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What is polycystic ovarian disease ?

Polycystic ovarian disease (PCOD) is a condition in which young girls/women develop irregular periods and hirsutism (excessive hairgrowth over face and body). Majority of these women are overweight/obese. If not properly managed, infertility is a concern.

What are the causes ?

Majority of the PCOD women are overweight/obese. Hormonal changes in PCOD are thought to be due to insulin resistance.

However, following endocrine conditions should be ruled out before branding the patient as having PCOD:
1   Cushing’s syndrome
2   Hypothyroidism
3   Prolactinoma
4   Non classical congenital adrenal hyperplasia

What are the symptoms & signs ?

  • Irregular periods (Anovulatory cycles)
  • Increase in facial & body hair; some may develop virilisation also (extreme degree)
  • Obesity
  • Features of insulin resistance (Ex: Acanthosis nigricans, skin tags)

Is there any criteria for diagnosis ?

Rotterdam criteria is generally used for the diagnosis of “PCOD”.
Any two of the following should be present for the diagnosis:
  • Clinical features (hirsutism/virilisation) or documentation of high androgen/ testosterone levels
  • Irregular periods (Anovulatory cycles)
  • Ultrasound showing “Polycystic ovarian” morphology/pattern.

Is there any criteria for diagnosis ?

  • FSH,LH,Prolactin,Testosterone,DHEAS, Dexamethasone suppressed cortisol, 17 hydroxy progesterone
  • Ultrasound of pelvis to look for “Polycystic ovarian” morphology; also to rule out ovarian/adrenal tumors

How to treat ?

Weight reduction (Diet & exercise) is the cornerstone in the management of PCOD.

Even 5-10% of weight loss produces remarkable improvement.

Metformin in a dose of 500 mg – 2 gm/day is helpful in some for weight reduction/ normalization of cycles and improving fertility rates.

Clomiphene citrate and Letrozole are used to achieve fertility.

Medicines like anti-androgens (Finasteride, Spironolactone, Cyproterone acetate) and local measures (Laser therapy, electrolysis and waxing) are helpful in the treatment of hirsutism.

When to Contact a Medical Professional ?

Contact your health care provider if:

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