When the blood pressure is considered abnormal and what are the symptoms?

How high the BP is abnormal?
120 mm of Hg systolic and 80 mm Hg diastolic is considered normal BP. But the blood pressure of a person is not a single entity. Throughout the day, depending on our stress, mood, physical activities it varies. So a single measurement above 120/ 80 cannot be considered abnormal and person cannot be called as hypertensive. If the reading continues to be high repeatedly even when he is relaxed then the person is considered as hypertensive.


For practical purposes systolic pressure >120 & <138>80 & <> 140/ 90 is treated actively.
Previously much importance was not given to raised systolic BP, and was considered due to stress or, anxiety. Nowadays persistently high systolic BP is considered as a disease entity and treated. Labile hypertension is another entity where a person’s BP is found mild to moderately elevated at some visits and normal at other visits. They are very likely to to step in the persistent hypertension club sooner or, later.

What are the symptoms of hypertension or high blood pressure?
Hypertension is also called rightly as “Silent Killer”. Most of the time it develops with no symptom at all. It steady increases without warning and develop symptoms when it has already damaged many organs beyond repair. The symptoms when occur, the hypertension is then severe enough. Headache is a well known symptom, mainly felt at the back of the head, particularly worse while waking up in the morning and gradually become less as the day progresses. Long standing hypertension, when affect the heart function may cause shortness of breath on exertion and swelling around the ankle. Easy tiredness, dizziness, low sexual potential, palpitations are the symptoms in severe hypertension.
Organ specific symptoms are also very late to develop. Effect on the vessels of nose give rise to nose bleeding or epistaxis, Urinary tract to blood in urine, brain to sudden black outs.
As these are very late to develop regular check up of blood pressure is recommended. After the age of 30 blood pressure should be checked every alternate years and after 40 each year.


This article is republished in India Study Channel

Common Causes ( Mechanism) of High Blood Pressure

As already mentioned in the previous post it is understood that elasticity of the arteries plays an important role in maintaining the BP. Factors which reduce the elasticity of the blood vessels, which naturally occurs with age raise the BP.
Apart from the elasticity, the diameter of the arteries is also important. The lumen of the arteries can become smaller by two important factors.


i) Deposition of fat in the wall, thereby reducing the lumen and raise the BP gradually
ii) Spasm of the muscles of the arteries, may cause sudden rise of BP
iii) The above two factors may act simultaneously some times – a double trouble!


The volume and quality of the blood is also important to maintain the blood pressure. If by any chance, the volume is low (blood loss) or quality is poor (anaemia), heart has to pump more frequently and vigorously to provide adequate oxygen and nutrition to the tissues. This in turn can raise the BP. Thus in case of sudden bleeding initial body response is a little raised BP preceding eventual fall.

Brain plays an important role to maintain the blood pressure. From the brain by different hormonal messenger the blood flow and the pressure of different arteries are controlled as per requirement. It has both good and bad effect for us. Good effect is – When you are ready for a nice lunch, you brain increases the blood flow to your stomach to digest your food. Similarly when you are annoyed or shouting the unwanted shoot up of BP is a detrimental effect caused by the brain.

Kidneys are another important organ which control our BP. They control the salt and water balance in our body by different hormonal mechanisms. They decide how much water and salt to be excreted in the urine and how thirsty we will feel? With generalized narrowing of the blood vessels due to deposition of fats kidney vessels are also affected and raise the blood pressure by affecting their function. Primary kidney related disease of the kidneys also elevate the blood pressure.

This article is republished in India Study Channel

What Is Blood Pressure?

Consider heart as water pump and blood vessels as net work of elastic rubber pipe networks. This will help you to understand what the blood pressure really means. It can be easily understood while the pump is pumping the maximum pressure is exerted on the wall of the tube, which is nearer to the pump. The furthest part has least pressure. The pressure also depends on the caliber of the tube,which is nearer to the pump.

