PCOD and Women Wellness
Polycystic Ovary Disease (PCOD), or Polycystic Ovary Syndrome (PCOS), is a medical condition that affects women of childbearing age (12 to 45 years). PCOD affects 1 in 10 women of childbearing age. Women suffering from PCOD have a hormonal imbalance and disturbed metabolism. These problems affect their overall health. PCOD is also, often, a common cause of infertility. However, infertility arising from PCOD can be treated with the right therapy.
PCOD and Women’s Health
In women, suffering from PCOD, the ovaries produce multiple immature eggs. These eggs, over a period of time, turn into cysts in the ovaries. Ovaries are the female reproductive organs that produce female hormones such as oestrogen, progesterone, inhibin, etc. The ovaries also control women’s menstrual cycle. When immature eggs accumulate in the ovaries, it causes the ovaries to swell. The ovaries then release the male hormone, which leads to infertility.
The hormonal imbalance caused by PCOD leads to an absence of ovulation, an irregular menstrual cycle, difficulty in conception, gain in weight, acne, hirsutism, etc. When left untreated, PCOD can lead to other health complications such as diabetes, cardiovascular diseases, obesity, and increased cholesterol.
The first symptoms of PCOD usually appear during the first cycle of menstruation when women reach puberty. There have also been instances of PCOD appearing in the later stages of women’s lives - usually caused as a result of weight gained over the years.
The common symptoms of PCOD include:
Increased levels of the male hormone - androgen. This causes excess facial/body hair and male-pattern baldness.
Disturbed/irregular menstrual cycle. This is attributed to the release of immature eggs by the ovary.
Difficulty in conceiving due to irregular/delayed/failed ovulation. Often, PCOD in women is diagnosed only when women visit the doctor complaining of difficulty in conceiving.
The increased production of the male hormone, androgen, causes hair loss or thinning of hair.
An outbreak of acne also usually accompanies PCOD.
PCOD also causes weight gain in women.
Causes of PCOD
Common causes of PCOD include -
Genetic Causes - If there is a family history of PCOD among the immediate female members of a woman’s family, there is a 50% chance of developing PCOD. PCOD is a risk factor for diabetes, and as a person ages, PCOD may lead to Type 2 diabetes. As per current medical knowledge, no single gene has been determined to cause PCOD. It is believed that PCOD is caused due to the involvement of multiple genes.
Insulin Resistance - Among women with PCOD, nearly 70% have been found to have insulin resistance. Insulin resistance is caused either due to genetic or lifestyle factors, or a combination of both factors. Poor lifestyle choices include poor diet and a lack of exercise, leading to obesity. Insulin is the hormone produced by the pancreas. Insulin helps the body utilise the sugar in the foods consumed - for the body’s energy needs. Due to insulin resistance, when the body is unable to use insulin optimally, the body has elevated demand for insulin. This causes the pancreas to produce more insulin.
Excess Weight - Excess weight exacerbates insulin resistance and worsens the symptoms of PCOD. Some women with PCOD, whose weight is under control, do not report symptoms such as irregular menstruation or hirsutism. These symptoms, however, appear once the woman gains excess weight.
Inflammation - PCOD may lead to elevated levels of inflammation in women. Excess weight increases inflammation. In women with PCOD, increased inflammation also raises androgen levels.
Diagnosis of PCOD
There is no single test to confirm that a woman is suffering from PCOD. Doctors diagnose the condition after a discussion of medical history followed by a physical examination. Following this, doctors may recommend a pelvic examination, blood tests to determine hormone levels, and an ultrasound to ascertain the state of the ovaries and the uterus.
Once the diagnosis of PCOD is complete, the doctor would prescribe regular and periodic checkups.
Other ailments associated with PCOD
The incidence of PCOD is observed to be accompanied by other health conditions. The other ailments that commonly afflict women suffering from PCOD include:
Metabolic conditions such as hypertension, cardiovascular problems, higher cholesterol levels, and increased blood glucose.
Women with PCOD often experience miscarriages.
Women also develop gestational diabetes.
Sleep apnea is characterised by blocked airways in the throat and nose.
Infertility during childbearing age.
