Inferitlity (PCOD/PCOS)

PCOD / PCOS

Poly means many and cysts are nothing but small fluid-filled sacs. So PCOD is a condition characterized by the presence of multiple cysts in the ovary along with a major imbalance in sex hormones. 

Polycystic Ovarian Disease (PCOD), also known as Polycystic Ovary Syndrome (PCOS) is a very common condition affecting women during childbearing age(12 to 45). A study on Polycystic Ovarian Syndrome (PCOS) to observe the trends in PCOS cases in young women in India has revealed, that today one in five women suffer from PCOS problem and East India leads the chart with 1 in 4 women suffering from PCOS.

What is Polycystic Ovarian Disease ?

A hormonal disorder causing enlarged ovaries with small cysts on the outer edges.

The cause of polycystic ovary syndrome isn’t well understood, but may involve a combination of genetic and environmental factors.

PCOS is characterised by the absence or irregular menstruation, excessive facial hair growth, acne, hair fall, obesity and many other associated symptoms.

It affects female in their reproductive age i.e. between menarche (commencement of menstruation) to menopause (permanent physiological stoppage of menstruation).

Prevalence of PCOS in India ?

Prevalence of Polycystic Ovarian Syndrome in Indian Adolescents. PCOS is a common female endocrine disorder with prevalence ranging from 2.2% to 26%. Most reports have studied adult women with age ranged from 18 to 45 years.

Understanding PCOS / PCOD

The three features are:

• Anovulation or oligo-ovulation;
• the presence of polycystic ovaries on pelvic ultrasonography;
• clinical and/or biochemical signs of hyperandrogenism.

Ovaries are the part of female genital organ presents both sides of uterus in lower abdomen.

There are two major functions of ovaries. First, it provides shelter to the egg, gets them mature and second as a gland it produces sex hormones which help the egg to be mature in every menstrual cycle.

At the time of birth, each ovary is packed with a lifetime reserve of eggs in the form of primordial follicle.

One of these follicles gets mature and release an egg in the uterus for fertilisation with sperm. If fertilisation occurs it results in pregnancy, if fertilisation does not occur there is shedding of uterus lining results in menstruation. All this process happens under the influence of hormones which gives signals for every event. These hormones released from brain  i.e. first from hypothalamus, which gives signals to the pituitary gland and the hormones released from pituitary gland (LH, FSH) gives a signal to the ovary to produce sex hormones (estrogens and progesterone).

FSH (follicle-stimulating hormone) helps primary follicle to be mature and LH (luteinizing hormone) helps egg to release from the ovary.

After getting signal from F.S.H and L.H ovaries secret estrogen and progesterone (female hormones) which are necessary for normal functioning of uterus and ovaries. All normal ovaries also make a little bit of the androgen testosterone, a male sex hormone.

What happens in PCOD?

PCOS is caused by an imbalance in the hormones (chemical messengers) in your brain and your ovaries. PCOS usually happens when a hormone called LH (from the pituitary gland) or levels of insulin (from the pancreas) are too high, which then causes the ovaries to make extra amounts of testosterone. Eggs in the follicles do not mature and are not released from the ovaries. Instead, they form very small cysts in the ovary- hence the name polycystic ovaries.

In the uterus, uterine lining continues to proliferate due to lack of signal for shedding.

All this process results in the absence of menstruation or irregular menstruation and heavy menstrual bleeding.

Causes of PCOD

Doctors have yet to find the exact cause of PCOS. However, several factors may play a role in whether or not you develop PCOS. These include:

• Heredity. If you have family members with PCOS or a history of diabetes, you’re more likely to develop PCOS.

• Too much insulin. When you have too much of this hormone, your cells become resistant to it. This can cause increased androgen production and difficulty ovulating.
• High levels of androgen. When your ovaries produce too much androgen, you may develop hirsutism and acne.
• Inflammation. Women with PCOS have a type of low-grade inflammation that stimulates your ovaries to produce androgens.

This means women with PCOS can have:

1. Insulin resistance as a result of genetic factors.
2. Insulin resistance as a result of being overweight (related to diet and inactivity)
3. A combination of both of these factors.

Which are the health complications linked to PCOS ?

Women with PCOS appear to be at increased risk of developing the following health problems during their lives:

Polycystic ovary syndrome can result in a host of health issues and complications. Obesity and insulin resistance can also make your symptoms worse. PCOS complications include:

• Gestational diabetes or high blood pressure during pregnancy
• Infertility
• Miscarriage or premature birth
• Type 2 diabetes or prediabetes
• Sleep apnea
• Depression, anxiety, and eating disorders
• Endometrial cancer
• Obesity
• Metabolic syndrome
• Nonalcoholic steatohepatitis (severe liver inflammation)
• Abnormal uterine bleeding

Signs and symptoms of PCOD

Symptoms may vary from patient to patient. Not every patient shows the entire symptom set. Patient with more than five to six from below mentioned sign and symptoms should be taken into consideration and further investigation.

