30 Jan Do PCOD and PCOS mean the same thing or are they different?
Though it may sound similar enough, PCOS (Polycystic Ovarian Syndrome) is a bit different from PCOD. In PCOD the ovaries start releasing immature eggs that lead to hormonal imbalances and swollen ovaries, among other symptoms; while in PCOS, endocrine issues cause the ovaries to produce excess androgens, which makes eggs prone to becoming cysts. These cysts won’t, however, be released like in PCOD – rather they build up in the ovaries themselves.
About two years ago, one of my friends was diagnosed with PCOD over the holidays. When she came back to school and told us about it, most of our reactions were along these lines: “PCOD? Isn’t it called PCOS?” Or: “Wait, what exactly happens in that? Just irregular periods, right?” Or, more atrociously: “Oh, all you need to do is lose weight and go on a diet, it’ll be fine.”
The ignorance, whether or not it was wilful, was glaring – then again, at least at a school level, not many comprehensible resources have been compiled regarding this matter, or at least they aren’t widely available. The very least I felt I could do (since I’m not a licensed medical professional) was curate credible information from a few trusted sources to make a very rudimentary and brief guide.
If you are someone who menstruates or have had enough conversations with people who menstruate, you’ve probably heard of PCOD or PCOS at some point in your life. Depending on the setting, your pre-existing knowledge about the two may vary in accuracy – myths and misinformation are rampant when it comes to these surprisingly common health issues, and despite being quite different, the two abbreviations are often used interchangeably. Before we get to how exactly the two are different, let’s talk a little bit about what they actually are – their causation, their treatments etc.
PCOD (Polycystic Ovarian Disease) is mostly caused by a combination of hormonal imbalance and genetic tendencies. In a standard menstrual cycle, the two ovaries will alternately release mature, ready-to-be-fertilized eggs each month. For someone with PCOD, however, the ovaries will often release either immature or only partially-mature eggs, which can go on to develop into cysts(little sacs filled with liquid).
This also leads to the ovaries swelling and becoming enlarged. Generally, the ovaries release a limited amount of androgens (male hormones) during the cycle – but in this case, the ovaries will start producing androgens in excess, which leads to symptoms like male pattern hair loss, abdominal weight gain, irregular periods, and in some extreme cases, even infertility.
There is no set ‘cure’ as such for PCOD, but one of the best ways to manage it is by introducing changes in your lifestyle (after having consulted professionals, of course: your gynecologist, an endocrinologist and a dietician, preferably). Exercising and maintaining a healthy diet (low on sugars and carbohydrates, high on protein and fiber) are the most effective ways to get your PCOD under control. This also cuts out some of the weight gain, which is very helpful, as even a 5% reduction in weight eases treatment considerably.
Depending on the case, a person may be given medication to help balance their hormones. Some cases even require Second-line therapy – laparoscopic surgery, ovarian drilling, aromatase inhibitors, to name a few. However this is not that common. People may further consult other doctors to treat some symptoms specifically – PCOD induced acne and hair loss can usually be solved by skin treatments, and although in most cases, after minimal aid with conception, one can expect a smooth pregnancy, about 20% of cases (based on data collected on Indian women) may require fertility drugs or other fertility-enhancing treatments should they want to carry a baby.
PCOS has a lot of symptoms common with PCOD – weight gain, infertility, acne, irregular periods, etc. PCOS also induces metabolic syndrome, which increases risk of heart disease, strokes, and diabetes. It may also cause sleep apnea, which affects the body’s ability to breathe while you are sleeping – this means sudden pauses in breathing or inability to breathe while asleep, which in turn leads to a highly disturbed sleep cycle. As no ovulation is taking place, the uterine lining (lining of the uterus) builds up every month, which can also increase chances of endometrial cancer.
Treatment of PCOS usually includes taking oral contraceptives (birth control pills) which contain estrogen (female hormone) and progestin (which mimics progesterone, another female hormone) to stabilize the menstrual cycle and deal with a few other symptoms. Additional medication may be taken to reduce chances of endometrial cancer and diabetes – and for acne and skin problems. Weight loss and living a healthier lifestyle will also aid the treatment process in this case.
Now that we’ve covered the basic ground regarding both these menstrual health issues, let’s focus on a few differences between them too:
First and foremost, PCOS is usually considered a more serious condition. PCOD can often be managed just by making informed lifestyle changes, and may not even require further medical treatment at all. PCOS however is a disorder of the endocrine system – it has more threatening implications and its treatment almost always requires external hormone intake.
Along with that, PCOD is also far more common, at least in women. About one-third of all menstruating women around the globe have PCOD. PCOS is not that common – though it isn’t rare either. According to a study conducted in Southern India and Maharashtra, about 9.13% of menstruating women in those regions suffer from PCOS, while 22.5% have PCOD.
And finally, both the hormonal disorders do have infertility as a shared side effect, but not to the same extent. As discussed before, if one has PCOD, with some extra precautions, and minimal medical intervention, pregnancy is almost always possible. However, PCOS has too many hormonal irregularities, and conception is much harder in this case. While a drug called Clomiphene is commonly taken to increase fertility if one has PCOS, this medication also usually results in increased chances of twins/multiple births, which is not always something that people want.
Whether it’s PCOS or PCOD, one cannot argue that both have a sense of social stigma and misinformation surrounding them, especially in Indian society. They’re such common disorders yet they’re treated as something shameful, to keep under wraps – as are all things related to periods.
Lack of conversation always leads to a lack of education – and even basic knowledge about menstruation, which may happen to extend beyond the diagrams in an eighth-grade biology book, is unknown to most people. But we can always make an effort to educate ourselves, and if you’re still here reading till the end of this article, you’re one of those people – and we thank you for it 🙂