Type 2 diabetes is marked by insulin resistance and sugar buildup in the blood. It has also been observed, that in women over 40 years of age and with PCOD, almost 50% develop pre-diabetes or become diabetic.
Clinical depression and associated mental disorders.
Abnormal uterine bleeding.
Severe and often untreatable acne arising from hormonal problems.
Chronic inflammation of the liver.
Medical science is yet to develop a definitive cure for PCOD. The condition can only be managed with proper medication and lifestyle changes. The management of PCOD follows a multidisciplinary approach involving a gynaecologist, an endocrinologist, a specialist on infertility, a dermatologist, and a dietician.
Weight management is an important aspect of PCOD management. Women suffering from PCOD are advised to exercise regularly, follow a healthy lifestyle and watch their diet. PCOD patients are advised to limit their carbohydrate and sugar intake and eat food rich in fibre and high in proteins.
Good menstrual health and menstrual hygiene practices are important for women with PCOD. Menstrual hygiene impacts overall women's wellness, but does not receive the necessary attention. Menstruation is a normal physiological process for women that begins in adolescence and continues till the onset of menopause.
Improper menstrual hygiene practices can lead to reproductive tract infection and other ailments in women. Menstrual hygiene is influenced by the financial ability of the women. Typically, women from economically weaker sections use homemade reusable sanitary pads or reusable pads. It is estimated that, in India, between 43% to 88% of women use reusable cotton pads. However, now Amala Earth provides a range of sanitary cloth pads that are affordable, reusable, and hygienic. The firm also provides a wide choice of period panties, reusable period panties, and ultra-thin sanitary pads. Besides reusable pads for periods, Amala Earth also produces a range of organic sanitary pads made from environment-friendly materials. Their range of products also includes organic oils that provide pain relief from menstrual cramps.
PCOD - Medication and Surgery
After a thorough physical examination and diagnostic tests, the doctor is likely to prescribe a course of medication to regulate and correct the menstrual cycle. The medication could include:
Birth control pills that contain a combination of progestin and oestrogen to reduce the production of male sex hormones. These pills also regulate hormonal production to enable the follicles to release the eggs. These pills also provide relief from acne and control hirsutism.
The prescribed treatment for PCOD could also include immature follicle aspiration - to improve endocrinology and reduce follicle count in the ovary and facilitate pregnancy.
The doctor is also likely to put the patient on a course of medication to improve ovulation.
Surgery is always a means of last resort. Surgical treatment might consist of laparoscopic ovarian drilling to initiate ovulation (release of the eggs from the ovaries).
Diet for PCOD Management
Together with lifestyle changes to better manage PCOD, it also helps to adopt a PCOD-friendly diet. The diet, essentially, should be low in fats and carbohydrates, and high in fibre and protein. Such a diet checks spikes in blood sugar levels and keeps the weight under control. A PCOD-appropriate diet would include:
Spinach, kale, broccoli, cauliflower, and green leafy vegetables.
Fibre-rich fruits and vegetables.
Nuts, legumes and whole grains.
Low-fat dairy products.
PCOD - Recommended Exercises
Maintaining one’s ideal body weight and keeping a strict watch on the Body Mass Index (BMI) is key to effective PCOD management. The exercises that help in this include:
High-intensity interval training (HIIT)
Cardiovascular exercises such as walking, jogging, swimming, stair-climbing, etc. based on one’s general physical fitness.
Strength training and weight training.
It is recommended that any physical activity be undertaken after due consultation with a doctor.
The cause(s) for PCOD is still unclear. It is vital, for the effective management of the condition, that it be diagnosed early. Early diagnosis helps reduce the severity of the symptoms and prevents complications.
Early commencement of treatment, comprising lifestyle changes, exercise and medication, will help in the management of the disease and associated complications.
Frequently Asked Questions
How does PCOD affect the quality of life?
Women suffering from PCOD endure a diminished quality of life due to lifestyle restrictions and increased psychological disturbances arising from hormonal imbalances.
Is PCOD a lifelong disease?
Unfortunately, yes. With no known cure, the disease can only be managed and may continue even after the child-bearing age has passed.
Is PCOD a serious medical condition?
PCOD is a common health condition, usually affecting women in their child-bearing age. However, it is not life-threatening or debilitating.