PCOD (Polycystic Ovarian Disease) : Causes, Symptoms, Diagnosis, Diet and Treatment

Overview

Polycystic Ovarian Disease (PCOD) is one of the most common hormonal disorders affecting women in their reproductive years, typically between the ages of 12 and 45. It is characterized by hormonal imbalances that disrupt normal ovulation and menstrual cycles. In PCOD, the ovaries tend to produce an excess number of immature eggs, which fail to release and eventually form small fluid-filled sacs or cysts.

This condition is increasingly common, particularly in urban populations, due to lifestyle factors such as poor diet, physical inactivity, and stress. In India, studies estimate that between 9% and 22% of women experience PCOD—higher than reported rates in many other countries. While not life-threatening, PCOD can affect fertility, metabolism, appearance, and overall well-being if not properly managed.

What is PCOD?

Understanding Ovarian Function

The ovaries are a vital part of the female reproductive system. They are responsible for releasing eggs each month (a process called ovulation) and for producing essential hormones like estrogen, progesterone, and androgens. These hormones regulate the menstrual cycle, support pregnancy, and maintain hormonal balance.

What Happens in PCOD?

In PCOD, the ovaries start releasing multiple immature or partially mature eggs in a single cycle. These eggs do not complete their development or get released during ovulation. Instead, they accumulate inside the ovaries and form small cysts. This build-up can enlarge the ovaries and cause them to produce excess levels of androgens (male hormones), disrupting the delicate hormonal balance.

Hormonal Imbalance and Its Effects

The elevated levels of androgens in PCOD interfere with ovulation and lead to a variety of symptoms. These may include:

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

While PCOD and PCOS (Polycystic Ovary Syndrome) are often used interchangeably, PCOD is generally considered less severe in terms of long-term metabolic risks. However, both conditions share similar symptoms and require ongoing lifestyle and medical management.

If left untreated, PCOD can lead to infertility, insulin resistance, type 2 diabetes, high cholesterol, obesity, and increased risk of cardiovascular disease later in life.

Common Symptoms of PCOD

Polycystic Ovarian Disease (PCOD) presents with a range of symptoms primarily related to hormonal imbalance and ovarian dysfunction. While the severity and combination of symptoms can vary among individuals, the following are the most commonly observed in PCOD:

1. Irregular Menstrual Cycles - Women with PCOD often experience irregular, delayed, or missed periods due to the failure of ovulation. This is a result of multiple immature follicles that do not develop or release properly each month.
2. Acne and Oily Skin - Hormonal fluctuations, particularly elevated androgen levels, can cause increased sebum production, leading to acne breakouts and oily skin.
3. Excessive Facial and Body Hair (Hirsutism) - Higher levels of androgens may result in unwanted hair growth on the face, chest, abdomen, or back—a condition known as hirsutism. This is one of the more visible symptoms of PCOD.
4. Hair Thinning or Hair Loss - Alongside excess body hair, PCOD may also cause thinning of hair on the scalp, especially near the crown, resembling male-pattern baldness.
5. 5. Weight Gain or Difficulty Losing Weight - Women with PCOD often struggle with unexplained weight gain or find it difficult to lose weight despite efforts. This is often related to hormonal imbalance rather than metabolic disorders.
6. 6. Abdominal Bloating or Pelvic Discomfort - Some women may experience mild lower abdominal bloating, pelvic pain, or a feeling of heaviness due to enlarged ovaries filled with immature follicles.
7. 7. Difficulty Conceiving
8. PCOD is a common cause of infertility. The irregular release of eggs affects ovulation and reduces the chances of conception, especially without medical assistance.

How is PCOD Diagnosed?

There is currently no single definitive test that can diagnose Polycystic Ovarian Disease (PCOD) in isolation. Diagnosis typically involves a combination of medical history review, physical examination, blood tests, and imaging studies. The goal is to identify hormonal imbalances, ovarian abnormalities, and to rule out other conditions with similar symptoms.

