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One out of every four girls suffers from it. It causes all the problems that she most detests – weight gain, acne, facial hair growth and irregular periods. Not only young girls but even middle aged women may be affected by the problem of PCOD.
This is a problem that often runs in families and the mother and daughters may both be affected as there is a strong genetic component in its inheritance. One of the main problems in PCOD or Polycystic Ovarian Syndrome (PCOS) as it is now called is resistance to insulin.

As the person usually has high insulin levels she has a tendency to gain weight and to develop diabetes as she grows older. Also, as there is a problem of anovulation the ovary does not produce eggs every month, hence the girl suffers from irregular periods (usually delayed) scanty or heavy flow and often has difficulty in conceiving. Due to the excess of male hormone in the system, there is acne and excess facial hair growth. Some girls with PCOS may be thin and not show acne etc but sonography will show ovaries with multiple small water filed cysts thus establishing the diagnosis. Also a hormone check will show high levels of male hormone and also high levels of insulin. As a result of abnormal hormones and irregular periods for many years, these women have a higher chance of developing cancer of the womb.

The treatment of PCOS depends a lot on the symptoms the patient has. The most important thing in the obese patients is weight loss as it significantly improves the entire picture. Lifestyle change is necessary which includes improvement in diet, increase in exercise and keeping weight in control.

For a young lady who has lot of pimples and facial hair and has irregular periods the best treatment is combined hormonal pill. Some of these drugs contain medicines which reduce facial hair growth and within a few months the patient has significant improvement. The existing facial hair can be treated cosmetically, and new growth will reduce. Also pimples will clear out and menses will become absolutely regular with regular hormone treatment.

The other group of women in whom conceiving is the major problem the treatment is totally different. They require medicines such as clomiphene or gonadotrophin injections to induce ovulation. Sonography is done to check if the egg is coming out every month or not (ovulation). Many of these patients have a very erratic response to drugs, either no effect or an excessive number of eggs growing in response to normal dose of medicines. Hence great care has to be taken when these women are treated for infertility. Many of these women become pregnant either with simple treatment or with test tube baby treatment (IVF) but there is also a high miscarriage rate in women with PCOS.

A good drug in these women with high insulin levels is metformin, an antidiabetic drug but which has been proven to improve the metabolism and help weight loss in obese PCOS patents even when their sugar levels are normal. Another treatment for patients with many cysts in their ovaries is laparoscopic burning of the cysts with a thin needle through which a current is passed (laparoscopic ovarian drilling). This is a simple short procedure and requires 2 3 small (1 cm) cuts on the belly through which the laparoscope (telescope) and camera are passed. As the cysts are burned, the male hormone levels fall and the patient may begin to ovulate spontaneously. This is a good technique especially in infertile patients where the tubes also have to be checked to see if they are open or not, as the procedures can be combined.

The problem of polycystic ovaries is massive; the important point is to have a healthy lifestyle with a good diet and exercise which will help to control this epidem

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