Dr Rekha Agrawal is a well-known Gynecologist and Obstetrician who has experience of over 30 years. She has expertise in Intra-Uterine Insemination (IUI), Mirena (Hormonal Iud), Caesarean Section (C Section), Unilateral Salpingo-Oophorectomy, Hysterectomy (Abdominal/Vaginal). She has been an active member of the Bombay Obstetric & Gynaec Society, The Indian Medical Association (IMA).

Difference between PCOD & PCOS

Dr Agrawal begins, “PCOD is Polycystic Ovarian Disease whereas PCOS is Polycystic ovary syndrome. The disease is one thing but a syndrome is a collection of many things. PCOD which is a disease shows itself on sonography in the form of multiple cysts. Within this, there are many categories and criteria for its to be labelled as PCOD.”

“PCOS is a syndrome of prolonged menstrual cycle, excess weight, unwanted hair and insulin resistance.  So when someone says they are suffering from PCOD, then it is the wrong terminology. Just having polycystic ovaries doesn’t bring with it many problems. But if you have other problems on top of polycystic ovaries, makes you a patient of PCOS.”

2 Causes of PCOD

She explains, “In my 30 years of practice, I’ve found that initially, only 2-3% of cases were of PCOS. But those cases have risen to 1 in every 5. That means 20% of our younger population is suffering from PCOS. The reason behind this escalation is primarily the food that we eat.”

“The food we now eat is more refined, more caloric and less nutritious. Our food also has more hormones pumped into it to make it last longer and have a larger shelf life. Eating such foods pumps extraneous hormones into our system. The other cause of PCOS is inactivity.”

“This generation is stuck in a sedentary life from sleeping on the bed and sitting on an office chairs. There is no activity that leads to weight gain and inevitably to PCOS. PCOS is a lifestyle disorder like diabetes and hypertension. So by treating one’s lifestyle, PCOS too will get treated,”

Disadvantages of PCOD

Dr Agrawal says, “If one knows more about the menstrual cycle, then they will know about estrogen and progesterone. In our cycle, estrogen is there for 1 to 14 days and progesterone for 14 to 28 days. Estrogen is a devil hormone as it is the cause of breast cancer and ovarian cancer. But it is required for pregnancies. Progesterone is created to wipe off the negative effects of estrogen.”

“In PCOS, estrogen is there but without ovulation. This results in cysts. Also without ovulation, there is the absence of progesterone. Without progesterone, estrogen rises without any opposition. Excess estrogen then enters the fat cells and turns into testosterone. Testosterone gives one male-like feature of beard, facial hair and less hair on the head. So if some woman has male-like features then it is due to this syndrome. This is completely reversible with treatments.” 

“The hair loss experienced in PCOS too can be treated. High quantities of estrogen can increase the risk of cancer. Some women are okay with having their periods once every 3 months. But this doesn’t sit well with the body. So one must get it treated. Every woman should have her periods in 28 to 35 days. If they don’t see their periods within this timeframe then she must seek medical help.”

Symptoms of PCOS

Dr Agrawal mentions, “The first telling sign is prolonged and irregular periods. The second sign is acne. The third sign is hair growth at the chin and moustache areas. The fourth sign is weight gain. A common misconception in everyone’s mind is that PCOS is causing weight gain. On the contrary, weight gain is causing PCOS.”

“The moment you will start doing exercise to reduce your weight, you’ll see a change when your fat turns into muscle. So despite not reducing the kilogram, many people have seen changes in their PCOS. This is because their fat levels have decreased despite the number on the scale remaining unchanged.”

“So exercise as a daily habit is a must. Going to the gym is not bad but sometimes one may skip it. Instead, add exercise into your routine. take the stairs instead of a lift, walk to your workplace and do such small yet effective things.” 

“Periods are hormonal events. So if your hormones are alright it will result in normal periods. But if your periods are not alright then you must visit a gynaecologist.” 

Pregnancy and PCOS

She mentions, “There is no ovulation in PCOS but it is not that there is never ovulation. There might be one ovulation in the fifth cycle. It’s not like every PCOS patient will require a big treatment procedure to get pregnant, only minor help is needed. PCOS doesn’t mean you'll not use contraception and won’t get pregnant. It is not 100% safe.”

“In a year a woman gets 12-13 cycles. So there are around 12 opportunities to get pregnant. But in PCOS one get 2-3 cycles a year, so they get only 2-3 opportunities to get pregnant.  

Prevention of PCOS

Dr Agrawal says, “When our girl is growing up we should give importance to their food habits. 60-70% of their food should be home-cooked. I try that everyone in my house eats 80-85% of home-cooked food. Home-cooked food is rich in nutrition, low in calories and has no preservatives as it is fresh. If this habit is followed by the kids then their weight will stay under control.”

“An exercise-filled routine should be followed by even school going kids. Whether that form of exercise is sports or games.  They should enjoy and be proactive towards these activities, only then is this sustainable and lifelong. Along with these 2, one must be aware. Only with awareness can one prevent anything. Awareness must be there that if we have delayed periods then we should consult a doctor.”

“This disease can easily be treated with the help of a professional. The actual problem lies in taking the steps to come forward for help. The faster one seeks advice the faster it can be treated.’

“Another factor is the stress faced in this generation. We have everything with ease yet we have stress.  So de-stressing is very important. Everyone should have an hour of MeTime. Even the children should be taken away from their studies and tuition for an hour of relaxation. By following these steps one can get rid of PCOS from our lives.”

(Edited by Priyal Shah)