PCOD (Polycystic Ovarian Disease)

PCOD, elaborated as Polycystic Ovarian Disease, is a hormonal condition that affects a woman’s menstruation, fertility, as well as her overall health. PCOD develops during the reproductive years. It can initially appear during adolescence or in her early twenties. Many women live with PCOD for years before receiving a diagnosis, since its symptoms can easily be mistaken for those of normal menstruation. Most people confuse PCOD with PCOS (Polycystic Ovary Syndrome), which is a related but is a different condition. It is important to understand what PCOD is for proper diagnosis and care.

PCOD has been on the rise in recent decades. It is estimated that nearly 20% of all Indian women live with PCOD, making it one of the most common hormonal conditions affecting women today.

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What is PCOD?

Polycystic Ovarian Disease (PCOD) is a medical condition that affects women. If you have PCOD, the ovaries generate partially mature or immature eggs in large numbers during your reproductive years. These immature follicles accumulate in the ovaries because ovulation does not occur regularly, giving the ovaries a characteristic polycystic appearance. The ovaries may produce higher-than-normal levels of androgens (male hormones), which can contribute to irregular periods, acne, excess hair growth, and ovulation problems.

Medical Update: Understanding the Proposed PMOS Terminology

In 2026, a new term was coined - PMOS (Polyendocrine Metabolic Ovarian Syndrome) by global medical associations. This change was required as PCOS/PCOD focused only on ovarian cysts. In reality, the condition is about multiple hormone systems, metabolism, and overall health. PMOS is now the globally accepted medical term; still, PCOD continues to be the more commonly used term in India. This is still a fairly new update, so many Indian doctors and patients will keep using PCOD and PCOS for some time. This section is for general awareness only and does not change how PCOD is diagnosed or treated in India today.

What happens in PCOD

At the centre of PCOD is a hormonal imbalance. The ovaries produce higher-than-normal levels of androgens, the hormones that are usually present in small amounts in women. This excess disturbs the normal cycle of egg release and affects several parts of the body at once:

• Irregular or missed menstrual periods
• Difficulty conceiving
• Acne or oily skin
• Excessive facial or body hair (hirsutism)
• Thinning of scalp hair
• Weight gain, especially around the abdomen

Because these hormones affect more than just the reproductive system, PCOD is now understood as a whole-body condition rather than just an ovary problem.

Causes of PCOD

The exact cause of PCOS is now known, but as per experts, it develops from a combination of genetic, hormonal, lifestyle, and environmental factors, and not any one single reason. 

Genetic Predisposition / Family History

PCOD can be genetic. If your mother or sister has it, you are at risk of developing it. 

Hormonal Imbalance

PCOD is directly linked to higher levels of the male hormone androgen, which a woman’s body produces in small quantities. When this rises too high, it can interfere with ovulation and also trigger many PCOD symptoms. 

Insulin Resistance

Insulin resistance is very common in women who have PCOD. When the body does not respond to insulin, it starts producing more to compensate. The excess insulin can trigger the ovaries to produce more androgens, which in turn impacts ovulation. 

Chronic Low-Grade Inflammation

If a woman’s body has mild, ongoing inflammation in the body, it can also increase androgen levels. 

Lifestyle factors

A sedentary lifestyle, being overweight or obese, and eating an unhealthy diet on a consistent basis can lead to PCOD. Stress can also disrupt hormone regulation over a period of time. 

Environmental factors

Exposure to certain chemicals can also be a reason for PCOD, as per some studies. Still, this has not been firmly established. 

Symptoms of PCOD

Symptoms of PCOD occur mainly because of the underlying hormonal imbalance, and they can look quite different from one woman to another. Some women have mild PCOD symptoms, while others experience several symptoms together. Recognising the early symptoms of PCOD in females can help with faster diagnosis and better management.

Irregular or Missed Periods

Your periods may have a higher interval of 35 days or more, or sometimes even stop for a few months. 

Heavy or Prolonged Menstrual Bleeding

Your periods can be unusually heavy or last longer. 

Difficulty Conceiving

Irregular ovulation makes it difficult to conceive without medical support.

Excess Facial and Body Hair (Hirsutism)

High androgen levels which can lead to hair growth on the face, chest, or back.

Acne and Oily Skin

Due to hormonal changes, you may see jawline and chin acne. 

Hair Thinning or Hair Loss

You may notice scalp hair thinning out, more noticeable near the crown. 

Weight Gain or Difficulty Losing Weight

You may notice weight gain around the belly that does not go away with diet changes or regular exercise. 

Darkened Skin Patches (Acanthosis Nigricans)

Some velvety, dark patches may be seen on the neck, underarms, or skin folds. It is linked to insulin resistance.

Skin Tags

Small, soft skin growths can develop, usually in areas of friction like the neck or underarms.

Ovarian Cysts (for some women)

Some, though not all, women with PCOD will have visible follicles or cysts on an ultrasound scan.

How is PCOD Diagnosed?

There is no single test that can confirm that you have PCOD. Your doctors are likely to diagnose based on observations. 

