POLYCYSTIC OVARIAN SYNDROME (PCOS)/HIRSUTISM
Polycystic ovarian syndrome is causes infertility. PCOS symptoms include irregular menses, excess hair growth on face and body, etc. PCOS treatment always required a complex approach to be applied and depends on the symptoms present. Below we will review this condition, as well as its` symptoms and signs, diagnosis and PCOS treatment options in more detail.
Polycystic ovarian syndrome (PCOS) is a disorder of the endocrine system and occurs commonly among women of reproductive age.Patients with PCOS may have enlarged ovaries that contain small collections of fluid. They are known as follicles and are located in each ovary that can be seen during an ultrasound exam. The exact cause of PCOS is unknown.
To reduce the risk of long-term complications such as type 2 diabetes and heart disease, early diagnosis and treatment along with weight loss may be beneficial.
Signs of polycystic ovarian syndrome generally occur shortly after a woman begins having her period (menarche). These signs include:
- Excess hair on the face, chest, stomach, thumbs or toes
- Decreased breast size
- Deepening voice
- Thinning hair
- Weight gain
- Pelvic pain
- Anxiety or depression
- Irregular menstrual cycles
- Increased muscle mass
COMPLICATIONS DUE TO POLYCYSTIC OVARIAN SYNDROME
PCOS may make the following conditions more likely especially if obesity is also a factor:
- Type 2 diabetes
- High blood pressure
- Cholesterol and lipid abnormalities such as elevated triglycerides or low high-density lipoprotein (HDL) cholesterol (the “good” cholesterol)
- Metabolic syndrome (a cluster of signs and symptoms that indicate a significantly increased risk of cardiovascular disease)
- Sleep apnea
- Depression and anxiety
- Abnormal uterine bleeding
- Cancer of the uterine lining (endometrial cancer) caused by exposure to continuous high levels of estrogen
- Gestational diabetes or pregnancy-induced high blood pressure
PCOS TREATMENT OPTIONS
Treatment of PCOS tends to focus more on the management of the individuals concerns such as infertility, hirsutism (the abnormal growth of hair on a women’s face or body) , ache or obesity.
Your doctor may prescribe medication to:
Regulate your menstrual cycle
Your doctor may recommend combination birth control pills (contain both oestrogen and progestin) to regulate your menstrual cycle. They work to decrease androgen production and also give your body a break from the effects of continuous oestrogen. This will lower the risk of endometrial cancer and also correct abnormal bleeding.
Alternatively, a skin patch or vaginal ring that contains a combination of oestrogen and progestin may be used to treat the condition as well. You won’t be able to conceive during the time that you take this medication to relieve your symptoms.
Another approach to treat this condition if you’re not a good candidate for combination birth control pills is to take progesterone for ten to fourteen days every one to two months. This type of therapy helps to regulate your periods and offers protection against endometrial cancer. However, it doesn’t improve androgen levels and it doesn’t prevent pregnancy. If you wish to avoid pregnany, the progestin-only minipill or progestin-containing intrauterine device are better choices.
An oral medication known as metformin (Glucophage, Fortamet) may be prescribed for type 2 diabetes to improve insulin resistance and lowers insulin levels. This may help with ovulation and lead to regular menstrual cycles. It also slows the progression to type 2 diabetes if you already have pre-diabetes. It also aids in weight loss if you follow a diet and an exercise program.
Help you ovulate
You may need medication to help you to ovulate if you’re trying to become pregnant. An oral anti-oestrogen medication known as Clomiphene (Clomid, Serophene) can be taken in the first part of your menstrual cycle to promote ovulation. If this medication alone isn’t effective, metformin may be recommended to induce ovulation.
If clomiphene and metformin doesn’t help you conceive, your doctor may recommend using gonadotropins. They are follicle-stimulating hormone (FSH) and luteinizing hormone (LH) medications that are administered by injection.
Another medication is letrozole (Femara). It is unclear how letrozole works to stimulate the ovaries but it may help with ovulation when other medications fail.
It’s important that you work with a reproductive specialist and have regular ultrasounds to monitor your progress and avoid problems when taking any type of medication to help you ovulate.
Reduce excessive hair growth
Birth control pills may be recommended to decrease androgen production. Another medication called spironolactone (Aldactone) helps to block the effects of androgens on the skin. However, spironolactone can cause birth defects; effective contraception is required when using the drug. It is not recommended if you’re pregnant or planning to conceive. Another medication, Eflornithine (Vaniqa) is a cream that slows facial hair growth in women.
DIAGNOSING POLYCYSTIC OVARIAN SYNDROME
There’s no one-way to diagnose PCOS, however some testing methods include:
- History taking and physical exam: Your doctor will ask questions about your past health, symptoms, and menstrual cycles. A physical examination will also be performed to look for signs of PCOS, such as extra body hair and high blood pressure. Your height and weight will also be checked to see if you have a healthy body mass index (BMI).
- Pelvic exam: A doctor manually and visually inspects the reproductive organs for any indications of any abnormalities.
- Blood tests: Used to measure the levels of a number of hormones to rule out any causes of menstrual abnormalities or excess amounts of androgen that mimic PCOS.
- Ultrasound: A transvaginal ultrasound is used examine the appearance of the ovaries as well as the lining of the uterus.