4. PCOS is a hormonal imbalance due to the
overproduction of androgens in ovaries
PCOS is a metabolic disorder that is more
severe than PCOD. In this condition, the
ovaries produce a higher quantity of the male
hormone and this leads to the formation of
more than ten follicular cysts in the ovary
every month. This stops the release of the
egg leading to an ovulation. Symptoms
include hair loss, obesity and infertility.
PCOD is hormonal imbalance due to
overproduction of immature eggs in ovaries.
They, eventually, turn into cysts. Junk food, being
overweight, stress and hormonal disturbances give
birth to this condition. Common symptoms of
PCOD are irregular periods, abdominal weight
gain, infertility and male pattern hair loss. The
ovaries usually become enlarged in this problem
and secrete large amounts of androgens that cause
havoc with the woman’s fertility and her body.
PCOS PCOD
5. Globally 8% to 13% deal with PCOS with up to 70% of the impacted female population remaining
undiagnosed. In India alone, 10% of the female population deal with endocrine disease.
An estimated one in five (20%) Indian women suffer from PCOS.
Polycystic Ovary Syndrome(PCOS) is one the most complex endocrine disease in women of child
bearing age & has cascading effect on reproductive health. PCOS is characterized by underactive
estrogen metabolism, ovulation disorders & polycystic ovarian changes.
Besides impacting reproductive health, PCOS increases risk of metabolic diseases such as obesity,
type 2 diabetes, cardiovascular diseases & hypertension. PCOS affected females are 3 times more
likely to experience anxiety & depression as compared to their health counterparts.
INTRODUCTION:
6.
7. The exact cause of PCOS is unknown. There’s evidence that genetics play a role. Several other factors,
most importantly obesity, also play a role in causing PCOS:
1. Higher levels of male hormones called androgens: High androgen levels prevent your ovaries from
releasing eggs, which causes irregular menstrual cycles.
2. Insulin resistance: Ana increase in insulin levels causes your ovaries to make and release male
hormones (androgens). Increased male hormones suppress ovulation and contribute to other symptoms
of PCOS.
3. Low-grade inflammation: People with PCOS tend to have chronic low-grade inflammation. Your
healthcare provider can perform blood tests that measure levels of C-reactive protein (CRP) and white
blood cells, which can indicate the level of inflammation in your body.
CAUSED BY :
9. A. Radiology
1.Pelvic Ultrasonography
2.Urine human chorionic gonadotropin level
3.Testosterone (free) levels
4.Dehydroepiandrosterone sulfate (DHEAS) and
androstenedione
5.Fasting insulin , Serum Prolactin , Serum TSH
B. Blood Sugar & Lipid Level Test
1.Fasting glucose
2.Total, HDL, and LDL cholesterol levels as well as
triglyceride levels
C. Biopsy
1.Endometrial biopsy
DIAGNOSIS
10. There is no cure for PCOS, but treatments can improve symptoms.
People who have irregular periods, trouble getting pregnant or excessive acne and hair growth
should speak to a healthcare professional.
Some symptoms of PCOS can be reduced through lifestyle changes. Take a balanced and wholesome
diet .
Do regular yoga and exercise can help reduce weight and reduce the risk of type 2 diabetes.
Birth control medicines (contraceptive pill) can help regulate the menstrual cycle and reduce
symptoms. Other medicines can reduce acne or unwanted hair growth caused by PCOS.
Treatments for infertility due to PCOS include lifestyle changes, medicines or surgery to stimulate
regular ovulation. In-vitro fertilization (IVF) may be used but it has some risks.
Take enough sleep of at least 8 hours every day
Avoid eating junk food, smoking, and drinking.
TREATMENT
12. Modificatio
ns In
Lifestyle:
• It is more important to have a healthy diet. A healthy diet should be high in fiber and
protein. According to research, reducing up to 5% of one's initial weight can help restore
regular menstruation and boost the reaction to ovulation and reproductive medications.
Ovulation
Inducer:
• Ovulation inducement is the cornerstone of treatment for infertile PCOS patients who want
to become pregnant because 70% of women with PCOS have no ovulation.
Selective
Estrogen
Receptor
Modulator
• clomiphene citrate DOC for ovulation induction in polycystic ovarian syndrome in
adolescents By inhibiting estrogen receptors in the hypothalamus,
• 1. CC works as an anti-estrogen, increasing the pulse width of gonadotropin-releasing
hormone (GnRH) in the anterior pituitary
• 2. increase in follicle-stimulating hormone production (FSH).
• 3. Luteinizing hormone (LH) is a hormone that aids in the development of follicles.
13. Aromatase
inhibitors
(AI)-
letrozole:
• Aromatase transforms androgens into estrogen. In the third generation, letrozole is the most
widely used non-steroidal selective AI for inducing ovulation. Letrozole inhibits ovarian
estradiol secretion. The sensitivity of the follicles to FSH rises when the pituitary secretes
more FSH, increasing the ovulation rate. This is due to the hypothalamus's release of
negative feedback and a short rise in androgens in the ovary.
Gonadotrop
in:
• Gonadotropin treatment for women with an ovulatory PCOS. Patients who have failed first-
line oral ovulation stimulation medicines should consider this as a second-line alternative,
such as AI and SERM.
