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PCOS : POLYCYSTIC OVARIAN SYNDROME

  • PCOS is a very common cause of infertility in women and is characterised by :

    • Cysts that develop in the ovaries (polycystic ovaries)
    • Ovaries that do not regularly release eggs (ovulation)
    • Higher levels of the male hormones – testosterone/androgen in the woman's body.

    The condition is associated with abnormal hormone levels in the body, including high levels of insulin. Insulin is a hormone that controls sugar levels in the body. Many women with PCOS are resistant to the action of insulin in their body and so produce higher levels of insulin to overcome this. This contributes to the increased production and activity of hormones such as testosterone. Being overweight increases the amount of insulin your body produces.

    The common symptoms of PCOS are :

    • irregular periods or no periods at all
    • difficulty getting pregnant (because of irregular ovulation or failure to ovulate)
    • excessive hair growth (hirsutism) – usually on the face, chest, back or buttocks
    • Excessive weight gain and higher BMI.
    • thinning hair and hair loss from the head
    • oily skin or acne

    Fertility treatments for patients with PCOS are

    • Oral contraceptive pills (OCP) or Progesterone pills may be prescribed to induce regular or absent periods.
    • A medication called clomifene citrate (CC) is usually the first treatment recommended for women with PCOS who are trying to get pregnant. Clomifene encourages the monthly release of an egg from the ovaries (ovulation).
    • If clomifene is unsuccessful in encouraging ovulation, another medication called metformin may be recommended. Metformin is often used to treat type 2 diabetes, but it can also lower insulin and blood sugar levels in women with PCOS
    • Laparoscopic ovarian drilling is recommended in patients with severe PCOS or who are unable to become pregnant with the medications mentioned above. Under general anesthesia, a thin telescope called a laparoscope is passed into abdomen. The ovaries are then surgically treated using heat or a laser to destroy the tissue that's producing androgens (male hormones). Laparoscopic ovarian drilling has been found to lower levels of testosterone and luteinising hormone (LH) and raise levels of follicle-stimulating hormone (FSH). This corrects your hormone imbalance and can restore the normal function of your ovaries.
    • Weight loss is another very important component in the management of PCOS and our experience is that significant weight loss in overweight patients can greatly decrease insulin resistance and ones chances of getting pregnant. Modern lifestyles, erratic food habits and career compulsions are often to blame for younger women suffering from PCOS in India. A comprehensive weight reduction programme that involves appropriate exercise and sensible eating habits supervised by our dietician, Dr.Lalitha Priya, can go a long way in achieving pregnancy and in improving ones health