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WHAT IS PCOD
Introduction: The full form of PCOD is polycystic ovarian disease. In this disease when ultrasound of ovary is done it is studded with multiple small cyst that is why this disease is called polycystic disease.
What is Menstruation ?
The brain receives stimulation from the environment in the form of nutrition, stress, emotion, light, smell, sound etc. This stimulation results in secretion of a hormone called gonadotropin (L.H. & F.S.H). Gonadotropin stimulates the ovaries to secrete female hormones oestrogen (Estradol) and progesterone. These hormones stimulate the uterus lining to prepare it for menstruation. Normal menstruation consists of blood, secretions, and disintegrating uterus lining.
The full form of PCOD is polycystic ovarian disease. In this disease when ultrasound of ovary is done it is studded with multiple small cyst that is why this disease is called polycystic disease. These cysts are not real cyst but they are immature egg follicle. These multiple partially developed eggs looks like multiple cyst.
WHY THIS OCCURS
In this disease there is formation of more than normal amount of male hormones as testosterone & Androstenidione from the ovary in that patients due to various causes mentioned below. For your information normally also ovary makes some amount of male hormone even in normal females. But in this disease the amount of secretion of male hormone increases due to various defects as absence of ovulation, appearances of hair growth over face.. The various causes of this excess male hormone formation from ovary is as follows.
1) PRIMARY PCOD: In this the ovary has inherent defect in structure & functions due to its defective development since birth so that it start making little more male hormone (testosterone & Androstenidione,free testosterone from ovary or 17 Ėoh progesterone & DHEAS from the adrenal glan) than normal females. This little extra male hormone suppresses the maturation of egg in ovary. Thus multiple immature egg are present in ovary in every cycle (these immature look like cyst on ultrasound, but in real sense they are not cyst) but none of the immature follicle completes the maturity to fully developed eggs. Thus ovulation does not take place. Once there is no ovulation that leads to deficiency of progesterone hormone resulting into absent periods.
2) Secondary PCOD: due to weight gain & stress, hypothyroidism (HighTSH), High Prolactin, high 17 OH Progesterone high DHEAS. Thus resulting into late periods.
NORMAL VARITION PCOD: Remember in aproximately 20% normal women also if ultrasound done may show PCOD like ultrasound picture. Thus only showing pcod on ultrasound does not makes you hormone abnormal. To call this as abnormal, you must have atleast two thing out of three main features as I have enumerated below. PCOD is a condition of ovarian dysfunction in which there is main feature of increased male hormone secretion from ovary on blood testing or because these male hormone increments occurs in such a tinyamount and may be varying also meaning in one cycle there may be increased blood level of male hormone whereas in next cycle hormone level may be absolutely jormal thus apparent clinical feature of increasd male hormone activity will taken as eveidence for increased male hormone seretion from the ovay such as increased amount of unwanted facial hair or body hair, resistant acne or excessive hair fall in women without any obvious cause this is called ovarian hyperandrogenism
Second feature is polycystic ovary (PCOD) on ultrasound.
Third main feature is late period due to inhibition of egg formation by increased male hormone in ovary. Which is manifested either by late period or absence of ovuation i.e. egg release on serial ultrasonography starting from day 8 of menstrual cycle. ( this test is call Follicular monitoring or ovulation studies)
Thus if your male hormone total testosterone , free testosterone and androstenidione, 17-oh progesterone DHEAS and Insuin is normal and your period is coming on normal time then youíre your pcod on ultrasound has no significance.
What laboratory tests are recommended for (Menstrual irregularity) abnormal bleeding ?
Blood tests for assessment of hormones secretion (LH, FSH, Testosterone, Prolactin, Free testosterone, Androstenidione, DHEAS, ESTRADIOL, 17-OH Progesterone Thyroid tests DHT, and Insulin fasting and PP etc.) .
Ultrasonography provides valuable information on the size of the uterus, thickness of the uterus lining, ovaries and any tumour in the reproductive organs.
1.) FOR UNWANTED FACIAL HAIR:
a.) Cyproterone Acetate
g.) LASER TREATMENT :Permanent cure for the facial hair is LASER TREATMENT at good laser centre.
j.) DOUBLE SQUARE PULSE THERAPY
2.) FOR late periods :
3) Weight Reduction
4) Regular Isometric exercises
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