Impact of Polycystic ovarian Disease (PCOD) on Women’s health

An unhealthy diet and a sedentary lifestyle are the contributing factors to demolish women’s health worldwide. PCOD/PCOS is one such health condition, prevailing among women of reproductive age worldwide. According to the World Health Organization (WHO), 116 million women (3.4%) are affected by PCOD/PCOS worldwide, a common endocrinal system disorder. Prevalence of PCOD/PCOS in India ranges from 3.7 to 22.5 per cent.¹ That implies, that one in every 10 women in India is suffering from PDOD/PCOS. 

These statistics are unexpected and can only be controlled with diet and lifestyle modifications.

Dealing with PCOD/PCOS can be frustrating at times. Figuring out the ways to manage its symptoms, awareness of your health condition ,and investing in your health is the only criteria to lessen the distress caused by PCOD/PCOS. This article aims to cover every relevant information required for the same.

Understanding PCOD

The reproductive system of women is based on two ovaries that release an egg alternately every month. Ovaries produce androgens (male hormones) in a small amount. In PCOD, ovaries release a lot of immature or partially-mature eggs which eventually turn into cysts. Several follicular cysts enlarge the ovary and lead to excessive production of androgen and estrogen hormones causing irregular menstrual cycle, infertility, male pattern hair loss, abnormal weight gain, and related body issues. 

Are PCOD and PCOS the same? 

It is an incorrect assumption that PCOD and PCOS are the same. Since both the conditions are related to ovaries and cause hormonal imbalance. Many of us often get confused between these two terms and consider them to be identical. As the matter of fact, both the health conditions are different.

PCOS (Polycystic Ovary Syndrome) is a metabolic disorder and more severe than PCOD. The eggs in the ovaries never mature enough to trigger ovulation, and instead convert into cysts. The lack of ovulation imbalances female hormones, while increasing male hormone androgen levels higher than usual. Hence, disrupts the menstrual cycle.

PCOD is more common and does not affect fertility. A Woman with PCOD can still ovulate and conceive by taking precautionary measures while for PCOS women, it is hard to conceive followed by a high risk of miscarriages, premature births, preeclampsia, and related complications. 

PCOS is followed by comorbidities such as type 2 diabetes, hypertension, cardiovascular disorders, obesity, endometrial cancer, mood, and eating disorders and seeks medical attention. Whereas PCOD is less complicated comparatively and can be controlled with lifestyle modifications.

Symptoms of PCOD

1. Irregular or unpredictable menstruation ( Oligomenorrhea)
2. No menstruation ( Amenorrhea)
3. Heavy menstrual bleeding (Menorrhagia)
4. Excess hair growth on the face, back, belly, chest
5. Acne on face, chest, back
6. Hair loss or male pattern baldness
7. Difficulty in conceiving
8. Darkening of skin or pigmentation around the neck, groin, under the breast
9. Sleeping difficulty

Cause of PCOD

1. Sedentary lifestyle
2. Unhealthy diet
3. Environmental Pollution
4. Certain medications also imbalance hormones
5. Physiological factors include:

• Insulin Resistance

Insulin resistance affects 70% of PCOD women.² The excess unutilized insulin due to insulin resistance stimulates ovaries to secrete more androgen which disrupts ovulation.

Obesity is one of the high-risk factors that develop insulin resistance.^.3

• Inflammation

Inflammation directly stimulates excess ovarian androgen production. In PCOD, a dietary glucose intake can induce an inflammatory response.⁴

6. Genetic factor

Many defected genes in our body are also involved in the chronicity of the PCOD.⁴

Diagnosis of PCOD 

According to new guidelines, for diagnosis of PCOD, two of the following three criteria should be met: ⁷

1. Clinical Or Biochemical Hyperandrogenism (excessive hair growth on your face and body)
2. Ovulatory Dysfunction (Irregular periods without pregnancy)
3. Polycystic ovaries (PCO)

If you are symptomatic of PCOD, your gynecologist might examine your pelvis and recommend you the required investigations. Some techniques for a thorough investigation of PCOD are:

1. Ultrasound Scan
2. Laparoscopy
3. Hormonal Investigations for androgen levels
4. Hysteroscopy (a thorough examination of the Uterus)

You might also prescribe blood tests to check your cholesterol, insulin, and triglyceride levels to evaluate your risk for related comorbidities of heart disease and diabetes.

