Polycystic Ovarian Disease (PCOD) is a condition that is characterized by an imbalance of hormones, especially the female sex hormones. These include the following:
- Changes in levels of oestrogen and progesterone, the female hormones that aid the release of eggs from ovaries.
- Raised levels of testosterone (androgen), a male hormone present in small amounts in women.
- Raised levels of luteinising hormone (LH), which stimulates ovulation.
- Increased levels of prolactin (in some women), a hormone that stimulates production of milk from the breast glands during pregnancy.
It is not exactly clear how and why changes in hormone levels occur in PCOD, but the disorder seems to run in families and can be passed down from mother’s or father’s side.
Genetics is thought to play a role in increasing a person’s risk to PCOD.
A healthcare provider will ask women suspected to be suffering from PCOD to undergo tests to check their hormone levels. The tests conducted check for levels of oestrogen, follicle stimulating hormone (FSH), LH, testosterone and 17-ketosteroids.
Effect of hormonal imbalance in PCOD
Hormones regulate important functions and processes in the body; their alterations of normal levels in the body result in further problems in the body, depending on the part of the body they influenced.
#1 Reproductive problems:
Hormonal imbalances linked to PCOD lead to changes in menstrual cycle, ovarian cysts, and various pregnancy related issues.
- Infertility – This results when ovaries fail to release an egg every month and ovulation does not take place. The increased levels of male sex hormones (androgens) disrupt the functioning of the female sex hormone called FSH, in the ovaries. FSH stimulates the development of ovarian follicles, which release an egg every month. In presence of high levels of testosterone, the activity of FSH is inhibited, making it difficult for ovaries to release an egg.
- Male-like characteristics – Extra facial hair, hair on chest, belly and nipples; decreased breast size, enlargement of clitoris, male-pattern baldness; skin changes like acne or skin darkening around armpits, groin, breasts and neck.
- Increased miscarriages – The exact cause for PCOD-linked miscarriages is unknown but is thought to be due to high insulin levels (another PCOD effect), quality of egg or problems in egg implantation to the uterus wall.
- Risk to gestational diabetes – This occurs more frequently in women with PCOD than those who ovulate regularly.
- Increased blood pressure during pregnancy
- Premature baby, smaller or larger baby
- Endometrial hyperplasia (pre-cancer of the uterine lining) – This occurs to due irregular menstrual cycles that lead to build-up of uterine lining.
- Increased risk of endometrial (uterine) cancer
#2 Insulin and sugar metabolism problems
Women with PCOD have shown to also have problems with how their bodies utilize insulin, a condition known as insulin resistance. The body becomes resistant to insulin, making it produce more insulin to have the same effect as normal dose. High levels of insulin in the body cause the ovaries to produce testosterone in excess, which interferes with the development of ovarian follicles (sacs in which eggs develop). Insulin resistance, therefore, prevents normal ovulation.
Insulin resistance also leads to weight gain, which worsens PCOD symptoms as excess body fat drive insulin production.
#3 Blood circulation and heart problems
Insulin resistance linked to PCOD can also create heart and blood vessel issues like clogging of arteries (atherosclerosis), high blood pressure, high cholesterol, coronary heart disease and heart attack and even stroke.
#4 Breathing and sleep issues
PCOD has been linked to an increased risk of breathing issues while sleeping, a disorder known as obstructive sleep apnoea, which may be a result of obesity and insulin resistance.
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