Irregular periods ail a significant percentage of the female population. While it isn’t always the case, sometimes this can be a symptom of conditions like Polycystic ovary syndrome (PCOS) and Polycystic ovarian disease (PCOD). Dr Chanda Karki, an obstetrician and gynaecologist, former principal and CEO of Kathmandu Medical College, a member of the House of Representatives, and the president of the Nepal Society of Obstetricians and Gynecologists, breaks down these conditions in an interview with the Post.

What is the cause of irregular periods?

Irregular periods can be caused by a variety of reasons—like hormone imbalance, poor diet, and weight fluctuations. Physical and emotional stress can also interfere with hormone production, which in turn affects the menstrual cycle.

The menstrual cycle can be impacted by a number of drugs, including hormone therapy or birth control tablets. Menstrual abnormalities can also be brought on by a hyperactive or underactive thyroid gland.

What are PCOD and PCOS?

In simple terms, PCOD and PCOS are two ovaries-related conditions that can cause irregular periods.

PCOD causes hormonal abnormalities and many ovarian cysts form as a result of it. PCOD can cause irregular periods, acne, excessive hair growth, and weight gain. Some women diagnosed with it can also have trouble getting pregnant.

PCOS is a more widespread and complicated condition than PCOD. Its symptoms include insulin resistance, which can result in diabetes, excessive levels of androgens, and metabolic abnormalities. Period irregularities, acne, excessive hair growth, weight gain, infertility, and insulin resistance are also some possible symptoms of PCOS.

There are differences between PCOD and PCOS, despite the fact that the two conditions have overlapping symptoms. The major one is that women with PCOS may have high levels of androgens, leading to symptoms like male pattern baldness or hair thinning. It is important to note that not all women with PCOD or PCOS will experience the same symptoms, and the symptoms can also vary in severity.

Does PCOD/PCOS affect pregnancy?

While women with PCOD/PCOS can get pregnant and give birth, these conditions do make it difficult for them to get pregnant. The irregularity in their menstruation cycle and hormonal imbalances they experience can affect ovulation and make it harder to conceive.

With proper diagnosis and treatment, pregnancy is still possible. Women with these conditions need to make some lifestyle changes such as maintaining a healthy diet, exercising regularly, and if needed, weight loss and have medications like insulin-sensitising agents or fertility drugs for treatment. In some cases, surgery may be necessary to remove ovarian cysts and improve fertility.

I advise women with PCOD/PCOS to consult a healthcare professional who focuses on reproductive health, such as a fertility specialist or gynaecologist before they try to conceive a child.

In addition to offering advice on fertility treatment, a specialist can suggest procedures like ovulation induction, intrauterine insemination (IUI), or in vitro fertilisation, and even assist in the diagnosis and management of PCOS through IVF. Additionally, they can provide guidance on dietary and activity modifications that can increase fertility.

Many women with PCOD/PCOS are given contraception and abortion pills to regulate their periods. Is that safe?

No, it is not safe to use abortion or contraceptive pills to regulate periods. Abortion pills are intended for terminating a pregnancy, while contraceptive pills are designed for preventing pregnancy. Both types of pills contain hormones that can affect the menstrual cycle, but they are not approved to be used as a treatment for irregular periods.

Using these pills (to regulate periods) can have serious health consequences like hormonal imbalances, blood clots, stroke, or heart attack. So using them to cure is not recommended.

Women experiencing irregular periods should consult with their healthcare provider to determine the underlying cause and develop a treatment plan that is safe and effective.

What measures can be taken to manage the condition?

Women with PCOD/PCOS can take a number of precautions to control these conditions and maintain excellent health. Maintaining a good diet and regular exercise are the basics. It is also important to manage stress through relaxation techniques like deep breathing, meditation, or yoga.

Healthcare professionals—specialising in reproductive health, such as an obstetrician, gynaecologists or endocrinologists—should be consulted regularly. If you have been prescribed medication to treat PCOD/PCOS or menstruation irregularities, it’s crucial to follow up with your doctor.

Women with these conditions are considered more prone to diabetes. Is that a myth?

No, it is not a myth. Women with PCOS/PCOD along with irregular periods are at a higher risk of developing type 2 diabetes, especially if they are overweight. The hormone insulin controls blood sugar levels. As the diagnosed women develop insulin resistance, which occurs when the body becomes less receptive to the hormone insulin, their blood sugar level rises. This can lead to type 2 diabetes.

Along with physical ailments, do these conditions affect diagnosed women’s mental health?

Our mental health can be impacted by cortisol levels. Cortisol is a hormone that is produced by the adrenal glands in response to stress, and it plays an important role in the body’s stress response system. When cortisol levels are elevated, it can have psychological effects.

Women with PCOS/PCOD may be at a higher risk due to the dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, which is responsible for regulating cortisol production. As a result, women with these conditions may be at an increased risk of suffering from mental health problems.

It’s important to manage stress levels and prioritise self-care to help regulate cortisol levels and promote overall health and well-being. Techniques such as mindfulness meditation, yoga, and regular exercise have been shown to be effective in reducing stress and promoting emotional and physical health.

Some women with PCOD/PCOS freeze their eggs to preserve their fertility. Is that always necessary?

Women with PCOD/PCOS who are concerned about their fertility may choose to freeze their eggs as a way to preserve their ability to have biological children in the future. Whether a woman should freeze her eggs depends on several factors, including her age, fertility status, and personal goals.

Freezing eggs can be an effective way to preserve fertility for women who are not yet ready to have children but are concerned about their fertility due to a medical condition or other factors. However, it’s important to note that egg freezing is not a guarantee of future pregnancy, and success rates can vary depending on a variety of factors.