How does PCOD affect Pregnancy?

PCOD interferes with the normal menstrual cycle and generates complications during conceiving.

PCOD patients are at very high risk of gestational diabetes and pregnancy-induced hypertension, after ovulation induction. In a finding, Pregnancy-induced hypertension in PCOD was associated with late pregnancy blood pressure > 140/90 mm Hg and returned to normal blood pressure by four to six weeks postpartum.^5,6

Before initiating infertility treatment with drugs, gynecologists recommend lifestyle and diet modifications for weight loss to process the natural ovulation cycle.

If the patient menstrual cycle doesn’t respond to lifestyle modification, she is prescribed medications to regulate ovulation. Birth control pills, patches, vaginal rings, and other medications help resume the normal menstrual cycle and also treat PCOD symptoms.

In obese young PCOD women and PCOD adolescents, Metformin is recommended for hyperinsulinemia reduces body mass index (BMI), and improves insulin sensitivity. 

Thus, an initial attempt with Metformin treatment is made before administering other fertility drugs.

Clomiphene is another fertility drug for PCOD. However, the administration of this drug is followed by multiple births. Therefore, it should be administered under appropriate medical guidance.

If a PCOD patient fails to conceive after taking clomiphene therapy, then Menotropin and a dose of Human Chorionic Gonadotropin therapies are recommended.

Another drug, Letrozole is found to be a more effective oral agent than clomiphene to induce ovulation in PCOD patients.

If ovulation doesn’t respond to medications, then Laparoscopic ovarian surgery and IVF are second-line therapies recommended for conception.

Hormonal contraception is recommended for sexually active adolescents and young patients due to the risk of unwanted pregnancy.

However, the factor of consideration is the use of a contraceptive pill in women with PCOD might increase the risk of venous thromboembolism (clot in the blood vessel) which can be a serious heath threat. ⁷

Therefore, it’s better to consult your gynecologist before proceeding with oral contraceptives in case of PCOD.

Lifestyle and Diet Modifications Recommended For PCOD

A case study on 238 women demonstrated that the quality of life is lowest among infertile PCOD women. ⁸

Both PCOD and infertility as individual factors may harm the quality of life of reproductive-age women.

Regular physical activity, bodyweight management, a diet with a low glycemic index, relaxation techniques, and adequate sleep can effectively help in a spontaneous resumption of the menstrual cycles cycle and improve the chance of conceiving in the first place.

Additionally, Yoga has proven effects in reducing and managing the symptoms of PCOD with or without medicine.⁹

Yogic treatment positively influences parameters such as blood lipid level, blood sugar levels, endocrine parameters, quality of life, cardiovascular parameters, anxiety, and depression in a PCOD patient.

Checkout Yoga for PCOD  at DrTrust360

Young PCOD patients have very good acceptance of lifestyle modifications as compared to adult patients.

Foods with a low glycemic index can help in potential weight loss and manage insulin levels. Here is the list of some foods to eat and avoid in PCOD.

Get your personalized diet plan for PCOD/PCOS from health experts with DrTrust360

How smoking and drinking affect PCOD

Smoking effects may be devastating for reproductive-aged women with PCOD. It not only increases cardiovascular risk but may have adverse effects on cholesterol levels and reproductive hormones.

The harmful chemicals from cigarette smoke (carbon monoxide, hydrogen cyanide, benzene, nicotine, PAHs) can exert composite effects on ovaries, oviduct, and uterus.¹¹ 

In a case study conducted on 98 PCOD smokers, the increased levels of insulin and testosterone, and androgen levels were demonstrated. However, other symptoms such as excessive hair growth, acne, and polycystic ovaries remained unchanged.¹⁰

Moreover, any kind of alcohol is fine if taken in moderation. However, PCOD should be aware of the following factors while taking alcohol:

• Too much alcohol can drop blood sugar levels
• Alcohol can increase the risk of liver diseases
• Alcohol can increase hunger levels
• Alcohol may increase the risk of obesity
• Alcohol affects gut health
• Alcohol affects sleep, increase the risk of depression
• Avoid mixing alcohol with medications for PCOD