FEMALE DISORDER - Infertility queen PCOD
A woman having delayed periods with excessive hair growth on face and body
must think of PCOD. So, if the monthly reminder (menses) is missed often, then
rule out PCOD first in the early days itself (better before marriage).
Women have two ovaries located in the pelvis alongside the uterus. The main
functions of the ovaries are to release eggs and produce hormones. They are
responsible for moods, sex drive and health. After getting a signal from the
pituitary gland through the FSH (follicle stimulating hormone), the ovaries
secrete oestrogen to attain menarche – the first monthly reminder of the
presence of the ovary in an active reproductive phase.
It also aids in breast development, widening of the pelvis, flat pads in
hips and pubic hair. In this fertile 30-35 years of monthly reminders,
ovulation occurs on the 14th day of the menstrual cycle. As age advances, the
quality of egg declines and the oestrogen level, which is very helpful in
preventing fat deposits in arteries, gets cut off, which in turn makes women
susceptible to coronary heart diseases.
At birth, the ovaries are provided with approximately one million eggs,
each surrounded by cells which develop into a small fluid-filled blister known
as a follicle. Each month, in women with regular periods (normal ovulation),
one of these follicles will develop and grow to about 20 mm in diameter and
then release a mature egg (ovulation), which passes into the fallopian tubes.
If there is fertilization, the fertilized egg (embryo) continues its course
through the tube into the uterus where it will implant in the lining
(endometrium) and develop as a pregnancy. If there is no fertilization, the
endometrium is shed as a menstrual period after 14 days of ovulation.
Three important groups of hormones – oestrogens, androgens and progesterone
– are also produced in the ovary. These, in turn, are regulated by the release
of two additional hormones – follicle stimulating hormone (FSH) and luteinizing
hormone (LH) – from the pituitary gland which is located at the base of the
brain. These two ‘reproductive’ hormones influence the development of the
follicle and the timing of ovulation.
For many couples, infertility can become the central issue of their lives.
Infertility is generally a complex problem and may involve one or both partners
who are trying to conceive. PCOD is most common female infertility cause which
should be treated before marriage itself if menstrual irregularity is noticed.
PCOD – poly cystic ovarian disease – is the most common ovarian dysfunction
and endocrine disorder which affects approximately 15-20 per cent of women in
the reproductive age. The affected women often have signs and symptoms of
elevated androgen levels, menstrual irregularity and weight gain, abnormal hair
growth on the face or the body and no periods at all (amenorrhea). The syndrome
has an initial onset in the peripubertal years and is progressive.
PCOD is a female hormonal imbalance where maturing eggs fail to be expelled
from the ovary, creating an ovary filled with immature follicles. The cysts
then contribute to the hormonal imbalance, which causes more cysts and enlarged
ovaries. Polycystic ovary disease is characterized by anovulation (no formation
of egg) irrespective of periods (regular or irregular or absent) and
hyperandrogenism (elevated serum testosterone and androgen). Also women with
PCOD who conceive have a higher rate of early foetal loss than women without
PCOD.
PCOD women have fewer chances to conceive, compared to normal women who
ovulate every month. Normal women get 12 chances in a year to conceive. But
PCOD women hardly get 3-4 chances due to delayed periods.
Relative causes of PCOD
PCOD does run in families. Several genes contribute to the pathogenesis of
PCOD. Many of these genes are related to insulin resistance with elevated
fasting blood insulin levels. The high levels of androgenic hormones interfere
with the pituitary ovarian axis, leading to increased LH levels, anovulation,
amenorrhea and infertility.
Young diabetic women treated with insulin are at special risk of PCOD. The
amount of insulin injected by insulin-dependent or insulin-requiring diabetics
is far in excess of what the body produces naturally.
Obesity is a common part of PCOD and many of these women are also
insulin-resistant. When a woman is insulin-resistant, her fat cell does not
respond normally to the insulin in the blood stream. Weight gain in itself can
result from high serum insulin levels.
Symptoms of PCOD
·
The most common symptoms of PCOD are
·
Irregular and infrequent menstrual periods or no
menstrual periods at all;
·
Infrequent or no ovulation with increased serum levels of
male hormones – testosterone;
·
Inability to get pregnant within one year of unprotected
sexual intercourse;
·
Weight gain or obesity;
·
Diabetes, over-production of insulin with abnormal lipid
levels and high blood pressure;
·
Excess growth of hair on the face, chest, stomach in male
pattern (hirsutism) and male-pattern baldness or thinning of hair;
Acne, oily skin or dandruff;
·
Patches of thickened and dark brown or black skin on the
neck, groin, underarms, or skin folds;
·
Skin tags, or tiny excess flaps of skin in the armpits or
neck area;
·
Male fat storage patterns – abdominal storage rather than
standard female pattern on thighs, hips and waist; and Mid-cycle pain
indicating painful ovulation – due to the enlargement and blockage of the
surface of the ovaries;
Consequences of PCOD
Hyperinsulinemia in PCOD has also been associated with high blood pressure
and increased clot formation and appears to be a major risk factor for the
development of heart disease, stroke and type-II diabetes
Women with irregular cycles need to have other conditions ruled out, such
as anorexia, stress or exercise-induced problems with the menstrual cycle,
other hormonal problems such as thyroid disease or medication problems.
The general consequences of PCOD are:
Menstrual irregularities – Constant oestrogen production stimulates
growth of the uterine lining which usually induces very heavy uterine bleeding.