• Irregular menses (heavy, frequent or irregular)
• Heavy menstrual bleeding
• Obesity
• Excessive hair growth (face, chin, or parts of the body where men usually have hair. This is called “hirsutism.” Hirsutism affects up to 70% of women with PCOS)
• Acne
• Skin tags (small excess flaps of skin in the armpits or neck area)
• Excessive thinning of hair
• Dark patches on skin creases like neck, groin and under the breast.
• Depression and Anxiety
• Decreased libido
• Fatigue
• High level of androgen
• High cholesterol
• High level of insulin

Diagnosis of PCOD/ PCOS

Diagnosis is based upon the combination of clinical findings, ultrasound and laboratory features.

1. Clinical findings: A full medical history about menstruation, changes in weight, physical examination for extra hair on your face, chest or back, acne, or skin discoloration is important.
2. A pelvic exam: The doctor visually and manually inspects your reproductive organs for masses, growths or other abnormalities.

3. Laboratory findings: Blood tests for check sex hormone levels, and other hormones related to other common health problems that can be mistaken for PCOS, such as thyroid disease.

4. Ultrasound: This test uses soundwaves to examine  ovaries for cysts and check the endometrium (lining of the uterus or womb). In PCOD, usually advice patient to get their ultrasound of lower abdomen and pelvic area after menstruation. It will give more clear view.

If you have a diagnosis of PCOS, your doctor might recommend additional tests for complications. Those tests can include:

• Periodic checks of blood pressure, glucose tolerance, and cholesterol and triglyceride levels
• Screening for depression and anxiety
• Screening for obstructive sleep apnea

Treatment of PCOD

If you are diagnosed with Polycystic Ovary Syndrome (PCOS), treatment will depend upon your goals. Some patients are primarily concerned with fertility, while others are more concerned about menstrual cycle regulation, excess hair growth (hirsutism), and/or acne. Regardless of your primary goal, Polycystic Ovary Syndrome (PCOS) should be treated because of the long-term health risks it poses.

• Treating excess hair. [Hirsutism]

Hair removal treatments include electrolysis, hair removal creams, waxing and shaving are temporary treatments. Laser treatment and electrolysis are not available on the NHS, and are quite expensive, however the results may last longer than with other methods.

A cream can be prescribed which is rubbed onto affected areas. However, if treatment is stopped, the hair will grow back.

Certain tablets can also help affect hair growth. These drugs work against testosterone, either by decreasing how much the body produces, or lessening the effect of testosterone in the body.

• Treating acne.

The treatment for acne is the same irrespective of the cause. Treatments for acne include antibiotic creams and facial washes, or antibiotic tablets. More severe acne may be treated by a skin specialist.

One of the common treatments for acne is the combined contraceptive pill. Because this treatment can also help relieve some of the other symptoms of polycystic ovary syndrome, it is quite a common treatment option for people with the condition.

• Treating irregular, absent or heavy periods.

There is a possible increased risk of cancer of the womb if you have no periods for an extended period of time. Therefore, some women take the contraceptive pill because it causes regular bleeds. An alternative option is to take another hormone, known as progesterone, each month.

• Treating fertility problems.

PCOD can cause a person to have difficulties conceiving. There are a range of treatment options to help with infertility. Treatments include:

This is a drug which has a mild stimulating effect on the ovaries. It is taken as a tablet for five days each month. This hormone stimulates the follicles in the ovary to fully develop. It is given as a daily injection.

• Treating insulin resistance.

A drug called metformin is commonly used as a treatment for people who suffer from type 2 diabetes.

There are other newer drugs on the market that have the same effect on the body as metformin, and may also be prescribed for people with polycystic ovary syndrome. These drugs are known as insulin-sensitising drugs.

• Treating PCOS (surgical treatment)

A surgical procedure, known as wedge resection of the ovaries, where a portion of the ovary is removed to decrease the amount of androgens produced by a Polycystic Ovarian Disease (PCOD) ovary.

Side effects PCOD treatments

Some of the more common side effects associated with hormonal contraceptive medication include:

• mood changes
• weight gain or loss
• bloating
• breast tenderness
• irregular bleeding

The oral contraceptive pill should not be used if you have high blood pressure, are a smoker, or have had a deep vein thrombosis (DVT) in the past.

There is some recent evidence to suggest hormonal contraception may increase insulin resistance, abnormal glucose tolerance (a sign of early diabetes) and cholesterol levels (triglycerides)

Some symptoms may return if the treatment is stopped.

