Dr. Sri Nagesh is one of the best Endocrinologists in Hyderabad with more than 10 years of experience in Endocrinology. He pursued his MBBS from the Gandhi Medical College. Later on, He completed his MD in Pediatrics from the Osmania Medical College. He further specialized in Endocrinology in the year 2009. Dr. Nagesh has proven his expertise in the field of Endocrinology and his areas of interest include treatment of Thyroid Disorders and Reproductive Endocrinology. He is presently working at Sri Nagesh Diabetes, Thyroid & Endocrine Clinic in Hyderabad. He has also worked as the Assistant Professor at the Osmania Medical College and was DM -Senior Resident in the Department of Endocrinology, Osmania Medical College from 2009-2012.

Dr. Nagesh says, “PCOS is not a rare condition. It is present in 10% of women of total reproductive age-aged 13-47. It is one of the most common endocrine disorders. This is a very common condition and has existed for a long time.

PCOS is a multisystem disorder

Dr. Nagesh explains, “Major organ system that is affected in PCOS is ovaries. Common presentation in PCOS is hyperandrogenemia and hyperandrogenism. 

Hyperandrogenism – When the concentration of the male hormone, testosterone increases in the female body, we get to see classic manifestations like irregular periods, hair loss, acne, excess facial hair.

Hyperandrogenemia – In this the total testosterone, free testosterone, DHE level goes up. Skin problems are very common, postural acne, excess body hair, excess facial hairs. Metabolic disorder increases the risk of gestational diabetes, hypertension, obesity.`` 

Dr. Nagesh adds, “All of this together causes irregular menstruation, problems in conceiving, metabolic problems which can further lead to cardiac problems like heart attack, stroke. Hence, it is a multisystem disorder that affects almost all organs.”

Irregular periods can be a sign of these health issues

Dr. Nagesh mentions some health conditions other than PCOS that can also cause irregular periods.

1. Increase in Prolactin hormone (milk hormone) secretion 

2. Ovarian cyst 

3. Hyperthyroidism 

Hypothyroidism causes normal periods but excessive flow. PCOS is the commonest cause of irregular periods but not all irregular periods are because of only PCOS.

Importance of diagnosis and treatment of PCOS

Dr. Nagesh listed out some significant consequences of PCOS if left untreated.

1. In the reproductive age group, irregular periods can cause problems with conception (in PCOS, ovulation is not as usual) and if at all the women conceives, there are high chances of miscarriage. In this age group, PCOS can also cause recurrent miscarriages.

2. Teenagers/adolescents may have cosmetic issues, excessive body hairs, excessive facial hairs.

3. During the perimenopausal age group, if PCOS is left untreated for a long time, it can cause diabetes. Because of excess hormones, women can develop breast cancer, endometrial cancer, and cardiovascular diseases.

The right treatment of PCOS

Dr. Nagesh stresses, “An ultrasound report showing a diagnosis of PCOS doesn't necessarily mean that you have PCOS. 20-25% of women with PCOS have normal ovaries. PCOS is a clinical diagnosis. Ultrasound is performed to rule out any other problems in the ovaries, biochemical tests are performed to detect hyperprolactinemia, testicular cancers, ovarian cancer, adrenal hyperplasia. When the results confirm the absence of all these, then those cases are PCOS.”

Dr. Nagesh concludes, “Right diagnosis, the right investigation is very important for the right treatment. PCOS treatment requires regular medication for at least 1 year and most importantly weight loss." 

(Edited by Renu Gupta)