If you are experiencing irregular periods, unwanted hair growth, acne, or difficulty conceiving, your gynecologist or endocrinologist may recommend the following steps to confirm a PCOD diagnosis:

1. Medical History and Symptom Assessment

Your doctor will begin by discussing your menstrual history, any patterns of weight gain, skin changes (like acne or hair growth), fertility concerns, and any family history of PCOD or diabetes. This helps assess whether your symptoms align with common PCOD patterns.

2. Physical Examination

A physical exam may be performed to check for:

• Signs of excess androgen levels (e.g., facial hair, acne, hair thinning)
• Body Mass Index (BMI) to evaluate weight
• Skin changes, such as darkened patches around the neck or underarms (acanthosis nigricans), which could indicate insulin resistance

3. Pelvic Examination

A pelvic exam may be conducted to detect:

• Ovarian enlargement
• Tenderness
• Other abnormalities in the reproductive organs

While not always essential, a pelvic exam helps identify physical signs of PCOD in some women.

4. Blood Tests

Blood work is typically done to evaluate hormone levels and rule out other causes of menstrual irregularities. Key blood tests may include:

• Luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
• Testosterone and other androgens (to check for excess male hormones)
• Prolactin (to rule out pituitary gland issues)
• Fasting glucose and insulin levels (to assess for insulin resistance or prediabetes)
• Thyroid function tests, as thyroid disorders can mimic PCOD symptoms

5. Pelvic Ultrasound (Transvaginal or Abdominal)

An ultrasound is one of the most important tools in diagnosing PCOD. It helps visualize the:

• Size and appearance of the ovaries
• Presence of multiple small follicles (often referred to as cysts)
• Thickness of the endometrial lining, which can be affected by irregular menstruation

Not all women with PCOD will have visible cysts on their ovaries, but an ultrasound can still help assess overall ovarian health.

Follow-up After Diagnosis

If you are diagnosed with PCOD, your doctor will likely recommend regular follow-up visits to monitor symptoms, hormonal levels, weight, and long-term risks such as insulin resistance or fertility challenges. Early intervention and ongoing management can significantly improve quality of life and prevent complications.

What to Expect When You Visit a Doctor for PCOD

If you're experiencing symptoms like irregular periods, acne, weight gain, or excess hair growth, visiting a doctor is the first step toward diagnosis and effective management of PCOD. Here's what typically happens during your appointment:

1. Detailed Medical History

Your doctor will ask about your menstrual cycle, symptoms, family history of PCOD or diabetes, weight changes, and any issues related to fertility.

2. Physical Examination

This may include:

• Measuring BMI and waist circumference
• Checking for visible symptoms like acne, hair growth, or scalp thinning

3. Recommended Tests

Based on your symptoms, your doctor may order:

• Pelvic ultrasound to detect cysts in the ovaries
• Blood tests to check hormone levels (LH, FSH, testosterone, insulin, etc.)
• Thyroid and glucose levels to rule out other causes

4. Referral to Specialists

Depending on your condition, you may be referred to:

• A gynecologist for reproductive health
• An endocrinologist for hormonal or metabolic concerns
• A dietitian for weight and nutrition support
• A dermatologist for acne or hair-related issues

Expect a personalized treatment plan tailored to your symptoms, lifestyle, and future goals like pregnancy or symptom control.

What Are the Problems Associated with PCOD?

If left unmanaged, Polycystic Ovarian Disease (PCOD) can lead to a range of health complications affecting not just reproductive function but also metabolic, cardiovascular, and emotional health. While not all women will experience every complication, early diagnosis and consistent management are essential to reduce long-term risks.

1. Infertility and Reproductive Challenges

PCOD is one of the most common causes of Infertility in women of reproductive age. Irregular or absent ovulation due to hormonal imbalance can make it difficult to conceive. In some cases, women may also experience:

• Miscarriages due to poor egg quality or hormonal imbalances
• Gestational diabetes during pregnancy
• Abnormal uterine bleeding, often due to irregular shedding of the uterine lining

Without ovulation, the endometrial lining may thicken excessively, which can contribute to endometrial hyperplasia or even endometrial cancer in rare, untreated cases.

