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Understanding PCOD

Understanding PCOD

by: Dr. Surinder Kaur Gambhir
Sr. Consultant - Obstetrics & Gynecology Paras Bliss, Panchkula

PCOD is a complicated hormonal disorder affecting many different body systems besides affecting your menstrual cycle and fertility. If you have PCOD, your risk for heart disease are increased as well.

Earlier, surgery was primary treatment for PCOD, but is much less common today as surgery may damage your ovaries. Before considering surgery, a number of medical treatments should be discussed or attempted like weight loss, birth control pills, spironolactone and symptoms management. Surgery is only recommended if these treatments are not effective.

Types of surgical interventions used to treat PCOD

For women having PCOD, laparoscopic ovarian drilling is one of the most common surgical treatment which results in ovulation. Electrocautery is used to destroy part of ovary. It is an option for women who are not ovulating after losing weight and fertility medicines. Ovarian drilling is done through a small incision with general anaesthesia. Surgeon makes a small cut in the abdomen at the belly bottom then tube is placed to inflate the abdomen with CO 2 gas. Then laparoscope is inserted through the same incision or some other small incision in the pelvic area.

After laparoscopy procedure you can go home the same day and can do your normal activities within 24 hrs. Its beneficial effects are due to destruction of androgens producing stroma. The procedure appears to have no effect on insulin sensitivity and lipoprotein profile. At least half of the patients achieve pregnancy. Beneficial effects are more in younger age group and low BMI.

The endocrine changes found after ovarian surgery in PCOS women seems to be governed by the ovaries themselves. Rapid reduced secretion of ovarian hormones restores feedback to the hypothalamus and pituitary resulting in appropriate gonadotrophins secretion.

Follicle development seems to be induced by increasing FSH levels following a reduction of the follicle excess (intra-ovarian) androgen levels. If you have laparoscopy procedure, you will likely to go home sane day and can do your normal activity within 24 hrs.

Risk of Laparoscopy

  1. Infection of the incision
  2. Bleeding from the incision
  3. Internal bleeding
  4. Accidental injury to internal organs or vessels
  5. Pain after the procedure from inflating the abdomen with CO 2 gas.
  6. Problems caused by anaesthesia.
  7. Adhesions or searing inside the body.

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