Table of Contents

• Is PCOS vs PCOD the same?

• What is PCOD and PCOS?

• What is PCOD problem?

• What is PCOS problem?

• Prevalence of PCOS in India

• The major differences between PCOS and PCOD

• Chart diagram for statistical analysis of risk factors in PCOS

• Symptoms of PCOD problem

• Common signs and symptoms of PCOS

• Causative factors of PCOD

• Causative factors of PCOS

• Diagnosis for PCOD

• Diagnosis for PCOS

• Management of lifestyle for PCOS and PCOD

• Complications of PCOS

• Treatment for PCOD and PCOS

• Myths and facts

• FAQ on PCOD and PCOS

Is PCOS vs PCOD the same?

Do you know that  PCOD is a disease and PCOS is a syndrome? And most of them assume that PCOD and PCOS are the same disorder, but they are not. 

It's important to properly understand the cause, symptoms and risk factors associated with a medical condition before getting treated. Most people do not know the difference between PCOD and PCOS. 

What is PCOD and PCOS?

PCOD is a disease with definite cause and treatment while PCOS is a syndrome without definite cause and treatment.

Women are afraid, feel uncomfortable, shameful to talk about female reproductive organs, irregular periods, fertility. Societal judgment over women’s health causes the risk of these disorders and prevents early detection of diseases where they can be treated and cured.

What is PCOD problem?

• PCOD (Polycystic ovarian disorder) is  a medical condition caused due to hormonal imbalance in women. Women with PCOD problems have ovaries that produce immature or partially matured eggs during ovulation. These immature eggs will eventually increase in number and form cysts in the ovaries.

• The ovaries increase in size and start releasing large amounts of male hormones leading to irregular periods, hair loss, weight gain, excessive hair growth like mustache.

• The main causative factors of the PCOD problem will include unhealthy diet and lifestyle, hormonal imbalance, lack of physical activity, and due to stress.

What is PCOS problem? 

PCOS (Polycystic ovarian syndrome) is an endocrine disorder where the ovaries produce higher levels of testosterone. The male hormone interferes with the ovulation process of the egg and leads to the formation of numerous cysts in the ovaries. Cysts mean sacs filled with fluid. 

These hormones prevent the release of an egg and they form cysts in the ovaries and get accumulated inside the ovary. This is the reason for irregular periods in women with PCOS conditions that eventually causes fertility problems in childbearing women. The symptoms like obesity, infertility, anxiety are observed complications of PCOS.

Prevalence of PCOS in India

It is found that prevalence of PCOS in India is ranging from 2.2% to 26%. On average the prevalence of PCOS in India is around 22.5%. Pcos is becoming a common medical condition in India due to many factors. Even though exact cause is not determined, it is believed that following have been implicated for the prevalence of PCOS in India-

• Genetics

• Insulin resistance or glycogen intolerance

• Inflammation

These factors cause an increase in the male hormone levels that cause irregular periods or the menstrual cycles in women with PCOS.

The statistics of prevalence of PCOS in India show that one in five Indian women suffer from PCOS. And it is also noted that 80% of women with PCOS suffer from obesity.

The major differences between PCOS and PCOD

Incidence

• PCOD is the most common disorder and occurs in over 10% of the world’s women population. PCOS on the other hand is less frequent and occurs in 5% of women. 

• Many people do not consider PCOD as a disease as it can be cured with proper diet and lifestyle changes. But PCOS is a serious illness that cannot be cured, so has to be prevented at the early stages of occurrence.

• Both PCOS and PCOD can cause fertility problems in childbearing women.

Cause 

PCOS is an endocrine disorder, whereas PCOD is a metabolic disorder. Experts believe that the key cause for both disorders is the hormonal imbalance of the female reproductive organs. Genetic factor plays a major role in hormone fluctuation. Glucose intolerance and inflammation are also associated with increased androgen levels.

The release of increased male hormones like testosterone will prevent the ovaries from ovulation, preventing fertility in women. 

Symptoms

Symptoms of PCOD problems mainly include Hirsutism (hair growth on the face or body), hair loss, darker skin near creases, irregular periods, increased bleeding, abnormal weight gain, acne on the face or body.

PCOS symptoms include irregular periods, male pattern baldness, darkness near creases, headaches, unwanted hair growth like mustache, acne, skin tags, pelvic pain, obesity, infertility.

Complications

• Insulin resistance can lead to overweight, cholesterol, heart disease, and diabetes in women with PCOS and PCOD problems.

