AshleyMommyto2
04-20-2009, 12:53 PM
Polycystic Ovary Syndrome
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women. It affects an estimated seven percent of females. PCOS, sometimes called Stein-Leventhal Syndrome after the physicians who first characterized it in the 1930s, is a common cause of infertility. It is also associated with an increased risk of diabetes and, possibly, cardiovascular disease.
~Age of Typical Onset~
The syndrome usually presents at puberty, with irregular or absent periods. As the term polycystic ovary syndrome suggests, the syndrome often is accompanied by enlarged ovaries containing multiple small painless "cysts" or tiny follicles about 1/4 to 1/2 inch in diameter. A "polycystic" ovary generally is defined as having more than 12 small cysts, or being of increased size.
~Symptoms~
The most visible symptoms of PCOS stem from excessive levels of androgens, such as testosterone, produced in the ovaries and the adrenal glands. Androgens often are called "male hormones," even though they are found in both men and women. They are usually present at much higher concentrations in men and are an important factor in determining male traits and reproductive activity. Androgens include testosterone, DHT and androstenedione.
Excessive levels of these hormones, a condition called "hyperandrogenism" in women, can lead to some of the most common symptoms of PCOS, including:
• Excess body or facial hair ("hirsutism")
• Oily skin and acne
• Oligo-ovulation (irregular ovulation)
• Scalp hair loss and balding
~Diagnosis~
Diagnosis begins with an inventory of symptoms, the most common of which are:
• Hirsutism (excess body and/or facial hair in a male-like pattern, particularly on the chin, upper lip, breasts, inner thighs, and abdomen)
• Irregular or infrequent periods
• Obesity, primarily around the abdomen
• Acne and/or oily skin (particularly severe acne in teenagers or acne that persists into adulthood)
• Infertility
• Ovarian appearance suggesting polycystic ovaries
• Hair loss or balding
• Acanthosis nigricans (darkening of the skin, usually on the neck. This condition is also a sign of insulin problems)
• Skin tags, small pieces of excess skin in the armpit or neck area
Women with PCOS may have varying combinations of these and other symptoms, but two essential features of the disorder are:
• Hyperandrogenism, or excess blood levels of androgens. Androgens are hormones such as testosterone that, in excess quantities, cause such symptoms as hirsutism and acne. In more severe cases, "virilization" -- taking on significant male characteristics associated with maleness, including include excess facial and body hair (hirsutism), an enlarged clitoris, baldness at the temples, acne, deepening of the voice, increased muscularity, and an increased sex drive) -- may occur.
• Lack of ovulation or irregular ovulation often resulting in irregular or absent menstruation. Women with PCOS usually have oligomenorrhea (eight or fewer periods per year) or amenorrhea (absence of periods for extended periods). Some women with PCOS have polymenorrhea, or periods that are too frequent.
The diagnostic process should include a thorough physical examination and history to check for signs and symptoms of hypothyroidism, Cushing's syndrome (a hormonal disorder in which the adrenal glands malfunction), and tumors (of the ovary, adrenal gland, etc.).
~Treatment~
The first step in managing polycystic ovary syndrome (PCOS) is getting regular exercise, eating a healthy diet, and not smoking. This is a medical treatment for PCOS, not just a lifestyle choice. Additional treatments depend on your symptoms and whether you are planning a pregnancy.
• If you are overweight, a small amount of weight loss is likely to help balance your hormones and start up your menstrual cycle and ovulation. Use regular exercise and a healthy weight-loss diet as your first big treatment step. This is especially important if you're planning a pregnancy.
• If you smoke, consider quitting. Women who smoke have higher levels of androgens than women who don't smoke.1 Smoking also increases your risk of heart disease.
• If you are planning a pregnancy and weight loss doesn't improve your fertility, your doctor may suggest a medicine that helps lower insulin. With weight loss, this can improve your chances of ovulation and pregnancy. Fertility drug treatment may also help start ovulation.2
• If you are not planning a pregnancy, you can also use hormone therapy to help control your ovary hormones. To correct menstrual cycle problems, birth control hormones keep your endometrial lining from building up for too long. This is what prevents uterine cancer. Hormone therapy can also help with male-type hair growth and acne.3 Birth control pills, patches, or vaginal rings are prescribed for hormone therapy. Androgen-lowering spironolactone (Aldactone) is often used with estrogen-progestin birth control pills. This helps with hair loss, acne, and male-pattern hair growth on the face and body (hirsutism).3
Taking hormones does not help with heart, blood pressure, cholesterol, and diabetes risks. This is why exercise and a healthy diet are a key part of your treatment.
Treatment for infertility from PCOS focuses on starting ovulation:
• If you have PCOS and are overweight, weight loss may be all the treatment you need. Even a small weight loss can trigger ovulation. Weight loss of as little as 5% to 7% over 6 months can lower your insulin and androgen levels. This restores ovulation and fertility in more than 75% of women with PCOS.5
• If weight loss alone does not start ovulation (or if you don't need to lose weight), your doctor may have you try a medicine such as metformin or clomiphene to help you start to ovulate. Several months of treatment may be needed. Sometimes combining these two treatments can trigger ovulation in women with PCOS.1011
• If metformin and clomiphene do not work, gonadotropins are sometimes used. These are similar to the hormones the body makes to start ovulation. But they also increase the chances of having a high-risk pregnancy with two or more embryos. During gonadotropin treatment, you must have daily checks of egg follicle development, using blood tests and ultrasound, to prevent ovarian hyperstimulation syndrome.
