It is one of the commonest female endocrine diseases we encounter at the clinics. This condition is characterized by physical signs like excessive weight gain (high Body mass index), acne, hirsuitism (excessive body hair) and acanthosis negricans (dark pigmented patches specially seen behind the neck and arm pit). Most of the patients present with sub fertility and infrequent menstrual periods (with heavy menstrual bleeding).
Polycystic ovarian syndrome (PCOS) is diagnosed based on clinical findings (signs and sympotoms) as well as ultrasound findings. Typical ultrasound findings in a patient with polycystic ovarian syndrome would show many fluid filled spaces inside the ovaries, which usually confirms the presence of polycystic ovarian syndrome when combined with clinical features.
Although there are hormonal imbalances in patients with PCOS, exactly why this particular syndrome occurs is still unclear. The process of ovulation is a delicate processes finely controlled by various hormones. When these hormonal control is lost process of ovulation doesn't happen, thus there will not be any ovum (egg) for the conception to occur.
Evidence increasingly shows that PCOS is part of a multi system metabolic syndrome, thus patients with PCOS need to be aware of their future health risks. Once this condition is diagnosed, patients need to be educated about these other risk factors as well as the available treatment modalities. These patient may develop cardiovascular diseases, Diabete melltus and their complications later in life if the condition is not controlled from the beginning.
First step in treating a patient with polycystic ovarian disease is to implement life style modifications to reduce weight and have a healthy BMI. This step can be achieved with dietary changes as well as proper / adequate exercise. along with the life style modifications, medical as well as surgical interventions can be implemented. Metformin is one of the leading drugs we use to control the metabolic effects of PCOS. It has been shown by many clinical trials that metformin has a positive outcome in controlling PCOS.
Laparoscopic ovarian drilling is one of the best and most effective ways in treating women with sub fertility due to PCOS. Since it enhance ovulation and thus improves hormonal balance in the body, signs and symptoms of PCOS will also be controlled thorough this procedure.
Ovarian drilling is a minimally invasive procedure done using only two very small abdominal incisions, thus cosmetic effects of this surgery is very minimal or no. surface of ovaries are punctured using an electrical current to increase the chance of ovulation happening. The procedure is a safe procedure with minimal side effects and currently accepted as the best treatment modality for this condition in centers with laparoscopic facilities.