The furthest part has least pressure. The pressure also depends on the caliber of the tube. Our heart has four chambers. Left ventricle actually pumps blood to the circulatory network at an average rate of 72/ min. The pump of heart works in different way than the water pump. It does not pump continuously. While beating at a rate of 75 per minute, it beats every 0.8 seconds. In this 0.8 sec, it pumps for 0.3 sec and rest 0.5 sec it relaxes to receive blood for pumping. Now you can understand the pressure in the blood vessels are not always equal. It is highest when the heart is pumping and lowest when it is receiving blood. Blood comes out through one large arched tube known as arch of aorta and then through divisions it comes to the arteries, which again divide and subdivide to arterioles and capillaries. Pressure is not equal in all these branches. For clinical purpose we measure blood pressure in arteries, precisely in the brachial artery in our arms.
You have noticed while doctors are telling the blood pressure, they are telling two values one is systolic that is on the higher side and one is diastolic that is on the lower side. The Systolic is the highest pressure exerted by blood on the wall of the arteries during contraction of the ventricle or systole and Diastolic is the lowest pressure exerted during relaxation or diastole. Normally the systolic blood pressure remains 120mm of mercury and the diastolic at 80 mm of mercury.
You may be wondered why the difference is so low and while the heart is relaxing why the lowest pressure is not 0! It is due to the elasticity of the artery which recoils during relaxation and expands during contraction and keeps the blood pressure to this limit, which is so essential for maintaining the perfusion of oxygen to the tissues.
If elasticity of the arteries is reduced it will increase the peak pressure and the gap between systolic and diastolic pressure will widen.
There are many other factors which maintain the normal blood pressure of our body. Few important factors are volume of blood, quality of blood, function of other organs like brain, kidney and other hormones. Altogether a complex phenomenon is maintaining the blood pressure, the pressure required to exchange nutrition and oxygen to the tissues.

This article is republished in India Study Channel

Premenstrual Syndrome (PMS)

What is Premenstrual syndrome? or, PMS?

A very common condition affecting the women mostly in their 30s and 40s. They notice premenstrual worsening of their physical wellbeing and mood. The symptom may vary month to month; being minimal in one month severe in other and moderate discomfort in some months. Some women also notice that the symptoms are less when they are on combined contraceptive pills. 3% of the affected women get these symptoms regularly and they may be so severe, that it cause major disruption to their lives. This syndrome is also known as Premenstrual tension or. PMT

What are the symptoms of PMS or PMT?

Tension, irritability, depression, bloating sensation, heaviness and tenderness in the breasts, headache, craving for carbohydrates, lack of sexual drive or, libido are the common symptoms. Many other bizarre symptoms may appear. To know whether one has PMS or, not it is essential to keep a diary of events. This diary will help the treating doctor to differentiate PMS with other disorders and will be helpful to find any psychological disturbance, she may be having. If she is having her symptoms worst premenstrual, she will have at least one week symptom free period after her menstruation.

How to treat Premenstrual syndrome (PMS)?

Reassurance is very important and she must understand this is not going to produce any serious disease or, cancer in future. Cooperation from the spouse and children is required to cope up with life. Find self help group support in the area. Improvement of diet, proper exercising, Yoga and rest, avoiding tobacco and alcohol will help. Herbal remedies though not tested properly some find them helpful. Try sage and fennel for irritability. Pyridoxine (Vitamin B6) 10 mg orally daily, either continuously or during the discomfort may help to elevate the mood and relive headache.

For severe cyclical pain in the breasts, cyclical mastalgia:

Avoid eating saturated fats as they increases the affinity of the oestrogen receptors for oestrogen.

Gamolenic Acid 160 mg orally 12 hourly

Bromcryptine 2.5 mg orally twice daily from 10^th to 26^th day of the cycle ( prescribed even when the prolactin level is within normal limit)

Danazol 100 – 200 mg 12 hourly orally for 7 days prior to menstruation.

