PCOD VS PCOS: The Difference
Many women across the globe are still stuck with a question: Can PCOD and PCOS terms be used interchangeably? Though both the terms may sound similar enough, they aren’t. Yes, they have similarities like common occurrences which means both the familiar women’s reproductive health concerns are ovarian conditions that cause hormonal disruptions but they are not the same.
So, let’s take a deeper look at PCOD and PCOS and find out what distinguishes them. 
What is PCOD?
PCOD or Polycystic Ovarian Disease is an ovarian disorder marked by the production and release of an abnormally high number of immature or partially mature eggs from the ovaries. The excess production of such eggs from the follicles takes place throughout the ovulation cycle. These immature or partially mature eggs take residence in the ovaries to eventually develop into multiple cysts (sac-like structures filled with fluids). When cyst formation takes place, the ovaries also release the androgen (male sex hormones) in excess which further results in many complications like irregular menses, weight gain, and chronic acne which are not serious. It is more common than PCOS. It usually happens as a result of stress, obesity, a poor lifestyle, and hormonal imbalances. [2,4]
What is PCOS?
PCOS or Polycystic Ovarian Syndrome is one of the most diagnosed medical conditions, a type of metabolic disorder in females. It occurs when androgens are produced in excess by the ovaries not because of the cyst formation but due to endocrine issues. Due to sex hormones being out of whack, the eggs present in the ovaries are prone to turn into cysts which won’t be released as in PCOD but get built up in the ovaries. Thus, PCOS leads to abnormalities in ovulation, thereby resulting in female infertility. It may result in PCOS acne and if very serious can cause complications such as type 2 diabetes, heart disease, and endometrial cancer. If women suffering from PCOS get pregnant, there is a risk of premature birth or miscarriage. [1,2,4]
Causes of PCOD/PCOS
There are many reasons behind PCOS or PCOD happening. Here are some of the common causes of these reproductive health issues-
- Genetic Predisposition- Some reports suggest that the incidence of women having PCOS is heightened if their family member has the same.
- Excess Levels of Insulin- Insulin is a hormone released by beta cells of the pancreas that increase androgen production.
- Low-Grade Inflammation- Studies have found that chronic inflammation could trigger the polycystic ovaries to produce excessive androgens
- Extra Male Hormones or Androgens (Hyperandrogenism)- These often lead to anovulation, acne, excess facial hair growth, infertility, and weight gain.
PCOD does not have a clear etiology. Other than the above-mentioned possible causes, contributing factors include pollution, early menarche, and unhealthy living. Similarly, the specific etiology of PCOS is still not discovered. Several causative factors for PCOS include-
- Increase in Luteinizing Hormones- The pituitary gland secretes a luteinizing hormone that plays a role in ovulation, the formation of the corpus luteum, and the production of androgens.
- Rise in Testosterone Levels- When insulin or luteinizing hormone levels are high, the levels of male sex hormones called testosterone gets elevated which disrupts ovulation.
- Increased Prolactin Levels- Prolactin is a hormone released after childbirth to aid in the production of breast milk. When it is produced in excess by the female body, estrogen levels decline. This results in hormonal imbalance which affects ovulation and leads to multiple cysts formation. [2,3,4]
Symptoms of PCOD/ PCOS
The symptoms or signs of PCOD or PCOS vary from one woman to the next. Some women experience some of the signs while others may show different symptoms. Usually, the symptoms are severe if the patient has a sedentary lifestyle or is obese.
The most common symptoms that can be noticed in both PCOD and PCOS patients include:
- Infrequent, irregular, or prolonged menstruation
- Heavy menstrual bleeding (Menorrhagia)
- Excess of the body or facial hair (hirsutism)
- Persistent acne, especially in the face, chest, and upper back
- Multiple cysts present in the ovaries or enlarged ovaries with follicles surrounding the eggs- this can be visualized in the ultrasound report
- Unexplained weight gain (especially around the abdomen)
- Skin darkening around the body folds or crevices
- Male pattern baldness in females (occasionally)
- Non-alcoholic steatohepatitis
- Infertility (in severe cases)
However, PCOS can increase the risk of stroke, heart disease, and type-2 diabetes. It may result in sleep apnea and as no ovulation is taking place, it could result in endometrial cancer.[3,4]
How is PCOD/PCOS diagnosed?
After taking a note of the patient’s symptoms followed by reviewing his/her medical history, lifestyle choices, and eating habits, the doctor may prescribe all or one of the following diagnostic tests:
- Pelvic Examination- During the initial consultation, the doctor checks the pelvic area including reproductive organs and the area surrounding it for the presence of abnormal growth, masses, or cysts. If anything unusual is found, they prescribe further testing to confirm the diagnosis.
- Blood Tests- It is prescribed to measure the hormone levels of estrogen, androgens, luteinizing hormone, and prolactin. Besides these, it is also done to test blood glucose or insulin levels.
- Imaging Tests- Ultrasound is the most definitive test to ascertain a diagnosis for PCOD or PCOS as it provides detailed images of the inside of the ovaries, uterus, and associated female reproductive organs to look for abnormalities or unusual growths.
- Mental Health Screening- As PCOS is a metabolic disorder, the hormonal imbalance can result in anxiety and depression among women which can be screened by the doctor. 
Treatment Options for PCOD/PCOS
The most effective treatment methods for PCOD or PCOS include-
- Having a healthy PCOS diet or making other lifestyle changes
- Intake of birth control pills as hormonal therapy
- Taking certain medications that help in ovulation
- Intake of diabetes medications to reduce insulin levels
- Laparoscopic Ovarian Drilling surgery- to remove ovarian cysts and Hysterectomy in case of the presence of cancerous cysts or endometrial cancer
- Fertility treatments- IVF and artificial insemination (when drugs and surgeries have failed). [2.3]
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