Treatment of PCOD in Homeopathy

Homeopathy, also known as homeopathic medicine, is a medical system that was developed in Germany more than 200 years ago. It’s based on two unconventional theories:

• “Like cures like”—the notion that a disease can be cured by a substance that produces similar symptoms in healthy people
• “Law of minimum dose”—the notion that the lowerthe dose of the medication, the greater its effectiveness. Many homeopathic products are so diluted that no molecules of the original substance remain.

Homeopathy in PCOD

Homeopathy focuses on the root cause of an ailment and works to correct hormonal imbalance, regularizing ovulation as well as restoring menstrual normalcy. Homeopathy for PCOS is an individualized treatment and therefore effectively addresses and helps to treat the associated symptoms of PCOS effectively. In homeopathy when PCOS is treated, the goal of treatment is to treat the patient holistically i.e. all the symptom of PCOS improves simultaneously weather it may be menstrual irregularity, hirsutism, obesity, depression or any other associated complaint. It’s not like the conventional treatment where you have to take different different therapies and treatment for each of your symptom. Homeopathic constitutional treatment will help balance hyperactivity of the glands, regulate hormonal balance, dissolve the cysts in the ovaries and force them to resume normal functioning. Hence, Homeopathic medicines can restore hormonal balance, normal ovulation, menstrual cycles, and also eliminate the need for hormone therapies and surgery. This can significantly increase the chances of conception. The different expressions of this disease can be managed effectively, safely and gently with Homeopathic remedies.

 Following homeopathy remedies or medicines are frequently indicated in PCOS cases. Please consult a Doctor for suitable medications for you.

LACHESIS

• PCOS with primary symptoms of heavy periods or no periods at all.
• PCOS with cystic growths more pronounced in the left-side ovary.
• Menstrual discharge is dark and clotted..
• Patient is irritable, depressed due to suppression of menses and feels better as menses begins.
• Feels less thirst, has offensive sweating.

                                     
THYROIDINUM

•  Little obese lady.
• Chronic diarrhoea, stool are not well formed.
• Easy fatigue. Tendency to recurrent cold.
• Tendency to fibroid tumour of the breast or uterus.
•  Disorders of pregnancy (abortions at 3rd month, vomiting, oedema of legs, hypertension, palpitation, vertigo, fainting, mental disturbance).
• It is useful in Eclampsia too.
  Deficiency of milk is associated with return of menses.
• In menorrhagia, metrorrhagia and amenorrhoea there is no better remedy.

   

   

  SYPHILLLINUM/LEUSINUM OR LEUTICUM
  

• If the lady has H/O repeated abortion in past, think of syphillinum.
• There is chronic neuralgia aggravation at night.
•  Female genitalia-Menses with the odour of rotten meat.
• Nocturnal aggravation of all complaints.
• Leucorrhoea profuse, acrid; greenish soaking through the napkin and running down to the heels.
  
  
  MEDORRHINUM
  

•  Nosode prepared from gonorrhoeal virus.
•  Sycotic sterility. -Menses-Profuse, very dark, clotted, stains difficult to wash out. Flow dark, clotted, offensive, in gushes, with malignant disease of uterus. -Leucorrhoea-Thin and of fishy odour. Craves ice.  Burning of hands and feet, wants them uncovered, wants to be fanned. Breasts cold as ice.
  

  
  OVININUM

• This ovarian extract is used in the sufferings caused by excision   of ovaries.
•  It is a good remedy for nervous breakdown in women at climacteric. It is useful for many of climacteric disturbances.
•  You can also try it in ovarian cysts. Dr. William Boericke mentions that Orchitinum is also effective for controling sexual weakness after ovariotomy. It also stops senile decay.

CALCAREA CARBONICA

• PCOS with profuse periods that are prolonged, early and duration lasts for more and usual duration.
• Easy weight gain and obesity are very common for this remedy.
• Excessive sweating on the head palm and soles.
• Extreme sensitivity to cold air.
• Craving in eating habits like a desire for sweets and boiled eggs and in a few cases, strange things like chalk and lime.
• Timid, low confidence, having fear of strangers.

   

NATRUM MURIATICUM

• Irregularity in menses after any grief or disappointment.
• Menses profuse.
• Difficulty in conception due to PCOS.
• Also have facial acnes or skin blemishes.
• May have chronic tendency of headaches.
• Aversion to heat of sun.
• Craving for extra salt in the diet.
• Reserved nature; has weeping spells especially when alone and often worsening of symptoms when sympathy is offered.

SEPIA

• Chief remedy for most of female complaints.
• PCOS with abnormal hair growth on the face, especially on upper lips.
• Late and scanty menses or may be profuse and early.
• Ovaries remain enlarged with fluid-filled cysts in them.
• Used to treat infertility cases due to PCOS.
• Mental irritability and indifferent behaviour towards family.
• Vaginal dryness, vaginal tension or yeast infections.
• Severe backache