The bleeding episodes may occur after long gaps of time (oligomenorrhea) or,
for some women, not at all (amenorrhea). Irregular periods are a nuisance and
suggest some hormonal disorder or risk of endometrial thickening.
Impaired Fertility- Another consequence of incomplete follicular development
is a lack of regular ovulation. Irregular ovulation usually means that
pregnancy is more difficult to achieve. Similarly, if ovulation is not taking
place, it is not possible to conceive.
Miscarriage – While miscarriage seems an unfortunate chance event
for most couples, it is clear that women with PCOD may be at increased risk of
early foetal loss. The hormonal environment in PCOD may interfere with egg
development within the follicle and disrupt embryo implantation within the
uterus.
Hair and skin problems – Androgen (male hormone) is a
byproduct of the ovaries. In PCOD, the production of androgen, such as
testosterone, is excessive, which causes abnormally increased hair growth and
contributes to acne formation. The assessment of excessive hair growth (or
hirsutism) may be difficult.
Obesity – About 50 per cent of women with PCOD are obese.
Obesity tends to enhance abnormal estrogen and androgen production in this
disorder, which only magnifies the problems of irregular bleeding and excessive
hair growth.
More important, the long-term effects of unopposed oestrogen place women
with the syndrome at considerable risk for endometrial cancer or breast cancer.
Diagnosis of PCOD – The signs of PCOD are ovaries slightly enlarged and
may contain 10 or more small cysts located at the periphery of the ovary, which
have led to polycystic ovaries. The size of these cysts is generally less than
8 mm and can usually be detected by ultrasound examination. Pelvic and physical
examination, ultra sound scanning, blood tests to measure hormone, insulin and
cholesterol levels will also help. Height and weight will be noted along with
any increase in facial or body hair or loss of scalp hair, acne and
discoloration of the skin under the arms, breasts and in the groin. Elevated androgen
levels or testosterone confirms the diagnosis.
General treatment for PCOD
Mostly patients take treatment for cosmetic ailments like obesity, unwanted
hair growth or acne. They will not mind the underlying delayed and heavy
periods which is to be treated first. Medical treatment should be given to
correct irregular menstruation, eradicate excessive hair growth or achieve
pregnancy.
Because there is no cure for PCOD in Allopathy, it concentrates on ways of
management to prevent further problems. The treatment can be as:
Medication: To induce a menstrual period and restore normal
cycles, birth control pills are used. It regulates menstruation, reduces
androgen levels and helps to clear acne. The method of treatment depends on the
severity of the symptoms and whether the patient is trying to get pregnant or
not. If not trying to conceive, then they are treated with hormones, including
the birth control pill. If trying to become pregnant, fertility drugs and other
treatments are necessary.
Getting normal can be tried:
1) Eating a balanced diet low in carbohydrates and maintaining a healthy
weight can help lessen the symptoms of PCOD.
2) Regular exercise helps weight loss and also helps the body in reducing
blood glucose levels. Aerobic activities such as walking, jogging or swimming
are advised. With reduction of weight and reduction in insulin resistance,
regular periods will mostly resume. It is not always possible to promise a
woman who has achieved ideal body weight and who continues with exercise that she
may have regular ovulation.
3) For reducing excess body and facial hair, bleaching, removal by waxing
or a hair removal cream can be used. For permanent facial hair removal,
electrolysis is done.
Treatment of PCOD for the infertile patient will usually focus on ovulation
inducting. They induce ovulation with fertility drugs. Sometimes fertility
drugs may induce risk of multiple pregnancies.
Surgery: Doctors used to perform ovarian surgery called wedge re-section to
help patients with PCOD to ovulate. A recent treatment option uses laparoscopy
to treat patients with PCOD. During operative laparoscopy, a laser is used to
drill multiple holes through the thickened ovarian capsule. When wedge
re-section or drilling is used, there is risk of inducing adhesions around the
ovary. As a result of these, surgeries are used as the last resort.
Homeopathic approach to PCOD
Homeopathy is the fingerpost on the cross-roads of healing which directs
the way to safe and permanent cure. Homeopathy works towards nature. All
homeopathy medicines are proved in human beings. It is very refined. It
comforts modern living. The medicines have no negative side-effects. They
are safe, effective and easy to attain cure.
In homeopathy, medicines are given to induce ovulation in a natural way
rather than causing menstruation. Homeopathy medicines will not create any
artificial menstruation. They go with nature. The system treats the condition.
By taking homeopathy medicines, ovulation and menses can be attained in a
natural way.
The most common medicines are Thuja, Bryonia, Pulsatilla, Lycopodium and
Apis mel, Radium brom, calcarea flour, calcarea phos, belladonna colocynthis,
mag phos, cimicifuga, senecio Q, thalaspi, kreosote, Sabina, etc. These
Medicines should be taken under the advice and diagnosis of a qualified
Homeopath.
for
new hope
Dr. S. Chidambaranathan, BHMS, MD (Homeo)
Laxmi Homeo Clinic
24 E. New Mahalipatti Road
Madurai, TN 625 001
India
Tel: +91-984-319-1011 (Mob /
Whatsapp)
Clinic : +91-452-233-8833 |
E-mail: drcheena@gmail.com
(Disclaimer: The contents of this column are
for informational purpose only. The content is not intended to be a substitute
for professional healthcare advice, diagnosis, or treatment. Always seek the
advice of healthcare professional for any health problem or medical condition.)