Medical History & Symptom Assessment

Your doctor will initially ask you about how regular your menstrual cycle is, its frequency, and its flow. They may also ask if you are experiencing any sudden weight changes, have acne, excessive facial hair, or thinning scalp hair. They may also ask if you are having any fertility issues. A family history of PCOD, diabetes, and any other hormonal disorders needs to be revealed at this time. This conversation will give your doctor all the inputs needed to diagnose whether you have PCOD or not. 

Physical Examination

A physical examination is required to measure your BMI based on your weight and to check for any visible symptoms of excess androgen in your body. Your doctor may also look for any changes in the skin, which can indicate insulin resistance. 

Pelvic Examination

A pelvic examination may be done to check the ovaries and reproductive organs, especially when there is a clinical observation indicating PCOD. 

Blood Tests

Blood tests that help confirm PCOD: 

• A hormone profile checking LH, FSH, testosterone, and prolactin levels
• Blood glucose or HbA1c, along with insulin levels, particularly if insulin resistance is suspected
• Thyroid function tests, since thyroid disorders can cause symptoms similar to PCOD
• A lipid profile, which can offer additional insight into metabolic health, though this isn't always required

Pelvic Ultrasound

A pelvic ultrasound is used to examine the ovaries, their size, the presence of any small cysts, the thickness of the uterine lining, etc. 

Follow-Up & Monitoring

PCOD is not just confirmed and treated in a single visit. Regular follow-ups and monitoring are required to note how your symptoms are changing, track hormonal and metabolic health, and adjust your treatment plan accordingly. 

Treatment for PCOD

There is no one-size-fits-all approach to treating PCOD. The treatment needs to be based on the specific symptoms that you have. Most successful treatment plans are a combination of medical management and lifestyle changes. You will notice the changes with the right mix, which can be concluded only over time. 

Lifestyle Modifications

Lifestyle modifications are the first suggestion for PCOD and it can improve your symptoms drastically. 

• A balanced diet that is also PCOD-friendly is the need of the hour
• Regular physical activity or exercise - for a minimum of 30 minutes a day, 5 days a week 
• Managing your weight, even losing 5-10% of your existing weight, can improve your PCOD symptoms 
• Stress management and good sleep can also help with hormone regulation 

Medications

Based on your symptoms, your doctor may recommend: 

• Hormonal therapy or oral contraceptive pills, which can regulate your menstrual cycles
• Insulin-sensitizing medications in case you are insulin-resistant
• Medications for acne, excessive hair growth (hirsutism), or hair loss, which are due to increased androgen levels 
• Ovulation induction medications if you are planning a pregnancy

Fertility Treatment

Ovulation induction or Assisted Reproductive Techniques (ART) like IUI or IVF may be recommended by your doctor to help with fertility. 

Surgical Management

Surgery is only for extreme cases. Laparoscopic Ovarian Drilling (LOD) may be suggested for women who do not respond to medications and still have ovulation problems. 

Management of Associated Conditions

PCOD is linked to your overall metabolic health. Hence, resolving any obesity or weight management issues, diabetes or prediabetes, high cholesterol, hypertension, and other metabolic complications can help manage PCOD. 

Ongoing Care

PCOD does not go away with one medication or a single visit to the doctor. You need to have your routine consultations with a gynecologist. Consistent monitoring of your menstrual health, metabolic parameters, and treatment response can help you make adjustments and modify treatment plans as needed. 

Medications for PCOD

Medications for PCOD should be advised by your gynaecologist or endocrinologist based on your symptoms, how severe it is, and also your pregnancy goals. 

Medications to Regulate Menstrual Cycles

Hormonal medications like oral contraceptive pills or progesterone therapy may be prescribed to regulate your menstrual cycles, reduce androgen levels and also lower the risk of endometrial complications. 

Medications for Insulin Resistance

Insulin-sensitising medications may be prescribed to improve insulin sensitivity, thereby regulating your menstrual cycle and also supporting ovulation. 

Medications for Ovulation and Fertility

Ovulation induction medications are prescribed if you are trying to conceive. Fertility treatment is suggested only if you are looking to conceive. 

Medications for Acne and Excess Hair Growth

Anti-androgen medications or some hormonal treatments may be suggested as they can help manage symptoms due to excess androgen in your body. 

Weight Management Medications (if indicated)

Weight-loss medications may be considered along with lifestyle modifications based on your overall health. 

Monitoring and Follow-up

Medical treatment plans need to be reviewed on a regular basis, as the treatment options may change based on your symptoms at a particular time. 

Diet for Women with PCOD

Diet plays an important role in managing PCOD symptoms as it can help improve insulin resistance, support hormonal balance, maintain a healthy weight, and reduce the risk of long-term complications. 

