The polycystic ovary or polycystic ovarian disease or polycystic ovarian syndrome (PCO/PCOD/PCOS) is a modern endocrine disease affecting almost 13-18 % women in the urban cities according to the present statistics and the incidence is rapidly rising leading to epidemic proportions. The irony is that both the patient and the treating doctor is struggling
to find the reasons and the ideal treatment. Patients with polycystic ovaries generally report with irregular periods, usually
scanty/delayed or absent periods, obesity or inability to lose weight, acne, increased body or facial hair, scalp hair loss, infertility etc. According to present research the polycystic ovaries are a manifestation of a bigger internal pathology called “Insulin resistance”. In this condition the body fails to respond adequately to the insulin hormone, leading to further
rise in insulin levels called ‘hyperinsulinemia’. The high insulin levels then trigger the formation of multiple cysts in the ovary which produce androgens (male pattern hormones) leading to symptoms like acne, increased body hair etc. The insulin resistance later makes these women more prone towards type II Diabetes, hypertension, high cholesterol levels
and cardiovascular accidents. Some patients of prolonged untreated PCO may also have a higher incidence of endometrial malignancies. So it is very important to diagnose and treat these women at the earliest to avoid these metabolic complications.
Coming to, what causes PCO. Somehow till 20 years back, nobody really heard of PCO. Even till today, the women in urban and affluent sections of society are somehow more predisposed to be having PCO. Our grandmothers never had PCO and women from low
socio-economic areas even today are somehow protected from PCO. Which means there is something which has happened in recent times in the lives of these women , starting this epidemic of PCO.Various theories have been postulated- genetic reasons, wrong diets, increased use of refined carbohydrates in the diet, lack of adequate physical activity, lack of good quality and
adequate sleep, increased stress levels, increased use of plastics in day to day life, increased use of electronic gadgets in life and many more. The search is on… So what can be done. I am not really fully convinced with the genetic theory. Our
grandmothers and the other elder women in the family did not have PCO, though we come from the same genetic pool. But now we know that some genes can be ‘turned on’ in response to change in the environmental factors. It is called ‘Epigenetics’, which I think is probably a more important factor in genesis of PCO. Till date, there is no treatment to totally cure a patient from PCO. The treatments are largely symptom based, for example- cyclical pills to regularize the periods, anti-androgens for acne and excessive hair growth,ovulation inducing drugs for infertility.However, some measures definitely help like weight loss, muscle strengthening or weight bearing exercises, sleep hygiene, avoiding refined carbohydrates from the diet, minimizing
the use of plastics and electronic gadgets from the life, stress management and relaxation techniques.