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Poly-Cystic Ovarian Disease (PCOD)

What is PCOD:
The full form of PCOD is polycystic ovarian disease is also know as PCOS Polycystic Ovarian Syndrome. 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. 

Before discussing other detail about PCOD, I'll like to let you know about what is the normal physiology of menstruation. In normal female there are lacs of immature egg (ovarian) follicle lying in dormant state in the ovary. During the normal menstrual cycle on third day of cycle approximately 30 egg follicles starts maturing finally one of them will mature to full stage to form mature egg. When all the hormones are normal then one out of all maturing egg follicle is selected for further maturation & rest all shrink & atrophy. Finally this selected eg follicle passes through various stages of development & finally matures into a completely developed egg called ovum. Then egg is released out of the ovary (i.e. ovulation). Once the ovum is released ovary starts secreting progesterone for next 10 days. This progesterone hormone leads to strengthening of walls of blood vessel of endometrium. After 10 days of egg release i.e. ovulation, the production of progesterone hormone from ovary ceases. Thus the sudden deficiency of progesterone hormone leads to weakening of the linings of endometrial blood vessels which ultimately shrink & stop supplying blood to endometrium i.e. inner uterine lining. Thus in nut shell the production of estrogen from ovary lads to formation of inner lining of the uterus during menstrual cycle, where as production of progesterone from ovary after the ovulation leads to maintenance of this uterine lining. The menstrual bleeding occurs due to shedding of uterine inner lining i.e. endometrium due to disruption of its blood supply because of sudden deficiency of progesterone because of stoppage of its production from ovary. Thus if no ovulation occurs, there will not be any cyclical exposure of progesterone resulting in absence of regular menstrual bleeding. 

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 PCOD 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) 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: When all the classical features occurs due to obesity, congenital adrenal hyperplasia, Hypothyroidism, hyper-prolactinemia, etc.

 


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