Suppression of ovulation help in relieving symptoms in PMS

Yasmin a new entrant in combination pill is specially helpful to alleviate symptoms of PMS by suppressing ovulation.

Oestrogen Implants with cyclical progesterone is also used.

Danazol can also be given to suppress ovulation, but has other side effects like pimple, hair fall, weight gain etc.

Diuretics Spironolactone 25mg orally 6 hourly is also prescribed from 16^th to 26^th day of the cycle ( 1^st day being the first day of menstruation) when there is excessive fluid retention.

Other than these alprazolam, mefenamic acid and other analgesics are used to treat PMS.

In intractable patients removal of uterus and ovaries may be done and results are 96% satisfactory. These women should receive oestrogen replacement (HRT) following their operation.

This article is also republished at India Study Channel

Psoriasis: Diagnosis and Treatment

Psoriasis is an inflammatory skin condition affects 2% of the Caucasian populations at almost all age groups. There are two distinct types of this disease. Type I affects the younger age group around 20 years and type II affects older people peaking at age 50.

There are two pathologies are involved in psoriasis

1. Epidermal proliferation
   
2. T cell mediated inflammatory infiltration of dermis and epidermis
   

Known causes for psoriasis:

Hereditary: If both parents have psoriasis, the chance of their children to be affected is about 50%. About 30% of psoriasis patients has definite family history of affection.

Infection: Different infection of the skin may lead to psoriasis. Streptococci specially are major offender.

Drugs: Beta blockers, Lithium, Anti malarial are the known triggers for psoriasis.

How to diagnose psoriasis:

Psoriasis presents as symmetrical red plaques with well defined margins and silvery scales on it. They are mostly present on the outer (extensor) aspect of elbow, scalp, knees and sacral area. Non scaly lesions appears in the axillary folds, groins, umbilicus and below the breasts (sub mammary). Nails are also frequently affected with pitting, separation from the nail bed (onycholysis), thickening and subungual hyerkeratosis. In young individuals small plaques are also seen particularly when yhis is associated with streptococcal infection. Palms and soles are affected in pustular variety. Generalized psoriasis (erythrodermic and pustular) can cause severe systemic problems, which sometimes precipitated by rapid withdrawal of steroid drugs.

There are few signs of psoriasis.

Auspitz sign: when the scales are removed there will be pin point bleeding from the area.

Pepper pot nail pitting

Grease spot

In 7 % of the patients, joints can be involved in the process of psoriasis. These can be of five types:

• Asymmetrical Oligo mono arthritis
  
• Predominant DIP joints
  
• Rheumatoid-like Poly arthritis (Sero negative for Rheumatoid factor)
  
• Arthritis Mutilans (severe, destructive)
  
• Psoriatic Spondylitis
  

How to differentiate psoriasis with other skin conditions:

Psoriasis should be differentiated from the following skin disorders like eczema ( can be easily differentiated clinically) , mycosis fungoids ( these lesions has minimal scaling and they are asymmetrical as opposed to psoriasis. Biopsy is required to differentiate). Seborrhoeic dermatitis (These can coexist also)

Treatment of Psoriasis:

Patients must be counseled and educated properly. He must understand the condition is not curable, but control is possible by drugs. Trigger factors like infection or drugs, as mentioned earlier are to be removed. Topical drugs are used as a main form of treatment. Steroid creams, Calcipotriol, tacalcitol (vitamin D analogues) and different combinations are used to control the disease. Methotrexate helps in psoriatic arthropathy.

Drugs used in recalcitrant psoriasis

Tazarotene (a topical retinoid):

Prescribed in mild to moderate psoriasis affecting less than 10% of the skin surface. This is to be applied once daily.

Precautions:

Avoid in pregnancy.

Wash hands thoroughly after application.

Avoid contact with: Eyes, face, intertriginous areas, hair-covered scalp, eczematous or inflamed skin.

Avoid exposure to UV light/PUVA etc.

Don't use emollients or cosmetics within one hour of application of tazarotene.