Foods to Include

A good diet for women with PCOD should include: 

• High-fibre foods like leafy green vegetables, broccoli, carrots, and cucumbers it helps regulate blood sugar levels, improve digestion, and promote satiety.
• Whole grains and low-GI carbohydrates like oats, quinoa, brown rice, millets and whole wheat give you sustained energy and help prevent spikes in sugar levels. 
• Lean proteins like eggs, chicken, tofu, fish, paneer, legumes, and pulses can help with muscle health, controlling your appetite, and managing blood sugar levels. 
• Healthy fats like nuts, seeds, avocado, olive oil, and fatty fish as omega-3 fatty acids and unsaturated fats, can help hormone production and reduce inflammation. 
• Low-to-moderate GI fruits like berries, apples, pears, oranges, and guavas, but be mindful of portions. 
• Low-fat dairy like skimmed milk, low-fat curd, and paneer can be added to your diet based on your lactose tolerance level. 

Foods to Limit or Avoid

Be conscious not to include:  

Refined carbohydrates like white bread, white rice, pastries, and refined flour can spike your blood sugar levels. 

Sugary foods and beverages like soft drinks, packaged fruit juices, cakes, etc., have excessive sugar content in them, which can worsen insulin resistance and increase your weight. 

Processed and packaged foods like chips, instant noodles, processed snacks or meat, and ready-to-eat meals are often high in unhealthy fats, sodium, and preservatives.

Highly saturated and trans-fat foods like fried items, fast food, and bakery items increase inflammation and have a negative impact on heart health. 

Highly processed meats like sausages, salami, bacon, etc., should be consumed in moderation or best avoided. 

Excess caffeine and alcohol may cause hormonal imbalance and impact the overall health of women. 

Best Exercises for PCOD

Regular exercise is an important part of PCOD management. It helps improve insulin sensitivity, regulates menstrual cycles, helps manage your weight, and also improves your overall health. Here are some exercises that are good to do if you have PCOD:

• Cardio Exercises like walking, jogging, cycling, swimming, and dancing can help improve heart health, burn calories, and manage your weight. 
• Strength Training, like resistance training and bodyweight exercises, can aid in building muscle mass that can, in turn, boost your metabolism and improve how your body processes sugar. 
• Yoga and Stretching combine movement with breathing, which helps reduce stress by calming the nervous system. These improve flexibility and also support hormonal balance. 

Exercises cannot be a one-time or random effort. It is important to stay consistent. You can combine cardio with strength training or yoga and ensure that you perform these for at least 150 minutes per week, split across 5-6 days.
The best exercise plan depends on your individual fitness levels and health goals. Remember that what works for a friend or relative may not necessarily work for you. 

Difference Between PCOD and PCOS

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Health Complications of PCOD

If PCOD is left unattended, it can push your body in a different direction by affecting your reproductive health, metabolism, cardiovascular system, and also your emotional health. Here are some health complications of PCOD: 

Fertility and Reproductive Health

Irregular or missing ovulation can induce pregnancy-related complications. Timely treatments and fertility support where needed can help women achieve a healthy pregnancy. 

Metabolic Complications

As PCOD is linked to insulin resistance, it can affect how your body processes sugar and thereby your overall metabolism. Prediabetes, type 2 diabetes, obesity, and metabolic syndrome are possible complications. 

Cardiovascular Health

When PCOD is not managed well, it may increase the risk of high blood pressure, abnormal cholesterol levels, and heart disease.  

Endometrial Health

Infrequent or absent periods can build up the uterine lining and increase the risk of endometrial hyperplasia, or even endometrial cancer in rare cases. 

Mental and Emotional Health

PCOD causes hormonal changes along with physical changes such as acne, excess facial hair growth, and increased body weight. This can impact your mental and emotional health, leading to anxiety, depression, stress, and even reduced self-esteem. 

Skin and Hair Concerns

Acne, oily skin, excess facial or body hair, and scalp hair thinning may continue if PCOD’s hormonal imbalance continues. 

Sleep Disorders

PCOD leads to weight gain and obesity. Women with obesity are at a higher risk of experiencing sleep apnea or poor sleep quality. 

Most of the PCOD complications can be managed or even prevented when the diagnosis is made at an early stage. Lifestyle modifications and appropriate medical treatment can help keep the symptoms under control. 

What to Expect When You Visit a Doctor for PCOD

The first consultation for PCOD typically helps the doctor understand your symptoms and map them with your medical history and overall health to make a customised treatment plan for you. 

Step 1: Discussion of medical history, where the doctor may ask you about menstrual cycles, symptoms, family history, lifestyle, and pregnancy plans. 

Step 2: Physical examination where the doctor assesses your weight/BMI, blood pressure, and signs of hormonal imbalance. 

Step 3: Diagnostic tests like a blood test, ultrasound, or additional tests are recommended based on Steps 1 and 2. 

Step 4: The doctor will formulate your Personalised Treatment Plan

Step 5: Regular follow-ups are recommended as the symptoms will need monitoring and treatment plans adjusted accordingly. 

Conclusion

PCOD is a manageable condition when it is diagnosed on time, you make the necessary lifestyle changes, and undertake the recommended treatments. Unfortunately, it is not a condition that will resolve on its own. If you have any symptoms that don't seem to go away, consult a gynaecologist immediately. Early intervention is the right way to realise your pregnancy dreams and improve your overall health.

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