If weight loss and medicine do not work, treatment options include:
• In vitro fertilization. Eggs are fertilized with sperm in a lab, grown for a few days, then put in the uterus to start a pregnancy. This treatment is complex, difficult, and expensive, but it may improve your chances of pregnancy.
• Ovarian drilling, or partial destruction of an ovary. This is a surgical treatment that can trigger ovulation. It is sometimes used for women with PCOS who have tried weight loss and fertility medicine but still are not ovulating.11
~PCOS and Pregnancy~
There appears to be higher rates of miscarriage, gestational diabetes, pregnancy-induced high blood pressure (pre-eclampsia), and premature delivery in women with PCOS. Researchers are studying how the diabetes medicine metformin can prevent or reduce the chances of having these problems while pregnant. Metformin also lowers male hormone levels and limits weight gain in women who are obese when they get pregnant.Metformin is a FDA pregnancy category B drug. It does not appear to cause major birth defects or other problems in pregnant women. But, there have been no studies of metformin on pregnant women to confirm its safety. Talk to your doctor about taking metformin during pregnancy or if you are trying to become pregnant. Also, metformin is passed through milk in breastfeeding mothers. Talk with your doctor about metformin use if you are a nursing mother.
~Questions to Ask~
1. How much experience do you have diagnosing and treating PCOS? If you don't have a lot of experience, can you recommend a specialist?
2. How long will it take to see effects from my medications? How dramatic can I expect the effects to be?
3. What are the side effects of these medications? How can I spot them early?
4. How do you feel about prescribing insulin sensitizers?
5. I don't want to take birth control pills, what alternatives can you recommend?
6. Is it safe to conceive on these medications? What steps should I take if I decide I want to get pregnant?
7. Can you recommend any lifestyle changes that might make a difference in my condition? How big a change can I expect to see?
8. For my skin color and type, what is an optimal hair removal method?
9. How does PCOS affect my other health conditions?
All Information Was Taken From;
http://www.healthywomen.org
http://www.womenshealth.gov/faq/polycys ... ndrome.cfm (http://www.womenshealth.gov/faq/polycystic-ovary-syndrome.cfm)
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women. It affects an estimated seven percent of females. PCOS, sometimes called Stein-Leventhal Syndrome after the physicians who first characterized it in the 1930s, is a common cause of infertility. It is also associated with an increased risk of diabetes and, possibly, cardiovascular disease.
~Age of Typical Onset~
The syndrome usually presents at puberty, with irregular or absent periods. As the term polycystic ovary syndrome suggests, the syndrome often is accompanied by enlarged ovaries containing multiple small painless "cysts" or tiny follicles about 1/4 to 1/2 inch in diameter. A "polycystic" ovary generally is defined as having more than 12 small cysts, or being of increased size.
~Symptoms~
The most visible symptoms of PCOS stem from excessive levels of androgens, such as testosterone, produced in the ovaries and the adrenal glands. Androgens often are called "male hormones," even though they are found in both men and women. They are usually present at much higher concentrations in men and are an important factor in determining male traits and reproductive activity. Androgens include testosterone, DHT and androstenedione.
Excessive levels of these hormones, a condition called "hyperandrogenism" in women, can lead to some of the most common symptoms of PCOS, including:
• Excess body or facial hair ("hirsutism")
• Oily skin and acne
• Oligo-ovulation (irregular ovulation)
• Scalp hair loss and balding
~Diagnosis~
Diagnosis begins with an inventory of symptoms, the most common of which are:
• Hirsutism (excess body and/or facial hair in a male-like pattern, particularly on the chin, upper lip, breasts, inner thighs, and abdomen)
• Irregular or infrequent periods
• Obesity, primarily around the abdomen
• Acne and/or oily skin (particularly severe acne in teenagers or acne that persists into adulthood)
• Infertility
• Ovarian appearance suggesting polycystic ovaries
• Hair loss or balding
• Acanthosis nigricans (darkening of the skin, usually on the neck. This condition is also a sign of insulin problems)
• Skin tags, small pieces of excess skin in the armpit or neck area
Women with PCOS may have varying combinations of these and other symptoms, but two essential features of the disorder are:
• Hyperandrogenism, or excess blood levels of androgens. Androgens are hormones such as testosterone that, in excess quantities, cause such symptoms as hirsutism and acne. In more severe cases, "virilization" -- taking on significant male characteristics associated with maleness, including include excess facial and body hair (hirsutism), an enlarged clitoris, baldness at the temples, acne, deepening of the voice, increased muscularity, and an increased sex drive) -- may occur.
