Category: General

Polycystic Ovary Syndrome is a common condition that affects women during their reproductive age group. Around 10-25 % of women have it, depending on how the physician defines the disease.

To say that a lady has PCOS, any two of the following three conditions should be present

1. Irregular periods

2. Excessive hair growth on the face /other areas of the body ( or high male hormones in blood)

3. An appearance diagnostic of polycystic ovary in the ultrasound scan

Many women approach us with an ultrasound, believing that they suffer from PCOS. It is not so. Many other conditions, e.g. thyroid diseases, may also have these cysts in the ovary. Even a small population of normal women may also have it. So, the treating doctor will make sure that you don’t have any other disease that may cause cysts in your ovary before diagnosing PCOS.

Dr. Mathew John MD, DM

This is a query that I face every day when I deal with women with PCOS. PCOS is an incompletely understood disease. Many of these women have excess body fat, leading to changes in hormone levels in the pituitary gland and ovaries and a lack of ovulation. But even some lean women may have it.

Every person with PCOS has some unique problem. For some, it may be irregular periods; for others, it may be hirsutism (excessive hair growth over the face or limbs) or infertility.

Treatment will aim to resume regular periods and ovulation, reduce hirsutism, and reduce the risk of metabolic diseases like diabetes. This can be achieved with weight loss, dietary modifications, combined oral contraceptive pills, anti-androgens, and LASER therapy. The aim is not to make the cysts in the ovary disappear.

Many women start having ovulation and regular periods when they lose weight, but hirsutism persists. For others, despite weight loss, periods may not resume. So, a combination of lifestyle measures and medicines will help people with PCOS. Furthermore, many benefits of weight loss may disappear when the person regains weight.

So, PCOS may not be curable, but it may be controlled.

Dr. Mathew John, MD, DM

Polycystic ovary disease is a hormonal problem that affects women in their reproductive age groups and cause menstrual irregularities infertility, hirsutism, glucose intolerance and obesity. But menopause marks the end of the reproductive state.Even though menopause doesn’t cure PCOD it can become less pronounced as a woman reaches her menopausal state around the age groups 45-55 years .Both PCOD and perimenopausal period ( the period before actual menopause ) share some common features like delayed or lack of menstruation for few months, acne, mood swings, changes in glucose metabolism and cholesterol levels and even abnormal weight gain. Women with PCOD are at increased risk of developing these problems putting them at high risk of developing cardio metabolic complications once they reach menopause. Hence proper life style management like dietary interventions, regular exercises and weight management are crucial to avoid these complications and should take the advice of the health care provider as and when required.In short,while menopause doesn’t cure PCOD, it can alter some of the hormonal imbalances and potentially reduce some PCOD symptoms.

Dr. Deepa G, MHSc (Diab), Dip ( Diab)

Polycystic Ovarian Disease (PCOD) is a common disorder affecting women of reproductive age. While it may not be entirely preventable, adopting healthy lifestyle practices can significantly lower risk factors and aid in effective symptom management.

1. Maintain a Balanced Diet 
•    Incorporate whole grains, high-fiber foods, lean proteins, and a variety of fruits and vegetables.
•    Opt for healthy fats such as those found in olive oil, nuts, and avocados.
•    Ensure adequate hydration by drinking sufficient water; limit the intake of sugary and caffeinated beverages.
•    Minimize consumption of fried or processed foods, sugary snacks and drinks, refined carbohydrates, excessive full-fat dairy, and red or processed meats.

2. Achieve and Maintain a Healthy Weight 
•    Even a modest weight loss of 5–10% can contribute to symptom improvement.
•    Focus on gradual, sustainable changes rather than rapid weight loss.

3. Engage in Regular Physical Activity 
•    Aim for a minimum of 150 minutes of moderate exercise per week to assist with weight management, improve insulin sensitivity, and promote hormonal balance.

4. Manage Stress Effectively 
•    Implement stress-reduction techniques such as yoga, meditation, or mindfulness, as chronic stress can exacerbate symptoms.

5. Prioritize Quality Sleep 
•    Strive for 7–8 hours of restful sleep each night to support hormonal regulation and metabolic health.

6. Maintain Regular Meal Patterns 
•    Consuming meals at consistent intervals can help stabilize blood glucose levels.
In summary, while no single intervention can guarantee the prevention of PCOD, a comprehensive approach involving nutritional, physical, and psychological well-being can reduce risk and enhance overall health outcomes.

Dr. Tittu Oommen MD, DM

One of the major concerns for women with PCOD is hirsutism, which is the medical term for excess hair growth on areas like the upper lip, chin, chest, abdomen, or back.

