Polycystic Ovarian Disorder / Syndrome (PCOD / PCOS) is considered the most common endocrine disorder in the world in women of reproduction age. Formerly it was called Stein-Leventhal syndrome.

Who are at risk?

It occurs in teenagers and women of childbearing age.

What causes PCOS?

PCOS is a multifactorial and polygenic condition characterized by excessive androgen production by the ovaries mainly.

Common Symptoms:

Irregular, infrequent, heavy or no periods at all

Difficulty getting pregnant (because of irregular ovulation or failure to ovulate)

Thinning hair and hair loss from the head (Alopecia)

Excess hair growth on face, chest, buttocks or back (Hirsutism)

Oily skin or acne on face and body

Development of darkened skin patches (Acanthosis Nigricans)

Weight gain

Depression

Anxiety

Mood Changes

Sleep disorder

Erectile dysfunction in men

Low Sex drive

PCOS can lead to:

Short term consequences

• Obesity
• Infertility
• Depression
• Sleep apnea
• Irregular menses
• Abnormal lipid levels
• Non-alcoholic fatty liver disease
• Hirsutism/acne/androgenic alopecia
• Insulin resistance/acanthosis nigricans

Long term consequences

• Diabetes mellitus
• Endometrial cancer
• Cardiovascular disease

How to diagnose?

PCOS is diagnosed on the basis of a combination of clinical or biochemical evidence of hyperandrogenism, amenorrhoea or oligomenorrhoea, and the ultrasound appearance of polycystic ovaries.

• Ultrasonography:  Ovaries are enlarged in volume (≥10 ml). Increased number (≥12) of peripherally arranged cysts (2–9 mm) is seen.
• Thyroid Function Test (FT3, FT4 & TSH)
• Serum Prolactin level
• Serum testosterone levels
• Serum DHEAS levels
• FSH, LH, and estradiol levels (LH levels classically measure at least two-fold higher than FSH)
•  Anti-Mullerian hormone (AMH) (two- to three old higher in women with PCOS)
• 24-hour urine collection or urinary free cortisol
• Evaluation of insulin resistance by 2-hour glucose tolerance test (2-hr GTT)
• An endometrial biopsy is recommended or abnormal bleeding in any woman older than 45 years and in those younger than this with a history of unopposed estrogen exposure

When to visit your doctor about PCOS?

You have never been diagnosed, but you are concerned with your current symptoms

You have irregular periods or do not get periods on your own

You are obese and/or have weight gain that is difficult to manage

You have a PCOS diagnosis and are having trouble managing your condition

by

Dr. Ashmita Shrestha, Consultant Pathologist

Sources:

William’s Gynecology -3rd Edition