• Endometrial hyperplasia will be caused due to irregular and lack of periods that lead to an increased risk of endometrial cancer or endometriosis. 

• Infertility problems will cause risk factors like depression, stress, and anxiety in women who are trying hard to get pregnant. Infertility and miscarriages due to hormonal imbalances are some common PCOD problems after marraige.

• The risk of ovarian and endometrial cancer is high in women diagnosed with PCOS or PCOD.

Effect on body

Fertility in women

PCOS and PCOD problems can affect the menstrual cycle and cause irregular periods. Also fertility in women is one of the major PCOD problems after marriage.

Metabolism

As PCOD is a metabolic disorder it causes overweight in women, also women with PCOS are increased in weight due to insulin resistance which together increases the risk of high blood pressure, cholesterol, heart diseases, and diabetes. 

Sleep apnea

The sleep cycle is disturbed due to frequent breath difficulty during the night in women who are overweight. 

Endometrial cancer

The risk of endometrial cancer is more in patients with PCOS and PCOD problems as the lack of ovulation leads to uterine wall building (endometrial hyperplasia). 

Depression

The hormonal changes caused during PCOD and PCOS lead to symptoms like excessive hair growth that can affect social relations leading to stress, anxiety, and depression.

Difference between PCOD and PCOS table:

Chart diagram for statistical analysis of risk factors in PCOS

Symptoms of PCOD problem

The symptoms of the PCOD problems are less complicated and can be treated with medication, diet, and lifestyle changes.  

• Obesity and abnormal weight gain

• Irregular periods

• Heavy bleeding

• Male pattern baldness

• Infertility in women

Common signs and symptoms of PCOS

The common signs and symptoms of PCOS can be prevented from progression but cannot be cured completely. These are-

• Irregular periods (Oligomenorrhea)

• Missed periods (Amenorrhea)

• Heavy menstruation (Menorrhagia)

• Acne on face or body

• Pelvic pain

• Hirsutism 

• Weight gain

• Darker skin

• Cysts in ovaries

• Mood changes

• Skin tags

• Hair loss

• Infertility 

Causative factors of PCOD

The causative factors of PCOD are still not clear. Researchers claim that genetics and lifestyle can have a vast impact. Researchers have found that PCOD is associated with excess insulin, production of male hormones, low-grade inflammation (the level of C-reactive protein and white blood cells), and genetics. Obesity, unhealthy lifestyle habits, and pollution are considered to be other factors for PCOD cause.

Causative factors of PCOS

The PCOS is caused by higher levels of androgens (male hormones) that prevent the release of ovaries and cause irregular periods. 

Other causes are-

• Increased testosterone - The increased levels of insulin, luteinizing hormone causes excess release of male hormones. This affects ovulation leading to PCOS condition. 

• Increased luteinizing hormone - Luteinizing hormone is secreted by the pituitary gland, helps in the ovulation, development of corpus luteum, and secretion of testosterone in males. An increase in luteinizing hormone increases the male hormones and causes imbalance.

• Increased prolactin level - Prolactin is the hormone that supports the production of milk after giving birth. The increased levels of this hormone cause a decrease in estrogen and cause hormonal imbalance.

• Hyperinsulinemia - Insulin is responsible for the maintenance of body glucose levels. Glucose is the main source of energy and becoming insulin resistant will cause hyperinsulinemia (increased blood sugar levels) that affects ovaries and stimulates male hormones secretion.

Diagnosis for PCOD

Your doctor will diagnose PCOD by physical examination or ultrasound. 

• Pelvic examination: Your gynecologist will physically check your reproductive organs for the presence of lumps, abnormalities, or growth. 

• Ultrasound: An ultrasound scanning is conducted on each of the ovaries to detect the presence of cysts.

• Blood test: The blood test will help your doctor to know the male hormone (testosterone) levels in your blood.

• Glucose tolerance test: An oral glucose solution is given to understand the ability of your body to handle that glucose load.

Your doctor may conduct the following tests during PCOD diagnosis-

• Blood pressure

• Cholesterol

• Anxiety and depression

• Obstructive sleep apnea

Diagnosis for PCOS

Your doctor will diagnose bilateral polycystic ovary syndrome by medical examination. Your gynecologist will review your medical history and assess your body weight and BMI (body mass index).

Additional blood tests and ultrasound tests are conducted for detailed analysis. 