PCOD is a hormonal disorder that can cause irregular periods, acne, obesity, and sometimes difficulty in getting pregnant. It can also lead to hirsutism. While this can be distressing, the good news is that it is treatable!

How is Hirsutism Treated?
Treatment often involves a combination of approaches to manage the underlying hormonal imbalance and remove unwanted hair.

1. Medications to Balance Hormones :

·       Birth Control Pills : These are often the first step to regulate your menstrual cycle. It can take up to 6 months to see a reduction in hair growth.

·       Anti-androgen Medicines (e.g., Spironolactone, Finasteride) : These medications block the effect of male hormones. You might need to take them for at least 6 months to notice a difference. Consistent, long-term use is often recommended for best results.

·       Metformin : This medicine helps control insulin resistance, which is common in PCOD and can contribute to hirsutism.

2. Topical Treatment :

·       Eflornithine Cream (e.g. Eflora)  This prescription cream is applied to the skin to slow down hair growth directly. It can take about 6 to 8 weeks to see results.

3. Hair Removal Methods:

Several methods can be used to remove the hair itself. It’s often best to start these after your medical treatment has begun to reduce the growth of new, coarse hairs.

·       Temporary methods : Waxing, bleaching, plucking, and hair removal creams.

·       Long-term solutions : Electrolysis and laser therapy, which usually require multiple sessions.

Important Things to Remember:

·       It takes time to see results from medications.

·       A healthy diet and regular exercise can significantly improve the effectiveness of your treatment.

·       It is essential to work with your endocrinologist for hormonal management and a cosmetologist for hair removal advice.

Your treatment plan will be personalized to your specific needs.

Dr. Deepa G, MHSc (Diab), Dip (Diab)

While standard treatments for PCOS—like weight management, diet, lifestyle changes, and prescribed medications (e.g., Metformin, oral contraceptives)—are the most effective approach, many people are curious about natural supplements.

Let’s look at the evidence for the most popular options:

Myo-inositol : This natural sugar can help reduce insulin resistance and high androgen (male hormone) levels. Studies confirm it can improve insulin sensitivity and ovulation.

Verdict: Promising, but current research shows it is less effective than standard medications like Metformin.

Vitamin D : Can improve glucose levels and markers of inflammation.

Verdict: Recommended only if you have a confirmed Vitamin D deficiency.

Curcumin (from Turmeric) : Small studies show it may reduce inflammation and slightly improve blood glucose.

Verdict: No proven benefit for regulating periods or improving fertility.

Coenzyme Q10 (CoQ10) : This antioxidant may reduce inflammation markers.

Verdict: No significant effect on menstrual cycles or fertility has been found.

Omega-3 Fish Oils : May have minor effects on improving insulin resistance.

Verdict: Lacks definitive studies showing a real impact on important PCOS outcomes.

Others (N-acetylcysteine, Berberine, Zinc, Magnesium)

Verdict: Current evidence does not support their use for PCOS.

Myo-inositol and Vitamin D (if you are deficient) have the most scientific support, but they are not a replacement for standard medical treatment. Other supplements have very limited evidence.

Important : Supplements can interfere with medications and may not be safe for everyone. Always consult your endocrinologist before starting any new supplement.

Dr. Tittu Oommen MD, DM 

More than 50% of women with PCOS are overweight or obese. This is a critical point because excess fat is a primary driver of the condition and its related health risks, including diabetes, hypertension, and fatty liver disease.

The Impact of a Small Change The good news is that even a modest weight loss of just 5% can lead to significant improvements. For a 100 kg person, that’s just 5 kg!

 Key Benefits of Weight Loss 

 Periods : Helps restore menstrual regularity.

 Fertility : Can restart ovulation and improve the chances of conception.

 Health : Lowers abnormal glucose levels and reduces other health risks.

 How is Weight Loss Achieved? 
Effective strategies, often guided by a doctor, include:

1. Calorie-controlled nutrition

2. Medications (e.g., Metformin, Semaglutide, Tirzepatide)

3. Bariatric surgery (for eligible individuals)

4. Setting Realistic Expectations :It’s crucial to know that weight loss is for management, not a cure.

 What improves MOST?
Menstrual cycles, ovulation, and insulin resistance.

 What improves LESS ?
Symptoms driven by high testosterone, like hirsutism (excess hair growth), may only show limited improvement.

 Take Control of Your Health 
Ready to discuss your options? If you have PCOS, speak with your endocrinologist to see if a medically supervised weight loss plan is a suitable next step for you.