Phototherapy:

Narrow-band UVB (TL-01): Weekly for 6 weeks

Avoid if there is history of photosensitivity. This treatment is most suitable for guttate/small plaque psoriasis.

PUVA: UVA + oral/topical psoralen:

This therapy is suitable for extensive large plaque disease (oral psoralen) and localized disease (topical psoralen)

The total dose has to be limited to 1000J/150 treatments. Over dosage may cause excessive skin ageing and increase the risk of skin cancer. can be combined with oral retinoids.

Oral Medications:

Severe psoriasis often needs oral medication. This should be prescribed and supervised by the expert in this field.

Methotrexate: 10mg - 25mg/week orally. Elderly patients get most help from this. This drug is better avoided in younger patients as there is a long-term risk of developing hepatic fibrosis.

Cyclosporin: 2.5mg - 5mg/kg/day orally. Side effects outweigh the advantage at times.

Acitretin: This is a oral retinoid and useful for moderate to severe disease. Being teratogenic this is not to be used in pregnancy. Drying of skin and mucosa is one of the side effects. Blood glucose, lipid and liver functions to be monitored continuously during the treatment.

Hydroxycarbamide (Hydroxyurea): 0.5 to 1.5g in 24 hours orally. Bone marrow suppression is the main side effect.

Parenteral cytokine inhibitors/monoclonal antibodies:

Etanercept (25mg SC, twice-weekly for less than 24wks) is now licensed to be used in adult plaque psoriasis, when other forms of treatment failed to give results. Already 3 randomized trial has been done with this therapy. It is a TNF ( Tumor necrosis factor) also help in psoriatic arthropathy ( joint diseases).

Usually this is a well tolerated drug but has some side effects like vomiting, GI bleeding, myocardial or cerebral ischaemia , respiratory distress, seizures etc so this drug if used, only to be used by experts. Another alternative to this drug is Infiximab.

This article is republished in India Study Channel

Eczema and Dermatitis: Diagnosis and Treatment

Eczema:

Acute eczema appears as rash. To differentiate this from psoriasis, this is less well demarcated and less scaly. Eczema can be caused by infection, allergy (atopia), various irritants and venous stasis. Different variety may co exist in a single patient. It is very important to know about the hobby, work or any other source of allergen exposure.

Causes of Eczema:

• Genetic: A family history of allergy (atopy) is common to find in about 70% of patients.

• Infection: Staphylococcus colonized lesions and toxins act as super antigens.

• Allergy: This is very common. Radioallergosorbent test (RAST) help to find out specific causative agent like house dust, mite etc. Food allergy is not also uncommon. Dairy products, eggs can exacerbate eczema. Infants may also suffer from eczema; but fortunately most of them grow out of it by the time they reach teen.

Treatment of eczema:

The patient must understand there is no specific cure available for this condition. Medicines can only control and lessen the symptoms. They tend to have dry skins (Xerosis). This skin gets irritated very easily and becomes itchy. Liberal use of emollients is the mainstay of the treatment. These should be used even when the disease is not active. Conventional soap is better to be avoided. Use emulsifying ointments instead. Emollients to be used at least twice daily. In severe type greasy emollients work best. For less severe variety less greasy products may be used. Topical steroids are also prescribed in a dose depending on the severity, site and patient's age to reduce inflammation and itching.

Dermatitis:

Irritant Dermatitis

We all are susceptible to various kinds of irritants. Most commonly palms are affected. It starts with a dry fissure, which is followed by weeping and itchy lesion.

Common irritants to cause this type of lesions are detergents, soaps, oils, alkalis, repeated use of water, and various solvents. Washing vegetables may also the culprit due the pesticides they contain.

Treatment of irritant dermatitis:

Avoid all the known irritants as far as practicable. Good car of hands by avoiding conventional soaps, liberal emollients, drying the hand properly after washing, using cotton or rubber lined cotton gloves for wet works and use topical steroids intermittently in case of flaring up.

