.

2019

INTRODUCTION
Polycystic Ovarian Syndrome/ Polycystic Ovarian Disorder
(PCOS/PCOD) is a relatively common hormonal disorder that causes a
number of different symptoms in women of reproductive age.

Common to all women with PCOS is an irregularity in the menstrual cycle

and the presence of excess male hormones (androgens).

The condition was named because of the finding of enlarged ovaries

containing multiple small cysts (polycystic ovaries).

Desthali Vidhyapeeth Page 1

 . 2019

Some common Facts about PCOS/PCOD

Polycystic ovary syndrome (PCOS) is a condition that affects a woman’s

hormone levels.

Women with PCOS produce higher-than-normal amounts of male hormones.

This hormone imbalance causes them to skip menstrual periods and makes it
harder for them to get pregnant.

PCOS also causes hair growth on the face and body, and baldness. And it can
contribute to long-term health problems like diabetes and heart disease.

Birth control pills and diabetes drugs can help fix the hormone imbalance and
improve symptoms.

PCOS is a problem with hormones that affects women during their

childbearing years (ages 15 to 44). Between 2.2 and 26.7 percent of women
in this age group have PCOS.

Many women have PCOS but don’t know it. In one study, up to 70 percent of
women with PCOS hadn’t been diagnosed.

Desthali Vidhyapeeth Page 2

 . 2019

SYMPTOMS
 Disruptions in the menstrual cycle that typically begin around the onset
of puberty.

 An increase in the production of androgens (male hormones) by the

ovaries in PCOS may lead to excess hair growth in areas suggesting a
male pattern, known as hirsutism.

 Excess androgens can lead to acne and male pattern balding.

 Due to absence or reduction in ovulation, progesterone level reduces

which leads in growth stimulation of the endometrium which causes
dysfunctional uterine bleeding.

 Insulin resistance
 Weight gain and obesity

Desthali Vidhyapeeth Page 3

 . 2019

CAUSES
Currently, there is no known cause of PCOS. However, there are associations
with excess insulin, low-grade inflammation, and genetics.

Risk factors
PCOS is thought to have a genetic component. People who have a mother or
sister with PCOS are more likely to develop PCOS than someone whose
relatives do not have the condition. This family link is the main risk factor.

Sugar is the body's primary source of energy, and it is regulated in the body
by insulin, which is secreted by the pancreas. A person with insulin resistance
is unable to use insulin efficiently. This causes the pancreas to go into
overdrive secreting additional insulin to meet the body's glucose needs.

Excess insulin is thought to affect a woman's ability to ovulate because of its

effect on androgen production. Research has shown that women with PCOS
have low-grade inflammation that stimulates polycystic ovaries to produce
androgens.

Associated health risks

There are several health risks associated with PCOS.

These include:

 type 2 diabetes

 infertility

 high cholesterol

 elevated lipids

 sleep apnea

 liver disease

Desthali Vidhyapeeth Page 4

 . 2019

 abnormal uterine bleeding

 high blood pressure

 obesity possibly leading to issues with low self-esteem and depression

 metabolic syndrome

 nonalcoholic fatty liver (steatohepatitis)

 depression and anxiety

Also, there is an increased risk of endometrial cancer, gestational diabetes,

pregnancy-induced high blood pressure, heart attacks, and miscarriage.

HOW PCOS/PCOD AFFECTS YOUR BODY

Having higher-than-normal androgen levels can affect your fertility and other
aspects of your health.

Infertility
To get pregnant, you have to ovulate. 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.

Metabolic syndrome
Up to 80 percent of women with PCOS are overweight or obese. Both obesity
and PCOS increase your risk for high blood sugar, high blood pressure, low
HDL (“good”) cholesterol, and high LDL (“bad”) cholesterol.

Together, these factors are called metabolic syndrome, and they increase the
risk for heart disease, diabetes, and stroke.

Sleep apnea
This condition causes repeated pauses in breathing during the night, which
interrupt sleep.

Desthali Vidhyapeeth Page 5

 . 2019

Sleep apnea is more common in women who are overweight — especially if

they also have PCOS. The risk for sleep apnea is 5 to 10 times higher in
obese women with PCOS than in those without PCOS.

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.

Depression
Both hormonal changes and symptoms like unwanted hair growth can
negatively affect your emotions. Many with PCOS end up
experiencing depression and anxiety.

WHEN TO SEEK HELP

It is appropriate to seek the advice of your health care practitioner if you have
irregular or absent menstrual periods, abnormal or excessive hair growth,
difficulty in getting pregnant, or any of the other troubling symptoms of
PCOS.

Desthali Vidhyapeeth Page 6

 . 2019

DIAGNOSIS
A gynaecologist maybe able to diagnose PCOS on the basis of:

Medical history: To get detailed information about menstrual periods and

weight changesPresence of at least two of the following symptoms is
indicative of PCOS:

 Irregular periods

 Signs of high levels of androgens

 – Hirsutism

 – Acne

 – Thinning of scalp hair

 Higher blood levels of androgens

 Polycystic ovaries

Physical examination

A pelvic exam can look for any problems with your ovaries or other parts of
your reproductive tract. During this test, your doctor inserts gloved finger
into your vagina and checks for any growths in your ovaries or uterus.

