Physiology of ovulation

Polycystic Ovarian Disease/Syndrome


Polycystic Ovarian Disease/Syndrome (PCOD/PCOS) is a hormonal condition that affects approximately 5-10% of women between the ages of 12 and 45. It is a common health condition that can occur in teenage girls and young women, leading to various symptoms such as irregular menstrual cycles, cysts in the ovaries, absence of ovulation, difficulty in conceiving, weight gain, acne, and hirsutism. If left untreated, PCOD/PCOS can also increase the risk of developing diabetes, obesity, heart disease, and high cholesterol.

Understanding PCOD/PCOS

PCOD/PCOS is characterized by the presence of numerous small cysts (fluid-filled sacs) in the ovaries. The term “polycystic” refers to the presence of multiple cysts. These cysts are actually follicles containing immature eggs. When ovulation does not occur, these immature follicles can develop into small cysts and produce high levels of male hormones, disrupting a woman’s menstrual cycle and causing symptoms associated with PCOD/PCOS.


PCOD (Polycystic Ovarian Disease) and PCOS (Polycystic Ovarian Syndrome) are terms often used interchangeably, but they have slight differences in meaning.

PCOD refers to the condition characterized by the presence of multiple small cysts in the ovaries. These cysts are fluid-filled sacs that contain immature eggs. PCOD is primarily diagnosed through the presence of these cysts and may or may not exhibit symptoms such as irregular menstrual cycles or hormonal imbalances.

On the other hand, PCOS is a broader term that encompasses not only the presence of ovarian cysts but also various other symptoms and hormonal imbalances. It is diagnosed based on a combination of factors, including irregular menstrual cycles, hormonal disruptions, and the presence of cysts. PCOS often includes symptoms like infertility, weight gain, acne, excessive hair growth (hirsutism), and metabolic disturbances such as insulin resistance.

In summary, PCOD specifically refers to the presence of ovarian cysts, while PCOS is a syndrome that encompasses ovarian cysts along with a range of other symptoms and hormonal imbalances. PCOS is a more comprehensive diagnosis that takes into account the broader clinical picture of the individual’s condition.

Physiology of Ovulation

Ovulation is a complex process that occurs in the female reproductive system. It involves the release of a mature egg from the ovary, which can potentially be fertilized by sperm. Here is a brief overview of the physiology of ovulation:

1. Follicular Development: Ovulation begins with the follicular phase of the menstrual cycle. Multiple follicles start developing in the ovary, each containing an immature egg. These follicles produce estrogen, which prepares the uterus for a potential pregnancy.

2. Dominant Follicle Selection: As the menstrual cycle progresses, one follicle becomes dominant and continues to grow while the others regress. The dominant follicle secretes increasing amounts of estrogen.

3. Luteinizing Hormone (LH) Surge: A surge in luteinizing hormone occurs around the middle of the menstrual cycle, triggering the final stages of ovulation. The LH surge stimulates the final maturation of the dominant follicle.

4. Follicle Rupture: Under the influence of the LH surge, the mature follicle ruptures, releasing the mature egg from the ovary. This process is known as ovulation.

5. Egg Release: Once released, the egg enters the fallopian tube, where it can potentially meet sperm for fertilization. The fallopian tube’s cilia and muscular contractions help guide the egg toward the uterus.

6. Corpus Luteum Formation: After ovulation, the remaining portion of the ruptured follicle transforms into a temporary endocrine structure called the corpus luteum. The corpus luteum secretes progesterone, which prepares the uterus for the possible implantation of a fertilized egg.

7. Luteal Phase: If fertilization does not occur, the corpus luteum regresses, leading to a decrease in hormone production. This marks the end of the luteal phase, and the menstrual cycle begins again.

Understanding the physiology of ovulation is crucial for fertility and reproductive health. Various factors, such as hormonal imbalances or disorders, can affect the ovulation process, leading to infertility or irregular menstrual cycles.


PCOD/PCOS is primarily caused by inherent ovarian dysfunction and disturbances in the hypothalamic-pituitary-ovarian axis. These disruptions result in increased levels of gonadotropin-releasing hormone (GnRH), leading to the hypersecretion of luteinizing hormone (LH). The elevated LH levels affect androgen production and oocyte development.

Causes of Polycystic Ovarian Syndrome

The exact cause of PCOD/PCOS is unknown, but there are several factors that can contribute to its development, including family history and genetics, elevated levels of insulin and androgen hormones, and lifestyle or environmental conditions.


The signs and symptoms of PCOD/PCOS often appear around the time of the first menstrual period during puberty, but they can also develop later in response to significant weight gain. Common symptoms of PCOD/PCOS include:

1. Irregular periods or absence of periods

2. Infertility or difficulty getting pregnant due to irregular or failed ovulation

3. Excessive hair growth (hirsutism) on the face, chest, back, or buttocks

4. Weight gain

5. Thinning hair and hair loss from the head

6. Skin pigmentation

7. Acanthosis nigricans

8. Oily skin or acne

9. Sleep apnea and sleep disturbances

10. Mood disorders

What are the first signs of PCOS?

Irregular Menstrual Cycles: One of the primary indicators of PCOS is irregular or missed periods. Women with PCOS may have infrequent periods or experience prolonged cycles.

Excessive Hair Growth (Hirsutism): PCOS can cause unwanted hair growth on the face, chin, chest, back, or other areas of the body where men typically grow hair.

Acne: Many women with PCOS may experience persistent acne that doesn’t respond well to traditional treatments.

Weight Fluctuations: PCOS can contribute to unexplained weight gain or difficulty losing weight, especially around the abdomen.

Hair Loss: Thinning hair or hair loss from the scalp is another potential sign of PCOS.

Skin Issues: Darkening of the skin, particularly in areas such as the neck, groin, or underarms, known as acanthosis nigricans, can be an early sign of PCOS.

Risk Factors

PCOD/PCOS is associated with several risk factors, including:

1. Infertility

2. Type 2 diabetes

3. High cholesterol

4. Elevated lipids

5. Sleep apnea

6. Liver disease

7. Abnormal uterine bleeding

8. Endometrial cancer

9. High blood pressure

10. Obesity, which can lead to issues with low self-esteem and depression

11. Metabolic syndrome

12. Nonalcoholic fatty liver (steatohepatitis)

13. Depression and anxiety

Recommended Investigations

To diagnose PCOD/PCOS, various investigations are recommended, including blood sugar estimation, thyroid-stimulating hormone level assessment, and ultrasound of the abdomen and pelvis. Additional hormone estimations, such as serum androgens and luteinizing hormone, may also be required.

Homeopathy and PCOD/PCOS

Homeopathy offers a holistic approach to treatment, addressing both the individual and their pathological conditions. Homeopathic medicines aim to treat the root cause of the disease, correcting hormonal imbalances, regulating ovulation, and restoring the menstrual cycle. Homeopathy can effectively relieve the associated symptoms of PCOD/PCOS as well. The selection of homeopathic medicines is based on a comprehensive individualized case analysis, which includes the patient’s medical history, physical symptoms, mental symptoms, constitution, and clinical examination.

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