PCOD – This is one of the most common aliment diagnosed by doctors, patients, their family members and friends !! .
Yes it is the most misdiagnosed disease in women . Let us understand what PCOD is and issues with it .
So as the name suggests it is disease spectrum involving the ovaries of the woman primarily which are large and are seen to have large number of eggs (seen as follicles on sonogram).But this is not the only criteria for diagnosis. The doctor has to determine if you have other associated features like increase levels of male type hormones and menstruation irregularities , only then can the diagnosis be made . So it involves clinical symptoms, patient examination clinically , lab tests and sonography .Hence do not get disappointed when you get this written on the ultrasound reports, see a Gynaecologist specialising in Endocrinology and plan your treatment.
Concerns of PCOD are different in different age groups . In Puberty and early 20’s the issues are irregular periods, acne , facial hair growth , obesity. In the Reproductive age it is infertility, whereas later it is Metabolic diseases like Diabetes , high blood pressure , Cancers of uterus .
Treatment is targeted to the specific concern of the patient , but Lifestyle modification is must for all patients.
Lifestyle modification is a common element which should be followed by patients in the entire lifetime .Eating healthy by avoiding refined flour, sugar, high glycemic foods , caffeine, sweetened carbonated drinks, smoking, alcohol, preservatives are the mainstay of diet modifications. The other part is Exercise . this is the most neglected part . We must realise just as the body need nourishment it needs exercise to keep its musculoskeletal functions intact . Lets say if you own a certain gadget don’t you take care by doing proper maintenance , service checks to keep it in the best working condition? Without timely servicing the gadget will function but not optimum. Similarly body needs exercise to tone up the muscles , smoothen the joint functions and with it there is release of endorphins which help in relieving stress, improving metabolism & sleep , relieves anxiety and above all helps in weight loss.
Medical treatment is directed towards the presenting complaints of the patient . If it is irregular periods , hormonal treatments are given to regularise the same managed most often by the gynaecologist
If it is infertility, treatment is directed to ovulation induction (forming mature eggs )
If it is cosmetic concerns , medications as well as depilatory methods can be suggested in conjunction with a dermatologist.
For Diabetes and High blood pressure physician comes into the picture and treatment measures to keep the disease under control can be taken .
So do not worry , with proper care it is easily possible to keep the disease under control and live a normal healthy life .
Sarita suffered from Endometriosis. A condition in which there is accumulation of cells of the uterine cavity(womb) in the abdominal cavity and pelvis outside the uterus . The resultant effect is such that when she gets periods and uterus starts shedding out the menstrual blood , the same process happens in the outside the uterus in the abdomen , as there is no outlet for this blood it keeps accumulating and forms brown chocolate cysts or Endometriomas. Each time there is menses , each time patient has severe pain from the abdominal deposits .In some cases the pain does not settle with oral medications and patient has to be admitted and given injectables .
Why does it start ? There is no reason for this disease . It can happen to any woman , especially those having early puberty , late menopause, and those avoiding pregnancy. Pregnancy is protective .Basically any treatment by which patient has fewer menstrual cycles . This can be achieved with pills or Injections , but there is limit to the duration especially the injections. If the patient desires pregnancy the treatment is to fast track the fertility treatment and achieve pregnancy ,giving tablets or injections to avoid periods is a waste of time.
There are conditions when patient has to resort to surgery . Laparoscopy (or key hole surgery) is the preferred modality of approach . In this the cysts are removed with precision preserving the function of the remaining ovary as much as possible , the adhesions (bands which are formed due to the disease due to which the organs are stuck to each other ) are separated , the fallopian tubal patency is checked . This guides in further treatment of patient for fertility , whether spontaneous trial should be given or medical treatment or patient should be advised direct IVF/ICSI. At times patients having repeated cysts , repeated laparoscopies , or those who haven’t undergone laparoscopy but have large cysts or the ovarian function of the wife is too low , these have to resort to direct IVF/ICSI without doing surgery .So there is a definite indication of surgery and NOT ALL patients have to under the knife !!
So Endometriosis is a disease which keeps coming back , having no fool proof cure . Does that mean it is CANCER ? the chances are very rare , 1 in 1000 cases may turn cancerous.
So in a nutshell , if you have this disease, understand how the progression is , seek proper guidance , timely plan your pregnancy
