Polycystic Ovary Syndrome affects an estimated 5-10 percent of women of childbearing age and it is a leading cause of infertility. It is the result of a sever hormonal imbalance and affects each woman differently. It has been found that up to 30 percent of women have some symptoms of the syndrome.
The symptoms of PCOS include, but are not limited to the following:
- irregular or no menstrual periods (Amenorrhea)
- lack of ovulation (Anovulation)
- acne
- obesity/weight gain/inability to lose weight (if insulin resistant)
- breathing problems while sleeping
- depression
- oily skin
- infertility
- skin discolorations
- insulin resistance (at risk or can develop)
- diabetes (at risk or can develop)
- high cholesterol levels
- hair thinning
- hair loss (androgenic alopecia)
- elevated blood pressure (can develop)
- dandruff
- excess or abnormal hair growth and distribution (hirsutism)
- pain in the lower abdomen and pelvis
- multiple ovarian cysts (with PCOS at least 11+ on each ovary)
- skin tags
PCOS is generally considered a syndrome rather than a disease, though, it is sometimes called Polycystic Ovary Disease. It manifests itself through a group of signs and symptoms that can occur in any combination, rather than having one known cause or presentation. There is no cure for PCOS. It is a condition that is managed, rather than cured. Treatment of the symptoms of PCOS can help reduce risks of future health problems.
Blood-work for PCOS- A good basic screening would include:
- Fasting comprehensive biochemical and lipid panel
- 2-hour GTT with insulin levels (also called IGTT)
- LH:FSH ratio
- Total testosterone
- DHEAS
- SHBG
- Androstenedione
- Prolactin
- TSH
Your doctor might recommend that you:
Schedule regular checkups: Long-term, managing cardiovascular risks, such as obesity, high blood cholesterol, type 2 diabetes and high blood pressure, is important. To help guide ongoing treatment decisions, your doctor will likely want to see you for regular visits to perform a physical examination, measure your blood pressure, and obtain glucose and lipid levels.
Adjust your lifestyle habits: Making healthy-eating choices and getting regular exercise is the first treatment approach your doctor might recommend, particularly if you're overweight. Obesity makes insulin resistance worse. Weight loss can reduce both insulin and androgen levels, and may restore ovulation. Ask your doctor to recommend a weight-control program, and meet regularly with a dietitian. It is also recommended that women with PCOS stick to a low-glycemic index or "diabetes" diet as they are at a greater risk to develop insuline resistance or diabetes.
Regulate your menstrual cycle: If you're not trying to become pregnant, your doctor may prescribe low-dose birth control pills that contain a combination of synthetic estrogen and progesterone. They decrease androgen production and give your body a break from the effects of continuous estrogen. This decreases your risk of endometrial cancer and corrects abnormal bleeding. An alternative approach is taking progesterone for 10 to 14 days each month. This regulates your periods and offers protection against endometrial cancer. However, it does not improve androgen levels.
Prescribe Metformin (Glucophage, Glucophage XR), an oral medication for type 2 diabetes that lowers insulin levels. This drug improves ovulation and leads to regular menstrual cycles. Metformin also slows the progression to type-2 diabetes. If you already have pre-diabetes, you are at an increased risk for developing type-2 diabetes. Metformin can aid in weight loss if you follow a diet and exercise program.
Reduce excessive hair growth: your doctor may recommend birth control pills to decrease androgen production, or another medication called spironolactone (Aldactone) that blocks the effects of androgens on the skin. Because spironolactone can cause birth defects, effective contraception is required when using the drug, and it's not recommended if you're pregnant or planning to become pregnant. Eflornithine(Vaniqa) is another medication possibility; the cream slows facial hair growth in women. Shaving, waxing and depilatory creams are nonprescription hair removal options. Results may last several weeks, and then you need to repeat treatment. For longer lasting hair removal, your doctor might recommend a procedure that uses electric current (electrolysis) or laser energy to destroy hair follicles and control unwanted new hair growth.
Use medication to induce ovulation: If you're trying to become pregnant, you may need a medication to induce ovulation. Clomiphene citrate (Clomid, Serophene) is an oral anti-estrogen medication that you take in the first part of your menstrual cycle. If clomiphene citrate alone isn't effective, your doctor may add metformin to help induce ovulation. If you don't become pregnant using clomiphene and metformin, your doctor may recommend using gonadotropins — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) medications that are administered by injection.
Procedures to conceive: If medication does not help to conceive a child, procedures such as IUI or IVF are also explored and should be discussed with your RE.
