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ABOUT PCOS
Suffering from irregular and painful periods? Or just a sudden increase in the amount of acne you see on your skin? It's time you stopped ignoring those symptoms. According to Dr Chitwan Dubey, consultant OBGYN at SevenHills hospital, PCOS/PCOD is an extremely common syndrome seen in women these days.
According to Dr Chitwan Dubey, 'PCOS or poly cystic ovarian syndrome also commonly referred to as PCOD, is one of the most common endocrine disorders among women of the reproductive age group.' It is a collection of symptoms that manifest together and is commonly seen as a hormonal imbalance in women, although this symptom may manifest individually as well. Contrary to common belief, this condition may occur in both obese and non obese women.
PCOS CONTENT
Causes
Risk factors
Symptoms
Diagnosis
Treatment
Complications
CAUSES
The cause of PCOS is unknown but it is thought to be due to multiple genetic mutations. Dr Dubey says, 'Although the causes are not yet known, there definitely is a hereditary factor to it. PCOS can be passed on from one generation to the next.'
RISK FACTORS
There are a number of factors that play a vital role in mitigating the process of PCOS. A number of ongoing studies suggest that a family history of diabetes is a strong factor in leading to PCOS. Apart from that, family history and certain anti seizure medication can also make you more susceptible to suffering from the syndrome. (Read: Diabetes – Symptoms, causes, diagnosis, treatment and complications
SYMPTOMS
According to Dr Dubey, 'PCOS is not a single disease, it is a collection on symptoms that point towards the syndrome. Therefore it is quite possible that the symptoms may be seen either collectively or as single entities. The common symptoms that a girl might notice are -
Menstrual irregularities
Central –obesity (obesity around the mid region – stomach and thighs)
Hirsutism(unwanted facial or body hair)
Oily skin and acne
Thinning of hair on the scalp
Mood swings
Absence of breast development
Acanthosis (thickening of the skin)
Read more about top 15 women's health concerns.
DIAGNOSIS
The diagnosis of PCOS is based on a number of tests and a critical evaluation of your symptoms and family history. Apart from asking you about your symptoms , your gynaecologist will prescribe an abdominal ultrasound to check for any cysts that might be visible on the ovaries. He/she will also ask you to have a blood test to check for your hormonal levels and most importantly will diagnose your condition on what is known as the 'Rotterdam criteria', where one of the following 3 criteria are to be met, in order to be diagnosed with PCOS:
Oligo and anovulation (Irregular or lack of ovulation – diagnosed with an ultrasound scan, blood test and history of missing or irregular periods)
Excess androgen activity (Where there is too much secretion of the androgen or male hormone in your blood – diagnosed by a blood test)
Polycystic ovaries on ultrasound (Read: Get rid of unwanted body hair naturally!)
Apart from common diagnostic tests a doctor will also aim to rule out other medical conditions that often mimic PCOS like -
Hypothyroidism (low levels of thyroid hormone)
CAH(congenital adrenal hyperplasia)
Hyperprolactenemia(presence of abnormally high levels of prolactin in the blood)
Pituitary adenoma(non cancerous tumour on the pituitary gland)
Androgen secreting tumours
Cushings Syndrome
TREATMENT
According to Dr Dubey, 'Treatment is highly tailored depending on the signs and symptoms the lady suffers from and the level of hormonal imbalance she has at the time of diagnosis. The main aim of a treatment regime is to lower the woman's insulin resistance, restore fertility, treat hirsutism and acne, restore regular menstruation and thereby prevent endometrial hyperplasia (thickening of the internal walls of the uterus) and cancer.'
The main aim of the treatment is to bring back the woman's body to normal, by helping her maintain a healthy lifestyle, lose excess weight and eat right.
A woman can conceive even with PCOS, if the condition is managed properly. In cases where a woman cannot anovulation (lack of ovulation) or hormonal imbalance are the most common causes. If a woman wants to conceive it is essential that she lose weight and maintain a healthy diet.'
In some dire cases a woman's doctor may opt for 'ovulation induction' with oral or injectable medicines or even through IVF. Another uncommon yet practiced procedure is LOD or laparoscopic ovarian drilling, done especially for ovarian stimulation has its own benefits.' Says Dr Dubey. (Read: Fertility treatments – how safe are they?)
When managed correctly, having a baby is fairly simple, but there are some complications that a you should know about. Dr Dubey says , 'Women with PCOS are three times more likely to have a miscarriage, of suffering from complex conditions like gestation diabetes, preeclampsia (where the mother-to-be suffers from sudden high blood pressure) and pregnancy induced hypertension. Another complication is a 50% higher risk of having a preterm birth.' 'These women need increased surveillance during pregnancy and child birth. Their glucose levels and hypertension should be under control and hormones should be well balanced to sustain the pregnancy. Most importantly, visiting a doctor at the right time for proper management of symptoms is essential to ensure a safe pregnancy and delivery.' (Read: Is your pregnancy high-risk? (Expert interview))
COMPLICATIONS
Dr Dubey says, ' Women with PCOS are at a higher risk of suffering from complications during their pregnancy. Apart from that there is a greater chance of the infant spending time in the NICU (neonatal ICU) due to complications at birth. That being said, a mother-to-be can deliver a healthy baby safely if certain precautions are taken; like giving birth in a multispeciality hospital where there is a blood bank, NICU, neonatal specialists, and gynecologists who are trained in handling high risk pregnancies.'
