Dr Richa Sharma
What is PCOS?
Polycystic ovarian syndrome (PCOS) is a complex hormonal disturbance that affects the entire body and has numerous implications for general health.
There are plenty of eggs in ovaries but not getting mature to result in a baby .Women with PCOS are the largest group of women at risk for the development of cardiovascular disease and diabetes.
How common?
PCOS, starts in childhood but unfortunately, not always diagnosed at that age
30 % of all infertility associated with anovulation, & 85-90% of these attributed to PCOS
21 – 59 % of women in reproductive age demonstrate ultrasound picture of polycystic ovaries
About 30 – 50 % have clinical or biochemical (in blood tests) signs of Anovulation and excess male hormones.
With proper diagnosis and treatment, most PCOS symptoms can be adequately controlled or eliminated .Infertility can be corrected and pregnancy achieved in most patients In some patients, hormonal disturbances and anovulation may recur.
How it presents?
Menstrual disturbances (70.3 %)-can be normal, scanty, heavy or irregular.
Obesity- 50 %
Excess hairs (hirsutism)/oily skin/pimples – 70.3 %
Infertility – 24.8 % (85 -90 % of anovulatory infertility)
High abortion rate
Lack of premenstrual disturbances – Breast tenderness & dysmenorrhoea
Asymptomatic – 20 %
Whether it is inherited from mother to daughter?
It has a genetic trait associated. Abnormal function of genes for male hormone synthesis and insulin secretion and action.
What correlation body weight has?
50% of patients are obese.
Rather than PCOS leading to obesity, obesity drives polycystic ovaries to be more clinically manifest .
Typical obesity of PCOS is described as “centripetal,” or “apple” type.
Is it really a hopeless condition? How to rectify?
Its not a hopeless situation. Its a variation in normal ovary in terms of number and distribution of eggs. Its a very common condition in our Indian female.
Diagnosed by- Ultrasound and certain blood tests
Patient needs help to get pregnant in form of proper protocols and careful monitoring and foremost proper counselling.
How is PCOS treated?
* Till now there is no cure for PCOS
* The target is to:
Reduce symptoms
Prevent further problems
Ovulation Induction
Key to Success of Treatment –
Depends on ability to reduce body weight by life- style modifications
Diet modification
Exercise
Stress Management – Psychosocial support
Management of PCOS-HOW?
Directed by patients concern of
Symptoms
Degree of morbidity related to androgen excess – hirsutism/acne
Prophylaxis against unopposed Estrogen action
Desire to conceive
Determinants of success of Rx
Body weight, Insulin and LH levels.
(The author is an IVF Consultant Fortis Noida Group)
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