Allergic contact dermatitis

This is often very easy to diagnose as the offending allergen leaves clue by the sharp cut off margins at the lesion. Though there may be secondary spread elsewhere (Auto Sensitization). The common allergens are nickel (watches, jewellery, key and coins); Lanolin (creams and cosmetics), chromates (cements, leather), colophony ( ink, glue, sticking plasters) foam in the furniture, plants (primulas) and medicinal ointments ( antibiotics, antihistamines, anesthetics etc.) This is Type IV type of allergic reaction.

Treatment of contact dermatitis:

Implicated allergen to be removed. To find out the allergen patch testing may be done. Topical steroids are used locally depending on the severity of the condition.

Adult seborrhoeic dermatitis

This is a very common condition. Dandruff being the commonest presentation. It also affect eyebrows, cheeks, and the flexures of the joints. This is caused by the overgrowth of skin yeast in the affected area. This condition can be fulminating in HIV positive patients.

Treatment of seborrhoeic dermatitis:

Use of topical antifungal and steroid ointment intermittently depending on the severity. Dandruff to be treated by Ketoconazole shampoo.

This article is also available in India Study Channel

Sex After 50!

Growing old, by no way means the end of ones' sex life. Yet, the fact remains that the aging process causes certain irrevocable emotional andphysical changes which can sometimes affect the ability to enjoy sex.

In most cases, women enjoy sex more as they grow old because post menopause or a hysterectomy, they no longer suffer from the fear of an unwanted pregnancy. "Our sex life has become better as our relationship has grown. Being with each other and knowing one another over the years have added to our chemistry," smiles 57-year-old social worker Mona.

She further adds, "Aging is a natural process, but that should not stop us from enjoying our sex lives. The love, trust and care we have developed over the years looking past our respective imperfections is what makes our sexual relationship all the more special".

A study conducted by the University of California suggests that in the West, two-thirds of men and women above the age of 50 enjoy satisfying sexual relationships and 80 per cent of them were satisfied with their ability to enjoy sex. About half of the men and one-third of the women revealed that sex was an extremely important aspect of their lives. These studies bust the preconceived notion that a couple's sex drive goes down with age.

Psychologist Dr. Samir Parikh insists, "Feeling sexy has nothing to do with one's grey hair or wrinkles. It's all within oneself. Some women tend to think that grey hair or wrinkles make them less attractive to their sexual partner. However, if a woman believes being young or being able to give birth makes her more feminine, she may begin to worry about her desirable quotient. That might make sex less enjoyable for her".

"There are a lot of people who feel that age is tightly correlated with sexual activity or interest," says Professor Edward Laumann, University of Chicago. It's important for couples to bear in mind that sex involves more than mere penetration. All kinds of touch are stimulating and pleasurable.

"Being sexually active doesn't always have to mean that you are both in the mood for physical intimacy. Sometimes, it could just mean taking some time from your mundane schedule to give your partner pleasure because that is what you want to do for them. Masturbation (self or mutual) is also a way to keep sexually active," suggests 55-year-old, retired army officer Karandeep Singh.

Experts recommend taking the time to explore each other's bodies and find out what turns your better half on. Touch is a great alternative to intercourse. It can simply mean holding each other, cuddling with each other while watching a movie or a play or even indulging in a sensual massage to stimulate each other.

This article is taken from Times Of India

Pain During Intercourse- Dyspareunia

It is quiet a serious problem, which hampers a woman's personal and family life. In most cases this become a vicious cycle and anticipation of pain during intercourse lead to more spasm., less arousal and lubrication and more tense muscles and more pain!

Vaginismus is one condition where no pathology is found, and it is a psychological condition which leads to the spasm of the muscles and pain. She must be counseled properly and help of a sex therapist is required.

Few reasons of vaginismus are:

• Sexually abused sometimes in her life
  
• She is taught that sex is immoral, vulgar, or demoralizing
  
• Fear of pain associated with penetration, particularly rupture of hymen in first intercourse.
  

