PCOD

POLYCYSTIC OVARIAN SYNDROME

DEFINITION
-Polycystic ovarian syndrome (PCOS) is a relatively common hormonal disorder that causes a number of different symptoms in women of reproductive age.
-Women with pcos is an irregularity in the menstrual cycle and the presence of excess male hormones (androgens).
-Women with PCOS may have infrequent or prolonged menstrual periods.

PATHOGENESIS:
-The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.
-In PCOS, many small, fluid-filled sacs grow inside the ovaries.
-These sacs are actually follicles, each one containing an immature egg.
-The eggs never mature enough to trigger ovulation.
-So when their is lack of ovulation alters levels of estrogen, progesterone, FSH, and LH.
-Estrogen and progesterone levels are lower than usual, while androgen levels are higher than usual.
-Extra male hormones disrupt the menstrual cycle, so women with PCOS get fewer periods than usual.

SIGNS AND SYMPTOMS:

  • Irregular /skipped or prolonged: menstrual cycles are the most common sign of PCOS.
    -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
    ovaries might be enlarged and contain follicles that surround the eggs. As a result, the ovaries might fail to function regularly.
    -Heavy bleeding; The uterine lining builds up for a longer period of time, so the periods you do get can be heavier than normal.
    -Acne : Male hormones can make the skin oilier than usual and cause breakouts on areas like the face, chest, and upper back.
    -Weight gain
    -Male-pattern baldness:Hair on the scalp gets thinner and fall out.
    -Darkening of the skin; Dark patches of skin can form in body creases like those on the neck, in the groin, and under the breasts.
    -Headaches: Hormone changes can trigger headaches in some women.

ETIOLOGY
The exact cause of PCOS isn’t known. Factors that might play a role include:
*Excess insulin-Insulin is the hormone produced in the pancreas that allows cells to use sugar, your body’s primary energy supply. If your cells become resistant to the action of insulin, then your blood sugar levels can rise and your body might produce more insulin. Excess insulin might increase androgen production, causing difficulty with ovulation.
*Low-grade inflammation-This term is used to describe white blood cells’ production of substances to fight infection. Research has shown that women with PCOS have a type of low-grade inflammation that stimulates polycystic ovaries to produce androgens, which can lead to heart and blood vessel problems.
*Heredity-plays a major role in PCOS women who have pcod will have some family history of PCOS
*Excess androgen-The ovaries produce abnormally high levels of androgen, resulting in hirsutism and acne.

COMPLICATIONS:
*Sleep apnea-This condition causes repeated pauses in breathing during the night, which interrupt sleep.
*Metabolic syndrome – Both obesity and PCOS increase your risk for high blood sugar, high blood pressure, low HDL (“good”) cholesterol, and high LDL (“bad”) cholesterol.
*Depression – Both hormonal changes and symptoms like unwanted hair growth can negatively affect your emotions. Many with PCOS end up experiencing depression and anxiety
*Infertility – Women who don’t ovulate regularly don’t release as many eggs to be fertilized. PCOS is one of the leading causes of infertility in women
*Endometrial cancer – During ovulation, the uterine lining sheds. If you don’t ovulate every month, the lining can build up. A thickened uterine lining can increase your risk for endometrial cancer
*Gestational diabetes or pregnancy-induced high blood pressure
*Miscarriage or premature birth
*Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat accumulation in the liver.
*Metabolic syndrome — a cluster of conditions including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increase your risk of cardiovascular disease.
*Type 2 diabetes or prediabetes
*Depression, anxiety and eating disorders – most common symptoms

DIAGNOSIS
Based upon,
-menstrual periods and weight changes.
-by checking different physical signs
-Hair growth rate
-Insulin resistance and acne or severe skin color tone change
-Pelvic examination : The doctor visually and manually inspects your reproductive organs for masses, growths or other abnormalities.
-Blood test can be done to measure the hormone levels
-Ultrasound can be done to see the abnormal thickening of the endometrial layer.

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