PCOS and PCOD: what the terms mean
Polycystic ovary syndrome, or PCOS, is a common hormonal condition in women of reproductive age. In India you will also hear the term PCOD, polycystic ovarian disease. Many people use the two words for the same thing, and doctors today prefer PCOS. In PCOS the ovaries may not release an egg regularly, and the body often makes more male-type hormones than usual.
The exact cause is not known. It tends to run in families and is linked with resistance to insulin, the hormone that controls blood sugar. Having PCOS is not your fault. It cannot be removed permanently, but its symptoms can be managed well, and treatment is chosen according to what troubles you most.
Common symptoms
- periods that are irregular, come after long gaps or stop for months
- thick hair growth on the face, chin, chest or abdomen
- acne that persists beyond the teen years
- thinning of scalp hair
- weight gain, especially around the waist, though lean women can have PCOS too
- dark, velvety patches of skin on the neck or underarms
- difficulty in becoming pregnant
You may have only one or two of these. Symptoms often start in the late teens or twenties. Some women find out only when they have trouble conceiving.
How PCOS is diagnosed
There is no single test. Doctors usually make the diagnosis when at least two of three features are present: irregular ovulation, signs of raised male-type hormones, and polycystic ovaries on a scan. Other causes such as thyroid disease must be ruled out first.
- The doctor asks about your cycles, weight changes, skin and hair, and family history of diabetes.
- Height, weight, waist size and blood pressure are measured.
- Blood tests check hormones, thyroid, prolactin, blood sugar and cholesterol.
- A pelvic ultrasound scan looks at the ovaries and the lining of the uterus. In unmarried girls this is done through the abdomen.
- The results are put together and a plan is made with you.
In teenagers the diagnosis is made with extra care, because irregular periods and many small follicles are normal in the first years after periods begin.
Treatment depends on your main concern
| Main concern | What the doctor may discuss | Points to know |
|---|---|---|
| Irregular periods | Lifestyle changes, hormonal pills or cyclical progesterone | Protects the uterus lining |
| Acne and hair growth | Hormonal pills, anti-androgen medicines, skin care, hair removal | Takes several months to show |
| Weight and sugar | Diet, exercise, insulin-sensitising medicine | Checked with repeat tests |
| Wish to conceive | Medicines that trigger ovulation, follow-up scans | Given under supervision |
Lifestyle changes
Food and activity are the first line of treatment for most women. If you are overweight, losing even a modest amount, roughly five to ten percent of body weight, can make periods more regular and improve ovulation. Aim for regular meals with more vegetables, pulses, whole grains and protein, and fewer sugary drinks, sweets and fried snacks. About 30 minutes of brisk walking or other exercise on most days helps even if the scale does not move. Good sleep and stress control matter as well. Crash diets do not work in the long run.
Medicines
Medicines are added when lifestyle changes are not enough or symptoms are troublesome. Hormonal pills regulate bleeding and reduce acne and hair growth. An insulin-sensitising medicine may be advised if your sugar levels are borderline. Each medicine has side effects and is not right for everyone, so take them only on a doctor's prescription and do not copy someone else's treatment. Supplements sold online for PCOS have limited evidence.
Skin and hair care
Unwanted hair can be managed with threading, waxing, creams or laser hair reduction while the medicines take effect. Results are slow, often six months or more, because hair grows in cycles. A dermatologist may work with your gynecologist for stubborn acne or scalp hair loss.
PCOS and pregnancy
PCOS is a common and treatable reason for delay in conceiving. Many women with PCOS become pregnant naturally or with simple tablets that help the ovary release an egg. If this does not work, your doctor may suggest further infertility evaluation and treatment. Once pregnant, you have a somewhat higher chance of diabetes and high blood pressure in pregnancy, so early antenatal care is important.
Long-term health with PCOS
PCOS is more than a period problem. Over the years it raises the chance of type 2 diabetes, high cholesterol, high blood pressure and fatty liver. Going many months without a period can let the lining of the uterus build up, which is why doctors try to make sure you bleed at regular intervals. Low mood and anxiety are also more common. A yearly review with weight, blood pressure and sugar checks helps catch these early. Costs of tests and treatment vary by city, hospital and case.
When to see a gynecologist
Book a consultation if you have any of the following:
- fewer than eight periods a year, or no period for three months when you are not pregnant
- very heavy or prolonged bleeding after a long gap
- rapidly increasing facial or body hair, or a deepening voice
- trying for a pregnancy for a year without success, or six months if you are over 35
- sudden weight gain with great thirst or frequent urination
- persistent sadness, anxiety or distress about your body
This page is general information for readers in India. It is not medical advice. Speak to a qualified gynecologist about your own health.