Polycystic Ovarian Disease
What is PCOD?
Let's think about PCOD as a spectrum. On one end of the spectrum, women will experience irregular cycles and have difficulty getting pregnant. Their pancreas makes insulin that roams the blood, plugs into the insulin receptors, and helps break down carbohydrates and sugars, and everything is fine.
On the other end of the spectrum, women will experience irregular cycles but could also have oily skin, acne, facial hair, and may be overweight. These patients typically have insulin resistance. Their pancreas makes insulin but it has no receptors to plug into causing their carbohydrates and sugars to not be broken down. This causes them to gain weight.
These women don't ovulate which means they are not moving through a normal cycle. As a result of this, they start to have higher levels of progesterone causing the acne, oily skin, and facial hair.
How do we diagnose PCOD?
We obtain a history from the patient. We can also do an ultrasound and a blood test. The blood test checks for a follicle stimulating hormone (FSH) and a luteinizing hormone (LH).
- A normal range is 6-8 for FSH and 2-4 for LH.
- Ladies with PCOD it is the reverse. 2-4 for FSH and 6-8 for LH.
A vaginal ultrasound is done in the office. A PCOD ovary will be larger and have multiple cysts on the ovary and will be easy for our team to identify.
How do we treat PCOD?
We need to put patients on something to regulate their cycles and the easiest way to do that is to put them on a birth control pill. It regulates their cycle and balances out their estrogen and progesterone to limit unwanted side effects. We also use some medication to get rid of the insulin resistance. Metformin, Glucophage, and Glumetzin are three different medications we can use to help treat this.
How long will PCOD last?
No matter what age you may have been diagnosed, the sooner you start treatment the sooner you can get back to normal. You're going to need to be on these treatments during the entire time of your reproductive years. If at any time you reach menopause or have a full hysterectomy, you may discontinue treatment as you will no longer have functioning ovaries.
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