2. Metabolic and Cardiovascular Issues

PCOD significantly increases the risk of developing metabolic syndrome, a group of conditions that raise the risk of heart disease, stroke, and type 2 diabetes. These include:

• High blood pressure
• Elevated cholesterol levels
• Increased blood sugar (insulin resistance or pre-diabetes)
• Abdominal obesity

According to studies, nearly 50% of women with PCOD will develop prediabetes or type 2 diabetes by the age of 40.

3. Mental Health and Emotional Well-being

Women with PCOD are more likely to experience:

• Depression and anxiety
• Body image issues due to acne, unwanted hair, or weight gain
• Low self-esteem and emotional stress from fertility issues

Mental health support is a key component of long-term PCOD care and often overlooked.

4. Other Complications

Additional health concerns associated with PCOD include:

• Chronic liver inflammation (nonalcoholic fatty liver disease) due to insulin resistance
• Sleep apnea, especially in women who are overweight or obese
• Persistent acne and skin problems that do not respond to conventional treatments, indicating ongoing hormonal imbalance

PCOD in the Long Run

If left unmanaged, Polycystic Ovarian Disease (PCOD) can lead to a range of long-term health complications. Over time, hormonal imbalances and insulin resistance may worsen, increasing the risk of chronic conditions such as:

• Type 2 Diabetes
• High blood pressure and heart disease
• Obesity
• Infertility or pregnancy-related complications
• Endometrial hyperplasia or cancer (due to irregular or absent periods)
• Mental health disorders like depression and anxiety
  
   

Studies show that nearly 50% of women with PCOD may develop prediabetes or diabetes by age 40 if the condition is not properly managed.

That said, early diagnosis and a commitment to lifestyle modifications, regular medical follow-up, and targeted treatment can significantly reduce these risks. Many women with PCOD go on to lead healthy lives, including successful pregnancies and balanced hormonal health.

Treatment for Polycystic Ovarian Disease (PCOD)

While there is no permanent cure for Polycystic Ovarian Disease (PCOD), it can be effectively managed through a combination of lifestyle changes, medications, and, in rare cases, surgical intervention. The goal of treatment is to regulate hormone levels, restore ovulation, manage symptoms, and prevent long-term complications such as diabetes, infertility, or cardiovascular issues.

Multidisciplinary Approach

Managing PCOD often requires a team of specialists, depending on the symptoms and complications you experience. This team may include:

• Gynecologist – for hormonal balance and menstrual health
• Endocrinologist – to address insulin resistance or metabolic issues
• Infertility specialist – for ovulation-related treatments
• Dermatologist – for skin and hair-related symptoms
• Dietitian – to develop a sustainable, PCOD-friendly diet plan

Lifestyle Changes for PCOD Management

1. Weight Management

Even a modest weight loss of 5% to 10% of body weight can significantly improve hormonal balance, regulate menstrual cycles, and improve fertility. This can also reduce insulin resistance and androgen levels.

2. Diet and Nutrition

Adopting a balanced, low-glycemic index (GI) diet is crucial. Recommended dietary habits include:

• Reducing intake of refined carbohydrates and sugars
• Increasing fiber-rich foods like whole grains, vegetables, and legumes
• Prioritizing lean proteins and healthy fats
• Avoiding processed foods and sugary snacks

3. Physical Activity

Regular exercise helps improve insulin sensitivity, supports weight loss, and promotes emotional well-being. Aim for:

• At least 150 minutes of moderate-intensity exercise per week (e.g., walking, cycling, swimming)
• Strength training 2–3 times a week to build muscle and improve metabolism

Medications for PCOD

Your doctor may recommend one or more of the following medications, depending on your symptoms and whether you're planning to conceive:

1. Hormonal Birth Control Pills

Combination pills containing estrogen and progestin can regulate periods, reduce androgen levels, and improve acne and hirsutism (excess hair growth).

2. Progestin Therapy

Taking progestin for 10–14 days per month can help regulate your cycle and prevent endometrial hyperplasia (excessive buildup of the uterine lining).