In other forms of dyspareunia, pathology, some form of disease is found. This may be superficial or, deep type.

Superficial dyspareunia – reasons and treatment:

Superficial or introital dyspareunia occurs due to

• Dryness of vagina, lack of arousal – Oestrogen cream may help.
  
• Infection and or, ulcers, fungal or bacterial in the vagina or vulva. – To be treated by proper antibiotics or antifungal.
  
• Narrow introitus: surgical correction will be required
  
• Painful scar during previous delivery in the vulval region: painful scar may be removed if necessary. Local anaesthetic cream also helps.
  

Deep dyspareunia:

Here the pain felt deep inside during the thrust of intercourse.

The reasons and treatment of deep dyspareunia are:

• Endometriosis and pelvic infection – Treatment of the respective cause
  
• Ovaries may be placed at abnormal position mostly in the pouch of douglas, below and behind the uterus, where it is hurt during the thrust – Change of posture during sexual act or, corrective surgery (ventrosuspension), if necessary will solve the problem.
  
• Dermatographism: A condition where a linear wheal is formed with surrounding red flare anywhere on the skin after a firm stroke. The reason is unknown. This may be a rare cause of dyspareunia, where itchy wheals formed on the vulva. These can be relieved by application of 2% epinephrine cream and anti allergic tablets like cetrizine.

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Emergency Contraception

Emergency contraceptive should be used as an emergency measure in an isolated unprotected intercourse and not as a routine practice.Anyone who is in need of emergency contraception should consider a regular method of contraception from her next cycle.Most popular method of emergency contraception available today is levonorgestrel. The other invasive method is IUCD.

Levonorgestrel:

This is a progesterone only pill to be taken within 72 hours of unprotected intercourse. 1.5 mg tablet of levonorgestrel available in different brand name like ipill or, pill72 to be taken preferably within 12 hours and not later than 72 hours of the incident. The failure rate is 1.1%, earlier taken, lower is the chance of failure. If in case vomiting occurs within three hours of intake, take a second dose immediately. 1.5 mg of levonorgestrel offer some protection up to 120 hours.

The following menstruation in that cycle may be early or late and they should use condom till her next period. After that seriously consider any regular method. She must visit doctor if her period becomes irregular or any way abnormal or, in case of any lower abdominal pain.

Levonorgestrel is not suitable for those having focal migraine, history of thromboembolisim or having acute porphyria.

Emergency Intra Uterine Contraceptive Device (IUCD)

It is invasive procedure to insert a contraceptive device CuT in the uterus within 120 hours of unprotected intercourse. This is in fact more effective than the hormonal method and is available up to 5 days after the incident. This is based on the fact that the fertilized ovum is implanted in the uterus on the 6^th day after the fertilization. IUCD prevents implantation of the ovum.

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Eating Disorders - Anorexia Nervosa

What Is Anorexia Nervosa?

Typically there are 4 criteria:

1. When age, sex and height are taken into account weight of the affected person is less than 85% of the predicted weight and BMI is less than 17.5 kg/m
2. Even when underweight, the affeceted person is worried about her weight gain and do excessive exercise, dieting and even induced vomiting.
3. Always feel she is fat.
4. Cessation of menstruation unless she is on pills and lack of sexual drive in men

Who are affected with eating disorder?

Female: male is 10:1. Males remain mostly undiagnosed. The typical age of affection is mid or, late adolescence.

Causes of anorexia nervosa:

A single cause cannot be sited for this disorder. The reason is multi factorial. Usually these patients are the victim of depression, anxiety, obsessive compulsive disorders, personality disorder, many times they have unpleasant events in their life in the close relationship in the family and friends. They mostly suffers from low self esteem, perfectionism, impulsive nature. Psychological immaturity or antecedent sexual abuse is not a proved risk factor.

