Expertise Area
Obstetrician and Gynecologist
Normal Pregnancy
High Risk Pregnancy
Menstrual Problem
Heavy Periods Management
Contraceptive Mirena

Special Interest
Balloon Endometrial Ablation
Polycystic Ovarian Syndrome
Fibroids
Intra –Vaginal Slinglasty (IVS)
Menopause
Cervical Smear(Pap Test)

About Her Book
Menopause And Beyond

Polycystic Ovarian Syndrome(PCOS)

Dr.Asha Pahuja Provides diagnostic and management on PCOS.

What is Polycystic Ovarian Syndrome ?
PCOS is a condition in which ovary fails to make mature folicals(eggs)regularly. As a result of this women get abnormal periods or no periods. Harmone level changes with the predominaces of male hormone results in hairness,acene and baldness.They are often very obese.
The cause of this overian disfunctions is not completly understood but it has some genetic disposition and related to insulin function.

Why do women with Polycystic Ovarian Syndrome has problem with menstrual cycle?
The ovaries are two small organs, one on each side of a woman's uterus. A woman's ovaries have follicles, which are tiny sacs filled with liquid that hold the eggs. These sacs are also called cysts. Each month about 20 eggs start to mature, but usually only one becomes dominant. As the one egg grows, the follicle accumulates fluid in it. When that egg matures, the follicle breaks open to release the egg so it can travel through the fallopian tube for fertilization. When the single egg leaves the follicle, ovulation takes place. In women with PCOS, the ovary doesn't make all of the hormones it needs for any of the eggs to fully mature. They may start to grow and accumulate fluid. But no one egg becomes large enough. Instead, some may remain as cysts. Since no egg matures or is released, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman’s menstrual cycle is irregular or absent. Also, the cysts produce male hormones, which continue to prevent ovulation.

Symptoms
These are some of the symptoms of PCOS: • infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
• infertility or inability to get pregnant because of not ovulating
• increased growth of hair on the face, chest, stomach, back, thumbs, or toes
• acne, oily skin, or dandruff
• pelvic pain
• weight gain or obesity, usually carrying extra weight around the waist
• diabetes
• high cholesterol
• high blood pressure
• male-pattern baldness or thinning hair
• patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs
• skin tags, or tiny excess flaps of skin in the armpits or neck area
• excessive snoring and breathing stops at times while asleep

Diagnose of Polycystic Ovarian Syndrome (PCOS)?
Dr.Asha pahuja will do diagnose by blood test of different hormones level and ultrasound which gives characteristics appearances of polycystic ovaries.
If women characteristics appearances of ultrasound and she is not having any blood changes then she is not suffred with PCOS.

Treatment
Birth control pills. For women who don’t want to become pregnant, birth control pills can regulate menstrual cycles, reduce male hormone levels, and help to clear acne. However, the birth control pill does not cure PCOS. The menstrual cycle will become abnormal again if the pill is stopped. Women may also think about taking a pill that only has progesterone, like Provera, to regulate the menstrual cycle and prevent endometrial problems. But progesterone alone does not help reduce acne and hair growth.

Diabetes Medications. The medicine, Metformin, also called Glucophage, which is used to treat type 2 diabetes, also helps with PCOS symptoms. Metformin affects the way insulin regulates glucose and decreases the testosterone production. Abnormal hair growth will slow down and ovulation may return after a few months of use. These medications will not cause a person to become diabetic.

Fertility Medications. The main fertility problem for women with PCOS is the lack of ovulation. Even so, her husband’s sperm count should be checked and her tubes checked to make sure they are open before fertility medications are used. Clomiphene (pills) and Gonadotropins (shots) can be used to stimulate the ovary to ovulate. PCOS patients are at increased risk for multiple births when using these medications. In vitro Fertilization (IVF) is sometimes recommended to control the chance of having triplets or more. Metformin can be taken with fertility medications and helps to make PCOS women ovulate on lower doses of medication.

Medicine for increased hair growth or extra male hormones. If a woman is not trying to get pregnant there are some other medicines that may reduce hair growth. Spironolactone is a blood pressure medicine that has been shown to decrease the male hormone’s effect on hair. Propecia, a medicine taken by men for hair loss, is another medication that blocks this effect. Both of these medicines can affect the development of a male fetus and should not be taken if pregnancy is possible. Other non-medical treatments such as electrolysis or laser hair removal are effective at getting rid of hair. A woman with PCOS can also take hormonal treatment to keep new hair from growing.

Surgery. Although it is not recommended as the first course of treatment, surgery called ovarian drilling is available to induce ovulation. The doctor makes a very small incision above or below the navel, and inserts a small instrument that acts like a telescope into the abdomen. This is called laparoscopy. The doctor then punctures the ovary with a small needle carrying an electric current to destroy a small portion of the ovary. This procedure carries a risk of developing scar tissue on the ovary. This surgery can lower male hormone levels and help with ovulation. But these effects may only last a few months. This treatment doesn't help with increased hair growth and loss of scalp hair.

A healthy weight. Maintaining a healthy weight is another way women can help manage PCOS. Since obesity is common with PCOS, a healthy diet and physical activity help maintain a healthy weight, which will help the body lower glucose levels, use insulin more efficiently, and may help restore a normal period. Even loss of 10% of her body weight can help make a woman's cycle more regular.


For consultation, conact Dr. Asha Pahuja