Preventing Polycystic Ovary Syndrome
You are overweight. You have infrequent periods. As a matter of fact, you have been trying to have a baby and it is difficult. You have excessive facial hair. You may have polycystic ovary syndrome.
As the name implies, some women often have ovarian cysts. It doesn’t mean the cyst will rupture or that they rupture more often, but there are other characteristics of polycystic ovary syndrome or PCOS that are more important than the awful pain. That’s because women with PCOS are far more likely to have insulin resistance, which makes them subject to higher rates of diabetes and heart disease. Not surprisingly, most women with PCOS are overweight.
Women with polycystic ovary syndrome produce too much androgen, which is a male hormone. An excess of androgen can cause menstrual irregularities, weight gain, acne, excessive hair growth, and the production of those ovarian cysts. These women are also likely to have insulin resistance, which is a condition that develops over time and makes it harder for the body to metabolize energy. The body kicks up insulin production to compensate.
Unfortunately, most women with PCOS don’t realize they have it. It is estimated that about 5 million women in the United States have PCOS. They go on dealing with the spectrum of problems it brings without necessarily realizing the connection. Physicians, too, often don’t connect the dots, partly because the symptoms are likely to be treated by different specialists. Rough, dark skin or acne may take a young woman with PCOS to a dermatologist. If she is having painful periods or intercourse she will seek out a gynecologist.
But, often women just endure these discomforts without seeking help. That’s not good, because the painful monthly cycles and the daily discomforts of skin and hair problems are only the tip of the iceberg. It’s the more serious health problems of diabetes and cancer that are the real worries.
To complicate matters, there is no simple blood test or scan that enables a PCOS diagnosis. Even if a woman has an ultrasound revealing numerous ovarian cysts, that is no telltale indicator. Women can have multiple ovarian cysts that never become problematic and are totally unrelated to the disorder. Ultimately, a diagnosis is accomplished by identifying the usual symptoms and ruling out other causes.
There may be some PCOS patients that go unrecognized because they don’t fit the classic description. Skinny women can have PCOS too. Symptoms may vary among women. Some women don’t necessarily get those ovarian cysts.
To diagnose PCOS, your doctor will want to perform various tests. A pelvic exam will need to be done (where your doctor will visually and manually check for growths, masses or other abnormalities). Blood tests can be analyzed to measure hormone levels. A transvaginal ultrasound spews out images from a wandlike instrument placed in your vagina.
Treatment for PCOS focuses on individual symptoms such as obesity, hirsutism (excess hair growth), acne, and infertility. Like it or not, there are certain choices that need to be made to resolve PCOS. You may need to have some sort of exercise program if you want to lose weight (losing weight may reduce symptoms).
To regulate your menstrual cycle, your doctor may suggest combination birth control pills that contain estrogen and progestin. Regulating your hormones decreases the risk of endometrial cancer and repairs abnormal bleeding, excess hair growth and acne.
There is also progestin therapy. Taking progestin 10 to 14 days every one to two months can regulate your periods and protect against endometrial cancer. Progestin therapy doesn’t lower androgen levels and doesn’t prevent pregnancy. Try taking a progestin mini-pill or a progestin intrauterine device to avoid pregnancy.
To help you ovulate, your doctor may recommend clomiphene, an oral anti-estrogen medication and letrozole (Femara), a breast cancer medication that can stimulate the ovaries. Metformin is an diabetic medication that may be helpful in improving insulin resistance and lowering insulin levels. Gonadotropins are hormone medications that aid the ovaries in the long run.
To reduce excessive hair growth, your doctor may recommend birth control pills (to lower androgen production that causes the excess growth), spironolactone (Aldactone) that blocks the effect of androgen on the skin, eflornithine (Vaniqua) a cream that can stop facial hair growth in women, and electrolysis where a tiny needle inserted into each hair follicle that emits an electric current that damages the follicle.
You can decrease the effects of PCOS, by maintaining a healthy weight, limiting carbohydrates, and being active. Most of all, mind your mental health. Women with PCOS are at risk for developing depression and anxiety disorders, as well as eating disorders and sexual dysfunction. Weight gain, acne, excess facial hair, and infertility can affect your self-esteem, so seek out a mental health professional if needed.