According to Dr Chitwan Dubey, 'PCOS or poly cystic ovarian syndrome also commonly referred to as PCOD, is one of the most common endocrine disorders among women of the reproductive age group.' It is a collection of symptoms that manifest together and is commonly seen as a hormonal imbalance in women, although this symptom may manifest individually as well. Contrary to common belief, this condition may occur in both obese and non obese women.
PCOS CONTENT
Causes
Risk factors
Symptoms
Diagnosis
Treatment
Complications
CAUSES
The cause of PCOS is unknown but it is thought to be due to multiple genetic mutations. Dr Dubey says, 'Although the causes are not yet known, there definitely is a hereditary factor to it. PCOS can be passed on from one generation to the next.'
RISK FACTORS
There are a number of factors that play a vital role in mitigating the process of PCOS. A number of ongoing studies suggest that a family history of diabetes is a strong factor in leading to PCOS. Apart from that, family history and certain anti seizure medication can also make you more susceptible to suffering from the syndrome. (Read: Diabetes – Symptoms, causes, diagnosis, treatment and complications
SYMPTOMS
According to Dr Dubey, 'PCOS is not a single disease, it is a collection on symptoms that point towards the syndrome. Therefore it is quite possible that the symptoms may be seen either collectively or as single entities. The common symptoms that a girl might notice are -
Menstrual irregularities
Central –obesity (obesity around the mid region – stomach and thighs)
Hirsutism(unwanted facial or body hair)
Oily skin and acne
Thinning of hair on the scalp
Mood swings
Absence of breast development
Acanthosis (thickening of the skin)
Read more about top 15 women's health concerns.
DIAGNOSIS
The diagnosis of PCOS is based on a number of tests and a critical evaluation of your symptoms and family history. Apart from asking you about your symptoms , your gynaecologist will prescribe an abdominal ultrasound to check for any cysts that might be visible on the ovaries. He/she will also ask you to have a blood test to check for your hormonal levels and most importantly will diagnose your condition on what is known as the 'Rotterdam criteria', where one of the following 3 criteria are to be met, in order to be diagnosed with PCOS:
Oligo and anovulation (Irregular or lack of ovulation – diagnosed with an ultrasound scan, blood test and history of missing or irregular periods)
Excess androgen activity (Where there is too much secretion of the androgen or male hormone in your blood – diagnosed by a blood test)
Polycystic ovaries on ultrasound (Read: Get rid of unwanted body hair naturally!)
Apart from common diagnostic tests a doctor will also aim to rule out other medical conditions that often mimic PCOS like -
Hypothyroidism (low levels of thyroid hormone)
CAH(congenital adrenal hyperplasia)
Hyperprolactenemia(presence of abnormally high levels of prolactin in the blood)
Pituitary adenoma(non cancerous tumour on the pituitary gland)
Androgen secreting tumours
Cushings Syndrome
TREATMENT
According to Dr Dubey, 'Treatment is highly tailored depending on the signs and symptoms the lady suffers from and the level of hormonal imbalance she has at the time of diagnosis. The main aim of a treatment regime is to lower the woman's insulin resistance, restore fertility, treat hirsutism and acne, restore regular menstruation and thereby prevent endometrial hyperplasia (thickening of the internal walls of the uterus) and cancer.'
The main aim of the treatment is to bring back the woman's body to normal, by helping her maintain a healthy lifestyle, lose excess weight and eat right.
A woman can conceive even with PCOS, if the condition is managed properly. In cases where a woman cannot anovulation (lack of ovulation) or hormonal imbalance are the most common causes. If a woman wants to conceive it is essential that she lose weight and maintain a healthy diet.'
In some dire cases a woman's doctor may opt for 'ovulation induction' with oral or injectable medicines or even through IVF. Another uncommon yet practiced procedure is LOD or laparoscopic ovarian drilling, done especially for ovarian stimulation has its own benefits.' Says Dr Dubey. (Read: Fertility treatments – how safe are they?)
When managed correctly, having a baby is fairly simple, but there are some complications that a you should know about. Dr Dubey says , 'Women with PCOS are three times more likely to have a miscarriage, of suffering from complex conditions like gestation diabetes, preeclampsia (where the mother-to-be suffers from sudden high blood pressure) and pregnancy induced hypertension. Another complication is a 50% higher risk of having a preterm birth.' 'These women need increased surveillance during pregnancy and child birth. Their glucose levels and hypertension should be under control and hormones should be well balanced to sustain the pregnancy. Most importantly, visiting a doctor at the right time for proper management of symptoms is essential to ensure a safe pregnancy and delivery.' (Read: Is your pregnancy high-risk? (Expert interview))
COMPLICATIONS
Dr Dubey says, ' Women with PCOS are at a higher risk of suffering from complications during their pregnancy. Apart from that there is a greater chance of the infant spending time in the NICU (neonatal ICU) due to complications at birth. That being said, a mother-to-be can deliver a healthy baby safely if certain precautions are taken; like giving birth in a multispeciality hospital where there is a blood bank, NICU, neonatal specialists, and gynecologists who are trained in handling high risk pregnancies.'
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