Female Hormone Disorders

Polycystic Ovary Disease (PCOD)

PCOD, also called polycystic ovary syndrome (PCOS), is one of the most common female endocrine disorders. PCOD is a complex, heterogeneous disorder of uncertain etiology, but there is evidence that this disease is more commonly present in families with diabetes.

PCOS produces symptoms in approximately 5% to 10% of women of reproductive age (12–45 years old). It is thought to be one of the leading causes of female subfertlity and the most frequent endocrine problem in women of reproductive age.

The principal features are anovulation, resulting in irregular menstruation, amenorrhea, infertility, and polycystic ovaries; excessive amounts or effects of androgenic (masculinizing) hormones, resulting in acne and hirsuitism; and insulin resistance,  often associated with obesity, type 2 diabetes, and high cholesterol levels. Women with PCOS have a higher chance of developing endometrial cancer. The symptoms and severity of the syndrome vary greatly among affected women.

 

Non-classic Congenital Adrenal Hyperplasia

Congenital adrenal hyperplasia (CAH) is a group of disorders where the hormone synthesizing machinery in our adrenal gland is defective. The adrenal glands help keep the body in balance by making the right amounts of cortisol, aldosterone, and androgens. The classic form of CAH is rare and results in deficiency of cortisol and aldosterone and excess amount of androgens. People with nonclassic (late-onset) CAH  make enough cortisol and aldosterone, but they make excess androgens. Symptoms beginn typically in late childhood or early adulthood. Boys often do not need treatment. Girls usually need treatment to suppress their excess androgens. Manifestations often mimic PCOD but treatment is different.

 

Hyperprolactinemia

Hyperprolactinemia is a condition of elevated serum prolactin. Prolactin is a hormone produced in the pituitary gland. Its primary function is to enhance breast development during pregnancy and to induce lactation. Secretion is pulsatile; it increases with sleep, stress, pregnancy, and chest wall stimulation or trauma, and therefore must be drawn after fasting. Normal fasting values are generally less than 20-25 ng/mL, depending on the individual laboratory but can also vary for numerous reasons. Elevated prolactin results in oligomenorrhea, amenorrhea, or infertility. Galactorrhea (abnormal milk secretion from breast )is due to the direct physiologic effect of prolactin on breast epithelial cells. Pituitary tumor is one of the causes of elevated prolactin level.  It can also be caused by disruption of the normal regulation of prolactin levels by drugs, medicinal herbs and heavy metals. Hyperprolactinaemia may also be the result of disease of other organs such as the liver, kidneys, ovaries and thyroid.

 

Premenstrual Syndrome (PMS)

PMS refers to a wide range of physical or emotional symptoms that typically occur about 5 to 11 days before a woman starts her monthly menstrual cycle. The symptoms usually stop when menstruation begins, or shortly thereafter. The symptoms can be related to mood changes e.g depression, irritability, anxiety, confusion, social withdrawal, angry outbursts or somatic disturbances e.g breast tenderness, abdominal bloating,  headache and swelling of hands and feet. Numerous pharmacologic agents, medical interventions, and complementary/alternative therapies have been tested as potential treatments for PMS. Medicines like selective serotonin reuptake inhibitors (SSRIs) have been approvesd in symptom management of severe PMS. A recent meta-analysis demonstrated that no single SSRI agent was better than another or more effective for PMDD than PMS, but contrary to popular belief, continuous dosing regimens resulted in better symptom control than intermittent luteal dosing.