Insulin
sensitizing
agents:
• 1) Metformin: Metformin is a biguanide. Even though it is still an authorized application,
metformin has long been used to treat type 2 diabetes and is one of the most often utilized
insulin sensitizers in treating PCOS.
• Metformin improves insulin sensitivity in peripheral tissues by lowering hepatic glucose
production, boosting glucose absorption, and reducing hepatic glucose synthesis. As a
result, type 2 diabetes prevention is essential in this population, and metformin therapy has
been shown to lower the incidence of type 2 diabetes in patients with high PCOS.
14. Inositol:
• Inositol, a dietary supplement, aids insulin signalling. Its role in regulating PCOS'
metabolic and biochemical components is not well known. According to a new study,
menstrual periods and ovulation can be improved. Although this recommendation
cautions against using Inositol owing to the limited advantages, it also has a low risk
of adverse effects and is cheap.
Glucagon-like
peptide-1
receptor
analogue:
• Potentiation refers to protinogens such glucagon-like peptide1 (GLP1) and
glucose-dependent unguided polypeptides (GIP) that boost glucose-dependent
insulin release, especially after a meal. Reaction to incretins Insulin resistance,
especially type 2 diabetes, is linked to a change in incretin function. Researchers
revealed that PCOS patients have lower levels of the hormone incretin in a recent
study. As a result, targeting this system as a treatment for type 2 diabetes has become
a feasible alternative, with improved glycemic control and weight loss in type 2
diabetes patients. Mimetics is a promising drug that targets a specific metabolic
target and can be used to treat PCOS in various individuals.
15. Statins:
• Dyslipidemia, which is characterized by high LDL-C, triglycerides, and low HDL-C in
PCOS women, is a key predictor of cardiovascular risk. As a consequence, improving the
lipid profile and, as a result, decreasing the risk of cardiovascular disease would be a
successful PCOS therapy. Statins have been shown to help with the treatment of PCOS.
Antiandrog
ens:
• Spironolactone, flutamide, and finasteride are antigens that reduce hirsutism and acne
problems in PCOS patients. Individuals with increased lipid levels, which are frequent in
PCOS, may benefit from these antigens.
Oral
contracept
ives
• In the treatment of PCOS, the major mechanism of action of OCs is to control
menstruation. These drugs also reduce hirsutism, acne, and hirsutism by lowering
testosterone levels. Estrogen and progestogen combinations are the most common OCs
used to treat hirsutism and acne caused by PCOS.
16. Medroxyprogest
erone acetate:
• PCOS patients who are unable to conceive and are not in danger of becoming
pregnant, amenorrhea, or irregular uterine bleeding can be treated with
medroxyprogesterone acetate (MPA). Ovarian androgen production is suppressed by
monthly progestogen therapy, but abnormal endometrial .
Medications to
lose weight:
Orlistat
• Orlistat is a lipase inhibitor that inhibits triglyceride breakdown in the stomach and
pancreas, lowering dietary fat absorption. Orlistat is a weight-loss medicine that has
been shown to work, but its effectiveness has been questioned. Orlistat treatment
showed significant decreases in body weight and blood levels in a study that
investigated the effects of orlistat vs metformin treatment on biochemical and
hormonal variables in women with PCOS
17. PCOS is a complex hormonal, metabolic, and psychological disorder with numerous clinical
presentations. It is one of the most common reasons for infertility. Before contemplating any
pharmaceutical options, lifestyle changes should be considered the primary therapeutic prescription for
PCOS-related infertility.
Ovulation stimulation, which is best performed with letrozole, is the next phase, followed by CC.
Gonadotropins were the next step for women who had failed first-line oral ovulatory medication.
Pregnant women who do not use ovulation stimulants or who are experiencing other infertility issues
may benefit from ART. Metformin in combination with CC or gonadotropin and as an adjuvant to IVF
ICSI remains the best option for people with RI or hyperinsulinemia
CONCLUSION:
18. 1. Benjamin, Jiby Jolly, et al. "Stress and polycystic ovarian syndrome-a case control study among Indian
women." Clinical Epidemiology and Global Health 22 (2023): 101326.
2. Rocha, Ana L., et al. "Recent advances in the understanding and management of polycystic ovary
syndrome." F1000Research 8 (2019).
3. https://www.thehindu.com/sci-tech/health/one-in-five-indian-women-suffers-from-
pcos/article29513588.ece
4. https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/novel-scientific-way-to-deal-
with-polycystic-syndrome/articleshowprint/104555823.cms
5. https://www.medindia.net/health/conditions/polycystic-ovarian-syndrome-diagnosis.htm
6. https://www.google.com/url?sa=i&url=https%3A%2F%2Faskpinkypromise.com%2Ffaq%2Fpolycystic-
ovaries%2Fwhat-is-the-difference-between-pcos-and-
pcod%2F&psig=AOvVaw3GfSeIC03wJMd9tiRh8Cuv&ust=1714992002544000&source=images&cd=
vfe&opi=89978449&ved=0CBQQjhxqFwoTCLjdqJup9oUDFQAAAAAdAAAAABAJ
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