Blood tests

Blood tests will help to provide the best treatment for PCOD to women diagnosed with PCOS

Hormonal blood tests

Blood tests are conducted to assess the male hormone levels in your body. Blood tests of testosterone and free androgen index (FAI) will help to understand the complications of PCOS.

Other blood tests to diagnose PCOS problems are 

• sex hormone-binding globulin (SHBG)

• dehydroepiandrosterone sulfate (DHEAS)

• androstenedione

Ultrasound

An ultrasound is done to get the image of the uterus, pelvis, and ovaries. The image shows cysts in the ovaries if present. It also detects endometrial thickness, which in irregular periods leads to womb cancer.

Transvaginal ultrasound

Transvaginal ultrasound is done only for women who are sexually active.

Abdominal ultrasound

This test will help to analyze the ovaries from outside through the stomach wall.

Management of lifestyle for PCOS and PCOD

Lifestyle changes will bring a great difference in women with PCOD and PCOS. These changes will be related to diet, physical activity, sleeping habits, alcohol, and cigarettes.

Diet for PCOS and PCOD

Diet you take is directly involved in the maintenance of body weight. The BMR for healthy females ranges from 18.5 to 24.9. If BMR exceeds more than 30, it is considered obese. 

Over body weight is associated with PCOD and PCOS and can even lead to complications like diabetes, cardiovascular diseases, and increased blood pressure. Controlling the diet will help you improve insulin resistance, decrease weight, and improve the regularity of periods. 

Take more protein like lean proteins, whole grain flours, and fiber foods like sweet potato, pumpkin, nuts, beans. Increase intake of leafy vegetables such as broccoli, spinach. Also avoid consumption of carbohydrates like rice, sugars. Replace white rice with brown rice. Consumption of fats like oil, dairy, and trans fat can add to body weight. 

Try using oils like avocados, nuts, and olive oil. Along with this observe the pattern of eating. It is better to eat multiple small meals than three large meals in a day. Drink plenty of water approximately 3 to 5 liters as water helps you feel full and reduce weight. 

Physical activity for PCOS and PCOD

Physical activity reduces body fat and keeps you active throughout the day. Energy consumption helps to improve immunity and boost the pancreas to release insulin.  Doing regular exercise for 30 minutes helps in maintaining ideal body weight. 

Other physical activities like yoga, dance, workout, cardio, running, or swimming can also be preferred based on your choice and time. This will help to improve regular periods and solve fertility issues to some extent.

Diet with exercise is one of the best therapies to keep you active both physically and mentally during a disease condition. So, never neglect what you feed and what you do with your body. 

Sleeping habits for PCOS and PCOD

Besides eating habits, sleeping habits need to be observed to maintain a healthy weight. Sleep apnea and sleepiness during daytime are common disorders seen in women suffering from PCOS or PCOD. It is recommended to sleep at least 9 hours per day. 

To fix these sleep issues you need to avoid caffeine after 2:00 PM, avoid alcohol in the evenings, avoid heavy meals or snacks for dinner. Try a warm bubble bath to maintain a relaxing bedtime routine. Never use electronic devices in the bed.

Alcohol and cigarettes for PCOS and PCOD

Alcohol and cigarette consumption will increase the production of androgens. Tobacco consumption is unhealthy and is prohibited in women with PCOS or PCOD. This metabolic syndrome will be exacerbated by smoking as nicotine worsens the androgen levels in women with PCOS and PCOD.

Cholesterol levels and hyperandrogenism will increase in smoking women more than in non-smokers. 

Alcohol consumption is restricted in PCOS or PCOD women as it interferes with the medication. Alcohol is also believed to cause a temporary increase in estrogen and progesterone levels and also disturb hormonal changes that occur during the menstrual cycle.

Cutting alcohol will also assist to have a positive impact on lifestyle changes in PCOS and PCOD women. 

Complications of PCOS

Complications of PCOS include-

• Excessive hair growth on face or body

• Acne 

• Infertility in women or hard to  get pregnant

• Numerous cysts in ovaries

• High blood pressure

• Heart disease and diabetes (increased blood sugar levels)

• Skin tags growth on face or body

• Hair loss due to stress

• Infertile eggs that do not ovulate

• Miscarriage or premature birth

• Endometriosis or uterine cancer

Treatment for PCOD and PCOS

Treatment for PCOD problems and for complications of PCOS include treatment for various symptoms of PCOS vs PCOD that help in hormonal balance or irregular periods.