3. Ovulation-Stimulating Medications

For women trying to conceive, doctors may prescribe:

• Clomiphene citrate (Clomid) – a first-line drug to induce ovulation
• Letrozole – often used in women resistant to clomiphene
• Metformin – especially useful in women with insulin resistance or prediabetes
• Gonadotropins – injectable hormone therapy used in fertility treatment cycles

4. Treatment for Excess Hair Growth (Hirsutism)

To reduce unwanted hair growth, doctors may use:

• Oral contraceptives
• Spironolactone – an anti-androgen that slows hair growth
• Eflornithine cream – topical medication that helps slow facial hair growth

Surgical Treatment for PCOD (When Needed)

Surgery is rarely required for PCOD and is usually reserved for cases where medications have failed and fertility is a primary concern. The most common surgical approach is:

Laparoscopic Ovarian Drilling (LOD)

This minimally invasive procedure uses laser or heat to destroy parts of the ovarian tissue that produce androgens. It helps reduce male hormone levels and can stimulate ovulation in women who are resistant to medications.

Surgery is not a first-line treatment but may be considered after evaluating all other options.

Diet For PCOD

Diet plays a central role in managing Polycystic Ovarian Disease (PCOD). Since PCOD is closely linked to hormonal imbalance and insulin resistance, eating the right foods can help regulate blood sugar levels, support weight management, and improve overall hormonal health.

A well-balanced PCOD diet is typically low in refined carbohydrates and saturated fats, while being rich in fiber, lean proteins, and anti-inflammatory nutrients. The goal is to stabilize insulin levels, reduce inflammation, and support healthy ovulation and metabolism.

Key Dietary Principles for PCOD

• Focus on low-glycemic index (GI) foods to prevent blood sugar spikes
• Avoid processed, sugary, or refined foods like white bread, sweets, fried snacks, and packaged cereals
• Increase dietary fiber to improve digestion and regulate hormones
• Include lean protein and healthy fats to improve satiety and reduce cravings
• Eat at regular intervals and avoid skipping meals, which can destabilize insulin levels

Recommended Foods for Women with PCOD

Here are some foods that are beneficial for women managing PCOD:

1. High-Fiber Vegetables

Fiber helps regulate blood sugar and improves digestion.
 Examples:

• Spinach, kale, fenugreek leaves
• Broccoli, cauliflower, cabbage
• Carrots, cucumbers, bell peppers

2. Whole Grains

Rich in fiber and complex carbohydrates, these help manage insulin response.
 Examples:

• Oats, quinoa, brown rice, whole wheat bread

3. Healthy Fats and Lean Proteins

Support hormone production and keep you feeling full.
 Examples:

• Fatty fish like salmon, sardines, and mackerel (rich in omega-3)
• Eggs, chicken, tofu, paneer (low-fat)
• Nuts and seeds like almonds, walnuts, chia seeds, flaxseeds

4. Legumes and Pulses

Packed with plant-based protein and fiber.
 Examples:

• Lentils, chickpeas, kidney beans, moong dal

5. Low-Fat Dairy (in moderation)

Some women benefit from reducing high-fat dairy. Choose low-fat options such as:

• Low-fat curd, skimmed milk, paneer made from low-fat milk

Foods to Avoid

To prevent insulin spikes and hormonal disruption, avoid:

• Sugary foods (sweets, soda, desserts)
• White bread, pasta, and maida-based products
• Fried and fast food
• Processed meats or snacks
• Full-fat dairy (for women sensitive to it)

Every woman’s nutritional needs may vary. It’s best to consult a registered dietitian or nutritionist experienced in managing PCOD to create a customized plan. Combined with regular exercise, sleep hygiene, and stress reduction, a balanced diet can dramatically improve symptoms and long-term outcomes for women with PCOD.

What Exercises Are Best for PCOD?

