PCOD  is an increasingly common condition in young women.

When I was a student – almost 40 years ago! – it was rare, seen in significantly overweight ( which was itself uncommon!) women in their 20’s and 30’s. Now we see it in young teens, most of them of normal weight or even thin! What went wrong?

There was a recent report that there are 10 million young ladies with PCOD in India.

PCOD, like any condition, occurs when genetics, lifestyle and nutrition come together to create either wellness or derangement leading to illness. It is very obvious that our lifestyles have changed pretty drastically over the last 40 years, and so have our eating habits. Is it a wonder then, that illness should follow?

What happens in PCOD

1. Increased secretion of Luteinising Hormone by the pituitary leads to impaired maturation of ovarian follicles, so that no single follicle matures and the ovum is not released. This leads to anovulation and infertility.
2. This also leads to male features like acne, hair loss and facial hair.
3. There is Insulin Resistance leading to obesity.

If untreated, the high levels of male hormones lead to endothelial dysfunction and high insulin level causes sodium retention which in turn leads to high levels of the hormone angiotensin II. These increase the risk of developing high blood pressure, altered lipids and coronary artery disease.

The Insulin Resistance can lead further to Type II diabetes and obesity.

The altered features can lead to anxiety and depression, and social isolation.

When the patient does conceive, it may end in miscarriage in up to 40% of pregnancies.

The risk of developing endometrial cancer is 3 times higher than in a normal woman.

What can be done

All these years I have been advising conventional treatment, consisting of glucose-lowering medications like Metformin, even though there is no prospective randomized double-blind study supporting the use, and cycle regulating hormones like oral contraceptive pills and male hormone antagonists like cyproterone. None of these address the root cause, which is  metabolic disorder. Nor do they prevent progression of disease.

An integrative Medicine approach does address the underlying pathology.

1. An anti-inflammatory diet which leads to weight loss. Focus on a variety of vegetables and a limited number of fruits. Maintain adequate intake of protein and good fats.
2. Hormone Balancing using natural, bio-identical hormones, not synthetic chemicals which the body is unable to process safely.
3. Exercise improves insulin sensitivity.
4. Supplements such as chromium, vanadium, Vit D, which improve glucose metabolism.
5. Saw palmetto reduces acne, facial hair and hair loss by reducing the conversion of testosterone to DHT.
6. Antioxidants such as omega 3 fatty acids to reduce inflammation and counter the effects of oxidative chemicals from pollution, pesticides, etc.
7. Mindfulness, Stress Reduction, Meditation.

This approach can improve the quality of life and may restore normal cycles and fertility. Not to mention confidence and wellbeing.

I remember my patient AK, aged 25. She had never had regular cycles since menarche. She was not overweight but had significant facial hair and required regular maintenance. I suggested treatment and advised her to return in a couple of months. I warned her that the hair cycle is 6 months, so she should not expect instant results.

She returned in 3 weeks as she was going out of town. Her face was clean, which was unremarkable; I assumed she had recently taken care. But no, she hadn’t done anything! I was myself pleasantly surprised that she had not needed any care since starting the treatment advice.

A lifestyle approach is simple, safe and effective and can give lasting results.