Hair treatment

The hormonal imbalance of PCOS and PCOD can cause an increase in androgens or male hormones. This will lead to excess hair growth on the face in women. To treat hair growth and hair loss oral contraceptives like Yasmin, Co-cyprindiol, Dianette, Marvelon are used. Spironolactone is used for reducing hirsutism in PCOS or PCOD patients.

These medicines will suppress male hormone production in women with bilateral polycystic ovary syndrome and PCOD. Special creams are available to remove unwanted facial hair such as eflornithine cream. Or you can prefer waxing, plucking, shaving, threading, or laser hair removal treatments for pain-free and permanent solutions.

Surgery

Ovarian drilling is laparoscopic surgery for the removal of cysts in the ovaries that produce male hormones in women. Laparoscopy is advised to treat problems associated with fertility in women that do not respond to medicine.  Hysterectomy is preferred in the case of cancerous cysts or endometrial cancer. 

Medications

Numerous medicines are available to treat the common signs and symptoms of PCOS or prevent PCOD problems in future but there is no complete cure for the disease itself.

Birth control pills

Using oral contraceptives or birth control pills help in preventing irregular periods and improving fertility chances in women. The risk factors of cancer are reduced with the use of contraceptive pills.

Clomiphene or clomid

This medication will help in the regular and monthly release of eggs from the ovaries during ovulation. Letrozole can also be used for ovulation but is not licensed to treat PCOS. Metformin is used if clomiphene/clomid  is not effective.

Metformin

The use of metformin regulates glycogen intolerance in women suffering from type 2 diabetes along with PCOD or PCOS.

Metformin also encourages ovulation, reduces miscarriage, cholesterol, and the risk of heart diseases.

Fertility treatment

Fertility treatments for females with PCOS or PCOD include IVF (In vitro fertilization), Artificial insemination. The egg is fertilized with the sperm in the lab and is transferred into the mother’s womb for implantation. This is the final and one of the best treatment options for PCOD problems or polycystic ovary syndrome if medications and surgery do not work.

Myths and facts

PCOS or PCOD cannot be treated

Depending upon the symptoms and early diagnosis, women with PCOS or PCOD can be treated. But it is not necessary for every woman to get treatment, as diet and lifestyle change can control hormonal changes in most cases.

Women with PCOS or PCOD cannot conceive

It is not true. Women with PCOS and PCOD problems can get pregnant with help of medication, diet, and lifestyle changes. 

Losing overweight cures PCOD or PCOS

Weight loss diets like keto diet may help to reduce the severity of symptoms but it does not help to treat the disease. The reduced weight prevents you from further complications of PCOS like endometriosis. 

PCOS is a rare disease

PCOS occurs in almost 20% of the world’s women population of childbearing age. And it is undiagnosed in half of the women due to lack of awareness. In many countries like India, women feel discomfort in talking about periods, female hygiene; it is considered shameless and taboo.

Irregular periods are PCOD or PCOS

There are many reasons for irregular, heavy, or missed periods like breastfeeding, thyroid disease such as hypothyroidism, uterine fibroids, excess physical activity, stress, pelvic inflammation, extreme dieting. 

PCOD or PCOS means Polycystic ovaries

No, many women with PCOS or PCOD are not diagnosed with cysts. To have these disorders women need to fulfill three criteria- Androgen release, Irregular periods, Multiple follicles, or cysts in ovaries.

Take-home points

Women’s reproductive health is never discussed out of the box and it is taboo in India and many other Asian countries. 

Women are never allowed to speak about menstruation in public. Recently, the time has changed and awareness programs are held to make people understand that irregular periods are not normal and have to be treated. 

In rural areas, till today, girls are taken back from school after puberty due to a lack of awareness in women. Female reproductive health has to be given importance as early detection of these diseases will prevent women from fertility problems in the future.

• Remember to consult a gynecologist if you have irregular periods for more than 3 months.

• Home remedies for PCOD include diet and lifestyle changes with regular exercise.

• Untreated signs and symptoms of PCOD problems or polycystic ovary syndrome can lead to cancer risk factors.

• The difference between PCOD and PCOS is PCOD is a hormonal imbalance that can be reversed whereas polycystic ovary syndrome is an endocrine system disorder that cannot be reversed.

• Excess hair growth on the face and body along with body weight are common signs and symptoms of PCOS and PCOD.

• It is possible to get pregnant even with PCOS and PCOD.

References

• NIH GOV.

• NCBI

• NCBI

• NCBI