I recently had PCOD show up in my chart, but I’m finding it hard to find any info specifically on this — it’s all PCOS. What are the differences? What’s it mean for fertility?
—Jen
To answer your question, I think it is helpful to take a peek behind the curtain into your doctor’s process. You mention that this diagnosis of PCOD — polycystic ovary disease — appeared in your chart, not that your doctor discussed this diagnosis with you. I suspect this is where some of your confusion is coming from.
With the advent of electronic medical records (EMR), patients have access to more of their health information than ever. There are a lot of great things about that. One thing many medical records include that patients can see is a visit summary listing all the diagnosis codes the doctor associated with the visit. Your doctor is choosing those codes from a dropdown list, and typically there may be four or five or more codes associated with a single visit.
When I want to add a diagnosis of polycystic ovary syndrome (PCOS) to a chart, I type in the diagnostic code E28.2 in my EMR, and a list of 19 different descriptions pops up. They include polycystic ovary syndrome, polycystic ovaries, polycystic ovary disease, and — possibly my favorite — the eponym Stein-Leventhal syndrome, a term that hasn’t been in regular use in decades. All those iterations are associated with the same code. Hopefully your doctor is selective about which one they pick, but in the rush of charting and seeing patients, often doctors pick the one at the top. I would not assume one description was selected over the others intentionally.
Furthermore, while there are many sites online that list differences between PCOS and PCOD, the medical literature does not recognize this distinction. Neither the Endocrine Society nor the American College of Obstetricians and Gynecologists recognize PCOD as a diagnosis. Searches for PCOD in both PubMed and online medical resource UpToDate redirect to results for PCOS.
That is a very long way of saying PCOS and PCOD are used interchangeably, and PCOS is by far the more common terminology.
Additionally, if your provider hasn’t discussed this diagnosis with you, I would caution you not to come to any conclusions until you have more information. It is reasonable to ask your doctor about the diagnosis and why they included it in your chart. They may suspect you have polycystic ovaries but want more information before confirming the diagnosis with you.
PCOS is what in medicine is often called a spectrum disorder. The way it manifests in individuals is highly variable, including how it affects fertility. I have many patients with PCOS who have gotten pregnant without a problem and some who have struggled to conceive. It is difficult to predict whether or not fertility will be a problem until a patient tries to conceive.
The takeaway: PCOS and PCOD can be used interchangeably, but PCOS is much more commonly used in the medical literature. If there is a diagnosis in your EMR that your doctor has not discussed with you, you should feel comfortable reaching out to them to ask about it.
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