It is a disease that is characterised by small multiple sacs filled with fluid in the ovaries. Its structural representation is such that because of multiple follicles that line the ovaries like a string of pearls, the ovaries look enlarged. PCOD can impact every phase in a woman’s life, starting from adolescent to the reproductive years.
According to Dr. Nozer Sheriar, consultant obstetrician and gynaecologist at Breach Candy and Hinduja Healthcare hospitals, “The manifestation of PCOD in women comes in three forms. First is cosmetic, where excess male hormones leads to excess facial hair, hair loss, excess balding pattern, dark skin on the side of the neck, weight issue, bad skin and bad acne. The second is where there are menstrual issues like delayed periods. So when the lining becomes disruptive, there is excess bleeding when she eventually bleeds (sometimes with medication) and third is the fertility issue. Since PCOD is a metabolic, it is also a kind of prediabetic condition.”
Depending on the level of the hormones, a person could have a mild or severe form of PCOD. “There could be a young girl with mild PCOD with no cosmetic or period issues and at the other extreme a woman could be grossly overweight, with ugly facial hair and bad skin. Most women would be somewhere in between,” Sheriar said.
WHY IS PCOD ON A RISE?
There are multiple reasons for it. To start with, a lot of the food we eat is adulterated. According to nutritionist Naini Setalvad, “the average daily intake from pesticides alone is 115 grams per person. This causes hormone disruption which is one of the leading causes of PCOD.” Setalvad also believes that since we are no longer following the rhythms of the sun and the moon, our internal body clock is also disrupted. “Working, eating, chatting, messaging at late hours, waking up way beyond sunrise, adding white flour, white sugar and aerated drinks, and fried food breaks this rhythm leading to all kinds of hormonal disorders - one of them being PCOD,” Setalvad said.
For Dr. Sheriar, failing to limit what you eat is another cause of PCOD. “Women have always carried this but what’s affecting them in a big way today is that we are living in a world of plenty, especially when it comes to food. Our diets have changed to make us more overweight, messing with the body mass index. So here’s a woman who is doing quite well, has put on a lot of weight, and because of how PCOD works, it contributes back to the weight gain, so cosmetic becomes worse, periods becomes worse.”
Chawla was able to lose weight by following a proper exercise regime and a healthy diet. “Ever since my periods have been regular and I no longer have mood swings. I continue to take the vitamin tablets as prescribed and I’m able to maintain the weight I have lost.”
“Patients have been successfully treated over a period of time by good nutrition, the healing power of herbs and spices and also by switching to organic food and following the circadian rhythm,” Setalvad said.
However, Dr. Sheriar said some women need treatment in addition to switching to a healthier lifestyle. “If the problem is cosmetic, she can be anti-androgen to suppress the androgen levels”. If the symptoms include irregular periods, Dr. Sheriar recommends taking birth control pills. “It suppresses the ovarian function which means you suppress the abnormal hormones. It makes the periods regular and can be taken as long as she wants without any significant side effects,” Dr. Sheriar said.
However, neither of these are options for those who want to have children. For them, ovulation needs to be induced using a tablet or if she doesn’t respond to it, then with injectable medicines. “These medications stimulate the ovaries to grow the follicular egg, which is not happening naturally in this case. Once the egg and follicles develop, two things will happen – she will either conceive or she will get her periods if she doesn’t conceive. However, these medications cannot be used casually or indefinitely. They could have certain long term effects and so need to be taken under medical supervision,” Dr. Sheriar said.
Pharm.D @ SRIPMS-CBE-TN