What is PCOD (polycystic ovarian disease)?
Patients suffering from polycystic ovarian disease (PCOD) have multiple small cysts in their ovaries (the word poly means many). These cysts occur when the regular changes of a normal menstrual cycle are disrupted. The ovary is enlarged; and produces excessive amounts of androgen and estrogenic hormones. This excess, along with the absence of ovulation, may cause infertility. Other names for PCOD are Polycystic Ovarian Syndrome (PCOS) or the Stein-Leventhal syndrome.
Treatment of PCOD for the infertile patient will usually focus on inducing ovulation to help them conceive.
Regular exercise, a healthy diet, weight control, and not smoking are all important parts of treatment for polycystic ovary syndrome (PCOS). You may also take medicine to balance your hormones.
Treatments depend on your symptoms and whether you are planning a pregnancy.
There is no cure for PCOS, but controlling it lowers your risks of infertility, miscarriages, diabetes, heart disease, and uterine cancer.
Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.
The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.
Signs and symptoms of PCOS often develop around the time of the first menstrual period during puberty. Sometimes PCOS develops later, for example, in response to substantial weight gain.
Signs and symptoms of PCOS vary. A diagnosis of PCOS is made when you experience at least two of these signs:
- Irregular periods: Infrequent, irregular or prolonged menstrual cycles are the most common sign of PCOS. For example, you might have fewer than nine periods a year, more than 35 days between periods and abnormally heavy periods.
- Excess androgen: Elevated levels of male hormone may result in physical signs, such as excess facial and body hair (hirsutism), and occasionally severe acne and male-pattern baldness.
- Polycystic ovaries: Your ovaries might be enlarged and contain follicles that surround the eggs. As a result, the ovaries might fail to function regularly.
PCOS signs and symptoms are typically more severe if you're obese.
PCOS treatment focuses on managing your individual concerns, such as infertility, hirsutism, acne or obesity. Specific treatment might involve lifestyle changes or medication.
Your doctor may recommend weight loss through a low-calorie diet combined with moderate exercise activities. Even a modest reduction in your weight — for example, losing 5 percent of your body weight — might improve your condition. Losing weight may also increase the effectiveness of medications your doctor recommends for PCOS, and can help with infertility.
To regulate your menstrual cycle, your doctor might recommend:
- Combination birth control pills
- Progestin therapy
To help you ovulate, your doctor might recommend:
- Clomiphene (Clomid): This oral anti-estrogen medication is taken during the first part of your menstrual cycle.
- Letrozole (Femara): This breast cancer treatment can work to stimulate the ovaries.
- Metformin (Glucophage, Fortamet, others): This oral medication for type 2 diabetes improves insulin resistance and lowers insulin levels. If you don't become pregnant using clomiphene, your doctor might recommend adding metformin. If you have prediabetes, metformin can also slow the progression to type 2 diabetes and help with weight loss.
- Gonadotropins: These hormone medications are given by injection.
To reduce excessive hair growth, your doctor might recommend:
- Birth control pills: These pills decrease androgen production that can cause excessive hair growth.
- Spironolactone (Aldactone): This medication blocks the effects of androgen on the skin. Spironolactone can cause birth defect, so effective contraception is required while taking this medication. It isn't recommended if you're pregnant or planning to become pregnant.
- Eflornithine (Vaniqa): This cream can slow facial hair growth in women.
- Electrolysis: A tiny needle is inserted into each hair follicle. The needle emits a pulse of electric current to damage and eventually destroy the follicle. You might need multiple treatments.