Exercise is a key part of managing Polycystic Ovarian Disease (PCOD). It not only helps regulate hormones and insulin levels but also supports weight loss, boosts metabolism, and improves mood. One of the most important goals for women with PCOD is to maintain a healthy Body Mass Index (BMI)—even a small reduction in weight (5% to 10%) can lead to noticeable improvements in symptoms and fertility.

Choosing the right mix of exercises can enhance results while keeping the routine enjoyable and sustainable.

Best Types of Exercises for PCOD

1. High-Intensity Interval Training (HIIT)

HIIT involves short bursts of intense activity followed by periods of rest or lower-intensity exercise. It is highly effective for burning calories, improving insulin sensitivity, and reducing abdominal fat—a common concern in PCOD.

Examples:

• Sprinting followed by walking
• Jump squats, burpees, and mountain climbers in circuits
• HIIT workouts lasting 20–30 minutes, 3–4 times a week

2. Cardiovascular Workouts (Cardio)

Cardio helps with fat burning and heart health, and is a great way to boost metabolism.

Examples:

• Brisk walking
• Jogging or running
• Cycling
• Swimming
• Aerobics or dance fitness classes

Aim for at least 150 minutes of moderate-intensity cardio per week.

3. Strength Training

Building muscle through weight training improves metabolic rate, insulin sensitivity, and hormone regulation.

Examples:

• Dumbbell or resistance band workouts
• Bodyweight exercises like squats, lunges, push-ups
• Weightlifting sessions 2–3 times per week

Strength training also helps reduce body fat while preserving lean muscle mass.

4. Mind-Body Exercises (Low Impact)

These exercises reduce stress levels, which is important for hormonal balance in PCOD.

Examples:

• Yoga (especially asanas that support hormonal balance and pelvic health)
• Pilates
• Deep breathing and guided meditation

Practicing yoga regularly has been shown to improve menstrual regularity and reduce testosterone levels in women with PCOD.

5. Interval Training

Similar to HIIT, interval training alternates bursts of activity with periods of rest or lighter effort. It helps burn more calories in less time and is especially helpful for women who have limited time but want effective results.

What is the Difference Between PCOD and PCOS?

Though often used interchangeably, Polycystic Ovarian Disease (PCOD) and Polycystic Ovary Syndrome (PCOS) are two different conditions that affect a woman’s ovaries and hormonal balance. While they share similar symptoms such as irregular periods, acne, and fertility issues, they differ in causes, severity, long-term health risks, and treatment outcomes.

Understanding these differences can help women seek the right treatment and manage the condition effectively.

PCOD vs PCOS: Key Differences at a Glance

While PCOD is more common and generally less severe, PCOS is a complex endocrine disorder that often involves metabolic and systemic complications. Both conditions can affect fertility and quality of life, but early diagnosis, lifestyle changes, and appropriate treatment can help manage symptoms and reduce risks.

If you're unsure which condition you may be experiencing, consult a gynecologist or endocrinologist for a detailed evaluation.

Conclusion

There is no clear cause for PCOD. However, early detection or diagnosis of PCOD will be constructive in relieving the symptoms as well as to reduce the complications involved.

PCOD treatment helps you to manage your concerns, including infertility, hirsutism, acne, immature follicles, or obesity. However, specific treatment migBook An Appointmentht involve lifestyle changes or medication.

For more information about PCOD, visit or book an appointment with the Best Gynaecologist in India. You can know more about PCOD, its causes, symptoms and treatment.

Frequently Asked Questions

1. Is PCOD treatable?

Although there is no permanent cure for PCOD (Polycystic Ovary Disease), it is highly manageable. By adopting a healthy lifestyle, maintaining a balanced diet, and regular exercise, women can manage the symptoms of PCOD. Losing weight, controlling insulin levels, and restoring regular ovulation are key in managing this condition. Seek medical advice for treatments to help regulate periods, improve fertility, and reduce symptoms like acne and excessive hair growth.

2. How does PCOD occur?

PCOD occurs when a woman’s ovaries produce an excess of androgens (male hormones), leading to irregular ovulation and the development of cysts on the ovaries. While the exact cause is not fully understood, genetics and insulin resistance are believed to play significant roles in the development of PCOD. Women with PCOD may experience symptoms like irregular periods, difficulty conceiving, acne, and weight gain.

