Polycystic ovary syndrome is a common but treatable condition
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Approximately 5-10% of reproductive age women have it. This syndrome can have many symptoms. However, the key components are chronic anovulation (inability to ovulate), ovarian cysts and clinical hyperandrogenism (elevated male-type hormones).
Clinical features of PCOS
There can be many symptoms of PCOS.
- Irregular or absent menstrual cycles
- Infrequent or absent ovulation
- Excess facial and body hair
- Male-pattern balding
- Acne of face/back/chest
- Elevated FSH to LH hormone ratio
- Elevated levels of male hormones
- Multiple small cysts on the ovaries
- Insulin resistance
- Elevated cholesterol
The importance of seeing a specialist
Because polycystic ovary syndrome encompasses such a broad spectrum of symptoms, diagnosis can be frustratingly difficult. As there is not one specific sign or symptom that points directly to PCOS, it is important to see a specialist who can diagnose this disorder and prescribe treatment.
There are many options for polycystic ovary syndrome treatment
If you have PCOS, treatment will depend upon your goals.
If fertility is not an immediate concern, hormonal therapies often correct the problems with PCOS. Birth control pills, which may reduce the hirsutism (excessive hair growth) and regulate menstrual cycles.
For overweight women, simply losing 10-15% of total weight may be enough to allow spontaneous ovulation to occur. Weight loss is associated with lowered androgen effects, less insulin resistance, an improved lipid profile and resumption of ovulatory function.
Studies with Metformin indicate that most women with polycystic ovary syndrome will spontaneously ovulate after three months of treatment. We frequently start Metformin at a dose of 500 mg per day for one week working up to a total dose of 2000 mg per day.
If you need fertility medications, the first and simplest step is to use Femara (letrozole) or Clomid (clomiphene citrate). If these medications don’t help you ovulate, we may prescribe gonadotropins. Gonadotropins stimulate the growth of one or two eggs. We monitor egg growth and development with hormone measurements and ultrasound examinations. If monitoring shows that too many follicles are developing, and the risk of multiple pregnancy is high, then the treatment will be canceled.
Contact us to learn more about PCOS. We can help improve your symptoms and fertility.