Desthali Vidhyapeeth Page 7

 . 2019

Tests

 Blood tests check for higher-than-normal levels of male hormones.

You might also have blood tests to check your cholesterol, insulin, and
triglyceride levels to evaluate your risk for related conditions like heart
disease and diabetes.

 Imaging: Ultrasound can be safely used to demonstrate the presence of

cysts in the ovaries. Ultrasound uses sound waves to generate an image
of the ovaries.

Additional tests

 Screening for depression and anxiety

 Screening for obstructive sleep apnoea

Desthali Vidhyapeeth Page 8

 . 2019

TREATMENTS
There is no cure for PCOS, but treatment aims to manage the symptoms that
affect an individual.

This will depend on whether the individual wants to become pregnant and
aims to reduce the risk of secondary medical conditions, such as heart disease
and diabetes.

There are several recommended treatment options, including:

Birth control pills: These can help regulate hormones and menstruation.

Diabetes medications: These help manage diabetes, if necessary.

Fertility medications: If pregnancy is desired, these include the use of

clomiphene (Clomid), a combination of clomiphene and metformin, or
injectable gonadotropins, such as follicle-stimulating hormone (FSH) and
luteinizing hormone (LH) medications. In certain situations, letrozole
(Femara) may be recommended.

Fertility treatments: These include in-vitro fertilization (IVF) or

inseminations.

Excessive hair growth may be reduced with the drug spironolactone

(Aldactone) or eflornithine (Vaniqa). Finasteride (Propecia) may also be
recommended, but it should not be handled by women who may become
pregnant.

Other possible options to manage hair growth is laser hair removal,

electrolysis, hormonal treatments, or vitamin and mineral use.

Surgery

Surgical options include:

 Ovarian drilling: Tiny holes made in the ovaries can reduce the levels of
androgens being produced.

 Oophorectomy: Surgery removes one or both ovaries.

Desthali Vidhyapeeth Page 9

 . 2019

 Hysterectomy: This involves removal of all or part of the uterus.

 Cyst aspiration: Fluid is removed from the cyst.

What lifestyle modifications could be beneficial for

women with PCOS?
Some lifestyle modifications that can help in reducing the effects of PCOS
include

 Maintenance of a healthy weight: Weight loss can lower insulin and

androgen levels and may restore ovulation.

 Diet management and limitation in consumption of carbohydrates:

High-carbohydrate and low-fat diets may increase insulin levels.

 Exercise regularly: Exercise helps lower blood sugar levels and control
body weight.

Desthali Vidhyapeeth Page 10

 . 2019

PRESCRIPTION

Desthali Vidhyapeeth Page 11

 . 2019

Desthali Vidhyapeeth Page 12

 . 2019

Desthali Vidhyapeeth Page 13

 . 2019

Desthali Vidhyapeeth Page 14

 . 2019

Desthali Vidhyapeeth Page 15

 . 2019

Desthali Vidhyapeeth Page 16

 . 2019

SOME COMMON DRUGS USED IN THE TREATMENT OF

PCOS/PCOD

BRAND NAME GENERIC NAME COMPANY NAME

Metformin Metformin Zanza health care

hydrochloride
Seasonique Ethinyl estradiol Teva Pharmacueticals

Desolon-30 Desogestrel Dewcare

Blisovi Fe 1.5/30 Ethinyl estradiol / Lupin

norethindrone
Aviane Ethinyl estradiol/ Barr laboratories, Inc.
levonorgestrel
Levora Ethinyl estradiol/ Watson Pharma
levonorgestrel
Nobal spas Drotaverine HCL & Mankind
Nimesulide
Ovusitol D Vitamin D Italfarmaco
MyoNext Inositol,Melatonin & Cadila
folic acid
Furocyst Chemical Resources
Estrostep Norethindrone acetate- Allergan
ethinyl estradiol
Orthotri-cyslen Norgestimate-ethinyl Janssen
estradiol
Yasmin Drospirenone-ethinyl Bayer
estradiol
Fortamet Metformin Watson
Aldactone spironolactone Pfizer
Clomid Clomiphene citrate Aventis
Letrozole Letrozole Cipla
Provera progesterone Pfizer
Menopur menotropins Ferring
Bravelle urofollitripin Ferring
Victoza Liraglutide Novo nordisk
Propecia Finasteride Merick sharp & dohme
Melmet Metformin Micro labs
hydrochloride
Dox T Doxycycline hyclate Dr. Reddy's lab
Desthali Vidhyapeeth Page 17
 . 2019

Zantac Renetidine
Taxim Cefixime Alkem
Sarfixim-AZ Cefixime Sarcoma Remedies
Meftel spas Mefenamic acid and Blue Cross
Dicyclomine HCL
Pantoin-40 Pentoprazol Ajans life science

Desthali Vidhyapeeth Page 18