PCOS (Polycystic Ovarian Syndrome) strikes women between the ages of puberty and menopause. It is the leading cause of female infertility, and if left untreated can lead to diabetes, heart disease, and endometrial cancer. What symptoms does it cause? Period problems Acne, excessively oily skin or hairiness (hirsutism) due to excess male-type hormones Infertility Weight gain How is it diagnosed? Ultrasound scan This is usually done as an internal scan, meaning a small ultrasound probe is placed just inside the vagina, giving the best views of the ovaries and pelvic organs. In PCOS, the ovaries are found to have multiple, small cysts around the edge of the ovary. These cysts are only a few millimetres in size, do not in themselves cause problems and are partially developed eggs that were not released. An ultrasound scan showing multiple small cysts around the edge of the ovary Blood tests A couple of blood tests will assist in making the diagnosis - one to check the level of androgens, such as testosterone. Another test will measure the hormones involved in egg development - in PCOS there is a characteristic rise in leutenising hormone (LH). A progesterone blood test 7 days before your expected menstrual period can check if you are ovulating. Treatment With Insulin-Sensitizing Medications - A number of recent studies have shown that treating women with PCOS with insulin-lowering medications such as metformin (also known as Glucophage), used to treat adult-onset diabetes, can not only reduce the risks of heart disease and diabetes in women with PCOS by treating the underlying problems with insulin production and usage, but also relieve many of the bothersome symptoms and even make weight loss possible. These drugs do not lower blood sugar and so are generally safe even for those with hypoglycemia, but there may be side effects. Metformin often causes diarrhea and/or nausea, especially for the first few weeks and when the dosage is increased. This is most problematic if it's taken without food; these problems may be minimized by taking it halfway through a meal. A rare side effect is lactic acidosis, which may be fatal if not detected. Birth Control Pills Birth control pills treat a few of the symptoms of PCOS. They usually bring on a period each month (though some women with PCOS do not have regular periods even while taking birth control pills) which is important for women who do not have regular cycles because lack of menstruation puts a woman at higher risk for endometrial cancer. . Acne may improve as well. Weight gain is highly variable - for some women weight gain may stabilize while on the pill; for others it may get worse. Changing brands may help if you find yourself gaining weight or having other unpleasant side effects. The triphasic birth control pills, such as Ortho Tri-Cyclen, may be problematic in that the estrogen dose they provide in the early part of the cycle may be too low to prevent women with PCOS from developing follicles, possibly resulting in a greater number of cysts on the ovaries.1 Treating Hirsutism Hirsutism can an extremely difficult and emotional issue in a society where women are expected to be smooth and hairless. Shaving, plucking, waxing, electrolysis and laser hair removal treatments may work in many cases but can be, depending on the method, time-consuming, messy, painful and/or very expensive. Spironolactone (brand name Aldactone), if taken over a period of time, will stop new hair growth in many women with hirsutism and may possibly decrease existing growth for some. Provera Provera or other forms of synthetic progesterone are often prescribed to women experiencing amenhorrea (lack of periods). It's common for a Provera-induced period to be more heavy or painful than usual, but it's important that something be done to cause regualar menstruation because prolonged amenhorrea may increase a woman's risk for endometrial cancer. This doesn't mean that if you haven't had a period for a very long time that you are destined to get cancer, but it does introduce a higher than usual risk. Some women have had success using progesterone cream as an alternative to Provera. |
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