3. How can you control PCOD?

To manage PCOD symptoms, it is crucial to maintain a healthy weight, engage in regular physical activity, and follow a balanced, low-carb diet. This helps regulate insulin levels, manage blood sugar, and restore ovulation. Medical treatments like birth control pills and fertility medications can be prescribed to manage symptoms like irregular periods and infertility. Consult a healthcare provider for personalized treatment options.

4. Is PCOD the same as PCOS?

While PCOD and PCOS (Polycystic Ovary Syndrome) are often used interchangeably, they are slightly different. PCOD refers to the presence of cysts on the ovaries and irregular ovulation, but it is a less severe form of the condition. PCOS, on the other hand, involves a broader set of symptoms, including hormonal imbalances, infertility, and metabolic issues. However, both conditions involve cysts on the ovaries and share similar symptoms.

5. What is bilateral PCOD?

Bilateral PCOD refers to the condition where polycystic ovaries are present in both ovaries, not just one. This is commonly seen in women with PCOD. Bilateral PCOD can cause symptoms such as irregular menstrual cycles, difficulty in conceiving, and hormonal imbalances. It is important to manage the condition with lifestyle changes, medications, and, in some cases, fertility treatments.

6. Can PCOD be cured naturally?

While there is no permanent cure for PCOD, natural remedies can help manage symptoms. A healthy lifestyle is key to controlling the condition. Regular exercise, a balanced diet rich in whole grains, fruits, and vegetables, and weight management can significantly reduce symptoms. Supplements like omega-3 fatty acids, vitamin D, magnesium, and inositol have also shown potential in improving PCOD symptoms.

7. How to manage PCOD at home?

To manage PCOD at home, focus on making lifestyle changes that promote overall health. Regular exercise helps maintain a healthy weight and reduces insulin resistance. Eating a nutrient-dense diet with low-glycemic foods helps control blood sugar and hormonal imbalances. Try incorporating anti-inflammatory foods like leafy greens, tomatoes, and fatty fish. Reducing stress through yoga or meditation can also help improve hormonal balance.

8. What foods should be avoided with PCOD?

When managing PCOD, it’s essential to avoid foods that can cause blood sugar spikes and worsen insulin resistance. Limit high-carb foods like white bread, sugary snacks, and processed foods. Instead, focus on eating whole grains, fresh fruits, vegetables, and lean proteins. Reducing processed sugars and fats can help regulate hormones and improve overall health.

9. Can PCOD cause infertility?

Yes, PCOD can cause infertility in women. Irregular ovulation is a common symptom of PCOD, making it more challenging to conceive. However, with appropriate medical treatment, such as fertility medications or lifestyle changes, many women with PCOD can conceive successfully. Consult with a fertility specialist for tailored advice on managing infertility due to PCOD.

10. What is the best treatment for PCOD?

The best treatment for PCOD depends on the individual and her symptoms. Common treatments include hormonal medications like birth control pills to regulate periods, insulin-sensitizing drugs like metformin to manage insulin resistance, and medications to help with fertility if pregnancy is desired. Lifestyle changes, including a balanced diet and regular exercise, are also vital in managing PCOD. Always consult with a healthcare provider to find the right treatment for your specific needs.

11. Can PCOD lead to other health problems?

If left unmanaged, PCOD can lead to long-term health complications, including diabetes, high blood pressure, endometrial cancer, and heart disease. Women with PCOD may also experience metabolic syndrome, which can increase the risk of cardiovascular issues. Regular monitoring and early intervention can help reduce the risk of these complications.

12. How to lose weight with PCOD?

Losing weight with PCOD can be challenging due to hormonal imbalances, but it is possible with a dedicated approach. Focus on low-carb, high-fiber diets that help regulate blood sugar levels. Combine this with regular exercise, including both cardio and strength training, to boost metabolism. Even a modest weight loss of 5-10% of body weight can significantly improve PCOD symptoms and hormonal balance.