 Mrs. Rejitha Jagesh, MSc

Of course, many people with diabetes face a dip in sugar after a meal. A main meal consisting of high amounts of refined carbohydrates and low in dietary fiber, protein, or fat can lead to a sudden spike in blood glucose, followed by a dip in sugar levels. To prevent the variability in blood glucose after a meal, incorporate the following foods that help to stabilize your blood sugar levels.

1. Protein-rich foods : Protein-rich foods take more time for digestion and absorption. These foods provide fullness for a longer duration than carb-rich foods. Protein-rich foods include pulses and legumes, chicken, fish, eggs, Tofu, paneer, and cottage cheese should be included in the meal. Restrict red meats in the diet.

2. Complex Carbohydrates (Low-Glycemic Index Foods): Complex carbs (e.g., whole grains and vegetables) are high in fiber and digest more slowly than refined carbs (e.g., maida), thus helping manage blood sugar levels. The fibers in these foods delay the digestion and release of glucose into the bloodstream, leading to better control over blood sugar and hunger cravings throughout the day. Low GI foods include whole grains, legumes, fruits, and vegetables.

3. Healthy Fats : Fats contribute to early satiety and also slow down the digestion of food, and thus manage the glucose levels in the bloodstream. These should be consumed in the recommended quantity and used properly in cooking methods. Good sources of healthy fats are nuts and seeds, avocados, fatty fish (sardines, salmon), and olive oil. 

 Points to be remembered
 
•    To avoid such episodes, follow an individualized and balanced meal pattern based on overall health status, duration of diabetes, current medicines, and physical activity. 

•    Avoid refined carbs and sugars, especially white bread, pasta, sugary cereals, soft drinks, and many processed snacks. 

•    Do not skip your meals, which can cause hypoglycemia (low sugar).

 Mrs. Sreekutty S, MSc

Yes, there are several common medications that can cause hypoglycemia, which means low blood sugar. This condition can make you feel shaky, dizzy, weak, confused, or even faint if not treated quickly.

Medications That Commonly Cause Hypoglycemia:
1.     Insulin – Used to treat diabetes, insulin lowers blood sugar. If you take too much insulin, skip a meal, or exercise more than usual, it can cause your blood sugar to drop too low.
2.     Sulfonylureas – These are diabetes pills (like glipizide or glyburide) that help the pancreas to release more insulin. They can cause low blood sugar, especially if meals are missed.
3.     Meglitinides – Similar to sulfonylureas, these (like repaglinide) also increase insulin secretion and can lower blood sugar too much.
4.     Quinine – A medication used for malaria can sometimes lower blood sugar, although this is less common.
5.     Certain antibiotics – For example, fluoroquinolones (like levofloxacin) may occasionally cause low blood sugar, especially in older adults or people with diabetes.

Key Points
Consult Your Doctor Before Starting a New Medication
1. To Ensure Safety
Your doctor can determine if the new medication is safe based on your medical history, allergies, and current health conditions.
2. To Avoid Harmful Interactions
Some medications can interact with others you’re already taking, leading to side effects or reduced effectiveness. Your doctor can check for these interactions.
3. To Determine the Right Dosage
Doctors can prescribe the correct dose tailored to your age, weight, kidney or liver function, and overall health.
4. To Manage Side Effects
Your doctor can explain possible side effects, how to manage them, and what signs to watch for.
5. To Discuss Alternatives
There might be safer or more effective alternatives to the drug you’re considering. Your doctor can help you choose the best option.
6. To Plan Monitoring and Follow-up
Some medications require blood tests or follow-up visits to monitor how your body responds.

Mrs. Anila Nisha, D Pharm       

Insulinoma is a rare tumour of the Pancreas which produces excess insulin leading to very low sugar levels .Most of them  are found to be benign, but rarely some can become malignant. These are rare with an estimated incidence of 1 to 4 cases per million people per year.It is seen more in women and often get  diagnosed in the age groups of 40-60 years. It can occur associated with multiple endocrine neoplasia (MEN-1 syndrome) a genetic condition affecting multiple endocrine glands.

 Symptoms include
1.Undue tiredness due to repeated low sugar levels
2.Irritablity and difficulty in concentration
3.Anxiety
4.Blurring of vision
5.Slurring of speech
6.In severe cases it can lead to unconsciousness or seizures.

We can detect this condition by conducting a supervised prolonged 72 hour fasting test where we can find out the blood glucose fluctuations and take samples for insulin and C peptide levels. By doing imaging studies like CT scan, MRI scan or specialized PET scan we can confirm the diagnosis and take further steps to treat it. Usually surgical removal is done as part of the treatment.Dietary adjustments including small frequent meals with high protein and fiber are recommended.

 Dr. Deepa G, MHSc (Diab), Dip (Diab)