• Lack of ovulation or irregular ovulation often resulting in irregular or absent menstruation. Women with PCOS usually have oligomenorrhea (eight or fewer periods per year) or amenorrhea (absence of periods for extended periods). Some women with PCOS have polymenorrhea, or periods that are too frequent.
The diagnostic process should include a thorough physical examination and history to check for signs and symptoms of hypothyroidism, Cushing's syndrome (a hormonal disorder in which the adrenal glands malfunction), and tumors (of the ovary, adrenal gland, etc.).
~Treatment~
The first step in managing polycystic ovary syndrome (PCOS) is getting regular exercise, eating a healthy diet, and not smoking. This is a medical treatment for PCOS, not just a lifestyle choice. Additional treatments depend on your symptoms and whether you are planning a pregnancy.
• If you are overweight, a small amount of weight loss is likely to help balance your hormones and start up your menstrual cycle and ovulation. Use regular exercise and a healthy weight-loss diet as your first big treatment step. This is especially important if you're planning a pregnancy.
• If you smoke, consider quitting. Women who smoke have higher levels of androgens than women who don't smoke.1 Smoking also increases your risk of heart disease.
• If you are planning a pregnancy and weight loss doesn't improve your fertility, your doctor may suggest a medicine that helps lower insulin. With weight loss, this can improve your chances of ovulation and pregnancy. Fertility drug treatment may also help start ovulation.2
• If you are not planning a pregnancy, you can also use hormone therapy to help control your ovary hormones. To correct menstrual cycle problems, birth control hormones keep your endometrial lining from building up for too long. This is what prevents uterine cancer. Hormone therapy can also help with male-type hair growth and acne.3 Birth control pills, patches, or vaginal rings are prescribed for hormone therapy. Androgen-lowering spironolactone (Aldactone) is often used with estrogen-progestin birth control pills. This helps with hair loss, acne, and male-pattern hair growth on the face and body (hirsutism).3
Taking hormones does not help with heart, blood pressure, cholesterol, and diabetes risks. This is why exercise and a healthy diet are a key part of your treatment.
Treatment for infertility from PCOS focuses on starting ovulation:
• If you have PCOS and are overweight, weight loss may be all the treatment you need. Even a small weight loss can trigger ovulation. Weight loss of as little as 5% to 7% over 6 months can lower your insulin and androgen levels. This restores ovulation and fertility in more than 75% of women with PCOS.5
• If weight loss alone does not start ovulation (or if you don't need to lose weight), your doctor may have you try a medicine such as metformin or clomiphene to help you start to ovulate. Several months of treatment may be needed. Sometimes combining these two treatments can trigger ovulation in women with PCOS.1011
• If metformin and clomiphene do not work, gonadotropins are sometimes used. These are similar to the hormones the body makes to start ovulation. But they also increase the chances of having a high-risk pregnancy with two or more embryos. During gonadotropin treatment, you must have daily checks of egg follicle development, using blood tests and ultrasound, to prevent ovarian hyperstimulation syndrome.
If weight loss and medicine do not work, treatment options include:
• In vitro fertilization. Eggs are fertilized with sperm in a lab, grown for a few days, then put in the uterus to start a pregnancy. This treatment is complex, difficult, and expensive, but it may improve your chances of pregnancy.
• Ovarian drilling, or partial destruction of an ovary. This is a surgical treatment that can trigger ovulation. It is sometimes used for women with PCOS who have tried weight loss and fertility medicine but still are not ovulating.11
~PCOS and Pregnancy~
There appears to be higher rates of miscarriage, gestational diabetes, pregnancy-induced high blood pressure (pre-eclampsia), and premature delivery in women with PCOS. Researchers are studying how the diabetes medicine metformin can prevent or reduce the chances of having these problems while pregnant. Metformin also lowers male hormone levels and limits weight gain in women who are obese when they get pregnant.Metformin is a FDA pregnancy category B drug. It does not appear to cause major birth defects or other problems in pregnant women. But, there have been no studies of metformin on pregnant women to confirm its safety. Talk to your doctor about taking metformin during pregnancy or if you are trying to become pregnant. Also, metformin is passed through milk in breastfeeding mothers. Talk with your doctor about metformin use if you are a nursing mother.
~Questions to Ask~
1. How much experience do you have diagnosing and treating PCOS? If you don't have a lot of experience, can you recommend a specialist?
2. How long will it take to see effects from my medications? How dramatic can I expect the effects to be?
3. What are the side effects of these medications? How can I spot them early?
4. How do you feel about prescribing insulin sensitizers?
5. I don't want to take birth control pills, what alternatives can you recommend?
6. Is it safe to conceive on these medications? What steps should I take if I decide I want to get pregnant?
7. Can you recommend any lifestyle changes that might make a difference in my condition? How big a change can I expect to see?
8. For my skin color and type, what is an optimal hair removal method?
9. How does PCOS affect my other health conditions?
All Information Was Taken From;
http://www.healthywomen.org
http://www.womenshealth.gov/faq/polycys ... ndrome.cfm (http://www.womenshealth.gov/faq/polycystic-ovary-syndrome.cfm)