PCOS and PCOD

WRITTEN BY: PALLAVI VIVEKANAND KOLHAR CLASS OF 2025

This blog addresses about the main differences between pcod and pcos , the reason for its increase in 20th century and daily life routine to prevent pcos.

What is PCOS ?

Polycystic ovary syndrome (PCOS) is a hormonal condition which basically affects about 1 in 10 women. It is associated with elevated levels of two hormones in the body – insulin and androgens – which cause symptoms such as oligomenorrhea, hirsutism, acne, and weight gain.

For a diagnosis of PCOS, two of the following criteria must be met: irregular ovulation, which is usually indicated by lack of a cycle, irregular menstrual cycle . signs of elevated androgen levels or a CBC confirming having increased level and having multiple small cysts on the ovaries.

What are polycystic ovaries?

Polycystic ovaries have several features which include many growth-arrested follicles, thickened ovarian capsule (tunica albuginea) and an more amount of ovarian cortex with increase collagen content, having a more fibrous composition.

THE DIFFERENCE BETWEEN PCOD AND PCOS

In PCOD - The ovaries start releasing immature eggs that lead to hormonal disturbances and swollen ovaries

In PCOS - Ovaries produce more androgens which makes eggs become cysts and these won’t be released like PCOD but they build in ovaries.

CAUSES OF PCOS

Early studies of PCOS found familial linkage and subsequent twin studies identified a sizeable genetic component to the heritability of PCOS. GWAS and microsatellite linkage studies have identified a number of loci associated with PCOS. The genes closest to loci identified as predisposing to PCOS include FBN3 . Genetic cause of PCOS has triggered into discussion about how genes lead to reduced fertility.

FIRST CASE OF PCOS

Stein and Leventhal were the first investigators of PCOS, Italian scientists who mentioned about a married, infertile woman with lustrous ovaries with creamy white surface, and with the size of pigeon eggs, which is now accepted that it was multifactorial, genetic disease; Insulin resistance has been noted often among women with PCOS, especially in those with hyperandrogenism.

Now there is major evidence that cardiovascular disease risk factors and issues within carbohydrate metabolism are all elevated in patients with PCOS compared with the healthy population.

The majority of women with PCOS have increased androgen levels due to the increased number of antral follicles containing thecal cells that secrete more androgens. Therefore shows symptoms of excess androgen :-

Acne, hirsutism, central adiposity, menstrual irregularity, anovulatory infertility, miscarriage but also have increased risk of being obese, insulin resistance and of type 2 diabetes, non- alcoholic fatty liver disease, dyslipidaemia and depression.

Women with PCOS have at least a four-fold increased risk of type 2 diabetes, even without taking into account of their additional predisposition risk factor to becoming obese.

What causes a lean woman to develop PCOS?

• Abnormal fat and muscle ratio (even if they are lean they have less muscle but more fat in body)

• Increase central or visceral fat (even with normal /low BMI)

• Excess fat on lower abdominal region and hips are predisposing risk factors for PCOS.

Family History

Females whose sister or mother has PCOS, or type 2 diabetes are more likely to develop PCOS.

Insulin Resistance

A major part of the problem is insulin resistance which is is the hallmark condition of the modern age, affecting 1 in 4 adults.

Insulin resistance is the result of too much sugar in our diet, as well as smoking, obesity, trans fat, stress, and environmental toxins.

Insulin resistance is estimated to affect between 50-70% of PCOS women and is generally cleared to be a major contributing cause of the condition.

Excess insulin causes multiple cystic ovaries because this impairs ovulation and causing the ovaries to make more testosterone instead of estrogen

Lifestyle can have a major impact on insulin resistance, especially if a woman is obese because of an unhealthy diet and lack of exercise. Losing weight will mostly help improve symptoms regardless of the cause of insulin resistance.

PCOS CAUSE OVERWEIGHT OR BEING OBESE CAUSE PCOS?

It is complicated, and is not well understood. Although being obese is associated with PCOS, women of normal weight could have PCOS, and some overweight women don’t. These measures can reduce the impact of PCOS on our health and lifestyle.

• If a women is overweight, losing the extra fat will help improve the lipid profile and blood sugar control and this may even restore normal menstrual cycles and normal fertility.

• If a women has diabetes or pre diabetic , the healthcare provider must prescribe a medication such as metformin to improve the insulin sensitivity resistance.

• Have conversations with the healthcare provider about you taking birth control pills to balance hormones and regulate normal menstrual cycle. Oral contraceptives can help slow excess hirsutism, improve acne, and decrease major cancer risk.

• If a women is having trouble in conceiving, visit a fertility specialist. You may get benefit from procedures to induce ovulation and help you get conceive.