovascular diseases.
Causes of PCOD
The causal factors of PCOD are currently unclear; however, there is a link between PCOD and low-grade inflammation, excess insulin, excessive production of male hormones (hyperandrogenism), and heredity. PCOD is also influenced by different factors such as early menarche, an unhealthy lifestyle, and pollution. The genetic relationship between hormones and insulin resistance is still undergoing scientific research.
Excessive androgen (male hormone): The ovaries normally produce female sex hormones (estrogen) as well as male sex hormones (androgen). During each menstrual cycle, these aid in the healthy formation of eggs in the ovaries. An imbalance in these sex hormones is linked to PCOD. The ovaries begin to produce significantly more androgens as a result of PCOD. As a result of this condition, patients stop ovulation, get acne, and develop excess facial and body hair (hirusitism). Adrenal hyperandrogenism was found to affect about 3% of PCOD patients, according to a 2016 research.
Excess secretion of insulin: Insulin is a hormone that regulates blood sugar levels in the body. The blood sugar levels rise as human cells develop resistance to the action of insulin. As a result, the body produces excess insulin to keep the blood sugar level in check. Excess insulin production leads to an increase in the production of androgen, which are male hormones that are produced in much lower quantities in females. Ovulation is affected by this increased androgen production.
Insulin resistance is a common sign of PCOD in both obese and lean people. It occurs in 70-95% of obese PCOD patients and 30-75% of lean PCOD patients. High insulin levels is a primary contributor to the disease.
Heredity: There may be a hereditary link between PCOD and women. PCOD appears to run in families, so if other women in the family have PCOD, irregular periods, or diabetes, chances getting it are increased. Based on existing research, it is possible to conclude that PCOD has genetic factors. Simply put, PCOD is a condition that be inherited across generations. A woman with a family history of PCOD has a 50% chance having the condition. Her daughter or granddaughter is still at risk even if she skips it. This is due to the fact that PCOD becomes part of the genetic code, and the genes that are impacted are the most common ones.
However, the particular genetic abnormality, is yet to be identified. PCOD can be a genetic condition, however, how much of this genetic component contributes to the development of PCOD is still unknown.
Low-grade inflammation: PCOD causes low-grade inflammation, which may induce the polycystic ovaries to produce androgens. As shown by elevated levels of numerous inflammatory markers, PCOD is linked to low-grade systemic inflammation. Low-grade chronic inflammation has been identified as a crucial factor in the development of PCOD. The link between Polycystic Ovarian Disease and low-grade inflammation has been documented in several studies to be of unknown cause - obesity, insulin resistance or PCOD itself.
Symptoms of PCOD
A common assumption is that only obese or overweight women suffer from PCOD, however, even if a person is lean and has clear skin, they might still have PCOD. This is due to the fact that it is an endocrine condition that affects numerous body systems. Insulin Resistance and hyperinsulinemia, are the disease's major pathologies. Insulin is a hormone that controls blood sugar levels in the body. Insulin resistance is defined as a cell's failure to respond to insulin's function in transporting glucose (sugar) from the bloodstream into muscles and other tissues. As a result, the pancreas generates extra insulin in order to beat the elevated sugar levels.
Around the time of their first menstrual period, some women begin to experience symptoms. The signs and symptoms of PCOD vary, however in obese people, the symptoms are usually more severe. The following are some of the most often reported symptoms and signs of PCOD:
- Irregular periods that occur every 2 to 3 months (amenorrhea)
- Heavy bleeding (Menorrhagia)
- Hair growth on the body and face that is unusual (hirsutism). Women frequently have thicker, darker facial hair, as well as more hair on their chests, bellies, and backs.
- Acne that won't go away despite standard treatments. This is caused due to an excess of peripheral androgen.
- Uncontrolled weight gain, particularly around the waist
- Darkening or pigmentation of the skin around the neck (Acanthosis nigricans)
- Infertility
- Headaches
- Male-pattern baldness or hair loss
- Depression
- Fatigue
Treatment of PCOD
The cure for PCOD is yet to be discovered. The condition can be managed by altering one's lifestyle. Maintaining a healthy weight is the most effective way to control and manage PCOD. As a result, PCOD patients must exercise on a regular basis and consume a healthy diet. Sugars and carbs should be limited in the diet. For people with PCOD, a high protein and high fibre diet is suggested.
PCOD medical treatment focuses on addressing specific issues, such as infertility, hirsutism, acne, or obesity.
- Glucose levels in the blood are reduced.
- Fertility restoration
- Acne or hirsutism treatment
- Endometrial hyperplasia and endometrial cancer are prevented, and regular menstruation is restored.
The following medications are used to treat PCOD's abnormal hormones and menstrual cycles:
- Menstrual periods can be made more regular using birth control or progesterone tablets.
- Metformin, an insulin-sensitizing drug, can help with PCOS symptoms and can even bring menstrual periods back to normal. It may also aid weight reduction for certain women.
- Analogs of the LH-releasing hormone (LHRH)
- The egg matures and is released after treatment with clomiphene citrate. This or other reproductive medicines may be required by certain women in order to get pregnant.
The following medications or treatments may be used to address abnormal hair growth:
- Pills for birth control. It might take a few months to notice a difference.
- If birth control pills do not work, anti-androgen medicines such as spironolactone and flutamide may be attempted.
- In women, eflornithine cream may help to inhibit the growth of undesirable facial hair.
- Hair removal with laser and non-laser light sources damages individual hair follicles, preventing them from growing again. This can be costly, and several sessions are required. Other drugs and hormones can be used in conjunction with laser hair removal.
- Anovulation (lack of ovulation) and infertility are occasionally treated with a pelvic laparoscopy to remove part of the ovary or drill holes in the ovaries. However, the effects are temporary.
It should be remembered that no medicine or treatment will be effective until lifestyle modifications are made. The following are some lifestyle changes that can help reduce the complications of PCOS:
- Maintaining a healthy body weight: Weight loss can help restore ovulation by lowering insulin and testosterone levels.
- Controlling your diet and limiting your carbohydrate intake: Diets high in carbohydrates and low in fat may increase insulin levels.
- Exercise on a regular basis: Exercise can help you regulate your weight and reduce your blood sugar levels.
The prevalence of PCOS is rapidly increasing. Because of their sedentary lifestyles, an increasing number of teens are developing PCOD. PCOD has no known cure; its symptoms, however, can be reversed with the right diet, medicine, and lifestyle, until they appear to be removed.
Sources:
https://www.nightingales.in/blog/womens-health/pcod-causes-symptoms-and-treatment/
https://www.apollocradle.com/what-is-difference-between-pcod-vs-pcos/
https://www.yashodahospitals.com/diseases-treatments/pcod-pcos-symptoms-causes-treatment/
https://helloclue.com/articles/cycle-a-z/the-link-between-pcos-and-insulin-resistance
https://pharmeasy.in/blog/what-is-pcos-or-pcod-causes-symptoms-treatment-and-faqs/