I have clear, watery discharge from my vulva, I have pain as well

Hello Mishi

I will list some details about PCOD for your reference - Poly Cystic Ovarian Disease (PCOD)PCOD is the most common ovarian dysfunction and endocrine disorder which affects approximately 15-20 per cent of women in the reproductive age. PCOD is a hormonal imbalance where multiple small cysts are seen in their ovaries. These cysts occur when the regular changes of a normal menstrual cycle are disrupted. The ovary becomes enlarged; and it produces excessive amounts of androgen and estrogenic hormones.The affected women often have signs and symptoms of elevated androgen levels, menstrual irregularity and weight gain, abnormal hair growth on the face or the body and infrequent or no periods.maturing eggs fail to be expelled from the ovary, creating an ovary filled with immature follicles. The cysts then contribute to the hormonal imbalance, which causes more cysts and enlarged ovaries. Polycystic ovary disease is characterized by anovulation (no formation of egg) irrespective of periods (regular or irregular or absent) and hyperandrogenism (elevated serum testosterone and androgen). Also women with PCOD who conceive have a higher rate of early foetal loss than women without PCOD.Blood tests are also very useful for making the diagnosis. Typically, blood levels of hormones reveal a high LH ( luteinising hormone) level; and a normal FSH ( follicle stimulating hormone) level ( this is called a reversal of the LH : FSH ratio, which is normally 1:1); and elevated levels of androgens ( a high dehydroepiandrosterone sulphate ( DHEA-S) level).PCOD women have fewer chances to conceive, compared to normal women who ovulate every month. Normal women get 12 chances in a year to conceive. But PCOD women hardly get 3-4 chances due to delayed periods.

Relative causes of PCOD

PCOD does run in families. Several genes contribute to the pathogenesis of PCOD. Many of these genes are related to insulin resistance with elevated fasting blood insulin levels. The high levels of androgenic hormones interfere with the pituitary ovarian axis, leading to increased LH levels, anovulation, amenorrhea and infertility.Young diabetic women treated with insulin are at special risk of PCOD. The amount of insulin injected by insulin-dependent or insulin-requiring diabetics is far in excess of what the body produces naturally.Obesity is a common part of PCOD and many of these women are also insulin-resistant. When a woman is insulin-resistant, her fat cell does not respond normally to the insulin in the blood stream. Weight gain in itself can result from high serum insulin levels.

Symptoms of PCODThe most common symptoms of PCOD are

• Irregular and infrequent menstrual periods or no menstrual periods at all

• Infrequent or no ovulation with increased serum levels of male hormones - testosterone

• Inability to get pregnant within one year of unprotected sexual intercourse

• Weight gain or obesity

• Diabetes, over-production of insulin with abnormal lipid levels and high blood pressure

• Excess growth of hair on the face, chest, stomach in male pattern (hirsutism) and male-pattern baldness or thinning of hair;
Acne, oily skin or dandruff

• Patches of thickened and dark brown or black skin on the neck, groin, underarms, or skin folds

• Skin tags, or tiny excess flaps of skin in the armpits or neck area

• Male fat storage patterns - abdominal storage rather than standard female pattern on thighs, hips and waist; and Mid-cycle pain indicating painful ovulation - due to the enlargement and blockage of the surface of the ovaries

Consequences of PCODHyperinsulinemia in PCOD has also been associated with high blood pressure and increased clot formation and appears to be a major risk factor for the development of heart disease, stroke and type-II diabetes.Women with irregular cycles need to have other conditions ruled out, such as anorexia, stress or exercise-induced problems with the menstrual cycle, other hormonal problems such as thyroid disease or medication problems.The general consequences of PCOD are:

• Menstrual irregularities - Constant oestrogen production stimulates growth of the uterine lining which usually induces very heavy uterine bleeding. The bleeding episodes may occur after long gaps of time (oligomenorrhea) or, for some women, not at all (amenorrhea). Irregular periods are a nuisance and suggest some hormonal disorder or risk of endometrial thickening.
• Impaired Fertility - Another consequence of incomplete follicular development is a lack of regular ovulation. Irregular ovulation usually means that pregnancy is more difficult to achieve. Similarly, if ovulation is not taking place, it is not possible to conceive.
• Miscarriage - While miscarriage seems an unfortunate chance event for most couples, it is clear that women with PCOD may be at increased risk of early foetal loss. The hormonal environment in PCOD may interfere with egg development within the follicle and disrupt embryo implantation within the uterus.
• Hair and skin problems - Androgen (male hormone) is a byproduct of the ovaries. In PCOD, the production of androgen, such as testosterone, is excessive, which causes abnormally increased hair growth and contributes to acne formation. The assessment of excessive hair growth (or hirsutism) may be difficult.
• Obesity - About 50 per cent of women with PCOD are obese. Obesity tends to enhance abnormal estrogen and androgen production in this disorder, which only magnifies the problems of irregular bleeding and excessive hair growth.

May I suggest that you follow your doctor's advice in your situation. Good luck