The sufferer usually gives excessive importance to the weight reduction, in spite of her rickety features! They try to achieve that by over exercising, induced vomiting, overusing the laxatives and diuretics and appetite suppressants. They are compulsive about their controlled eating. They use to judge their self worth only in terms of their shape and weight. Binge eating and concealment is well recognized feature.

Other features of anorexia nervosa:

They are fatigued, constipated, excessively sensitive to cold. They usually have sleeping disorders, psychosexual problems, anemia, infertility, dental caries and in prolonged cases even osteoporosis due to poor nutrition.

How anorexia nervosa is managed?

The aim of treatment is to bring BMI to 20 kg/m² by restoring nutritional balance and increasing weight 1.5 kg/ week. Any complication of prolonged starving is dealt beforehand. Other factors, which may be causing this problem is explored. His/ her career and family problems are to be sought out. In severe cases where BMI is less than 15 kg/m² the patient need hospitalized management. Trusting relationship with the patient, self help and motivational books are of great help in mild cases.

No specific drug treatment is available for anorexia nervosa. Very severe cases resistant to treatment may die due to cardiac failure.

Overall prognosis of anorexia nervosa:

43% recovers completely, 36% improve, 20 % suffer from chronic eating disorder and 5 % ultimately die.

Refeeding syndrome:

This is a rare condition usually happens in the severe cases when they are treated in hospital. Domiciliary managed patients are usually mild to moderate type don't have this risk. Sudden active feeding after a prolonged starvation cause sudden stomach dialatation (acute gastric dialatation), destruction of muscles (rhabdomyolysis), seizures, coma and death due to respiratory and cardiac failure.

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PCOS/ PCOD: How Do I Know?

What is PCOS?

• The full form of PCOS is Poly Cystic Ovarian syndrome. This disease is also known as Stein Leventhal Syndrome or, PCOD (Poly Cystic Ovarian Disease).
  
• 6 –10 % women get affected by this disease and many of them are not aware of their presence.
  
• Though this disease is not curable but treatment is available to alleviate the symptoms.
  
• This is one of the major reasons for the women, who are unable to conceive.
  
• The effect of the disease process is more serious than just infertility.
  
• Don't think it is only a cosmetic problem.
  

What are the symptoms and findings of PCOS/ PCOD:

• Irregular or, no menstruation.
  
• Multiple small cysts in the ovaries. Though common but not consistent finding.
  
• High Blood pressure.
  
• Excessive pimples.
  
• Rise in the level if insulin, Insulin resistance or type II Diabetes.
  
• Unable to conceive or infertility.
  
• Excessive hair on face and body.
  
• Hair fall and male type of baldness.
  
• Gain in weight particularly central obesity.
  

Know whether you are a victim of PCOS by this small survey:

There are many other hormonal irregularities which may cause menstrual problems and some of the other symptoms, which may mimic PCOS. It is very important to diagnose whether it is PCOS or not?

Here are twelve questions for you to answer in yes or no format. If 5 or, more turn to be yes, there is fair possibility that, you may be suffering from PCOS.

1. You menstruate 8 or, less times in a year?
   
2. Have you ever experienced no menstruation for 4 months or more?
   
3. Do you suffer from irregular periods or, just stains at times?
   
4. Are you facing problem to conceive?
   
5. Do you have excessive hair on your face or body?
   
6. Are you irritated with your pimples?
   
7. You are losing your hair regularly?
   
8. Do you have velvet kind of skin near your neck?
   
9. Have you suddenly gained some weight?
   
10. You are getting fatter at your hip?
    
11. Do you love to take sweets or feel dizzy after taking food?
    
12. Any one of your first degree relative has Type II Diabetes?
    

If this survey result is 5+ for you, consult a gynaecologist immediately. As previously mentioned, PCOS is more than infertility and cosmetic problem. There is increased chance of endometrial cancer, heart diseases, and diabetes related complications. Proper and timely treatment, which is long term, will save you from lots of complications.