I was recently diagnosed with Polycystic Ovarian Syndrome. My doctor said that I have a fairly minor case, and he put me on birth control pills and a form of diabetic medicine to control symptoms. I know that some of the effects of this disease include weight gain, abnormal facial hair growth, acne, and infertility.
I am only 20 years old, so naturally infertility is a big concern. What can I start doing now to make it easier for me to conceive later? Are there any new drugs or treatments that can help? Also, what can I do for weight loss? I know that many women suffer from this troubling and often embarrassing disease. I hope you can help me.
It’s natural to be concerned, but no, you shouldn’t be worried. Polycystic ovarian syndrome (PCOS) is common; in fact, as many as one in ten women are affected by this complex condition. Menstrual problems and abnormal hair growth are the main reasons women seek help, but PCOS also increases the risk of obesity, heart disease, Type II diabetes, high blood pressure and uterine cancer. And, as you can imagine, it can lead to emotional problems as well — some women become depressed or introverted. The good news is that by recognizing and treating PCOS, these complications can be avoided.
PCOS tends to run in families and often starts with puberty. Rare or infrequent ovulation is the hallmark, and most women with PCOS have menstrual cycles longer than 35 days. Because ovulation doesn’t happen normally, the ovaries become filled with many tiny cysts, hence the name polycystic ovaries. Over time, the ovaries can become enlarged in size.
While normal ovaries produce small amounts of the male hormone androgen, polycystic ovaries produce greater amounts of androgen. Higher levels of this hormone are responsible for the acne, increased hair growth or male-pattern baldness seen in PCOS. We now know that most women with PCOS are less sensitive, or resistant, to insulin. Insulin helps maintain normal blood sugar levels, and when the body is resistant to insulin, more insulin is secreted. These higher levels of insulin stimulate the ovaries to produce more androgen.
Certain diabetes medications, including metformin, troglitazone, and D-chiro-inositol work by making the body more sensitive to insulin, and recent studies have shown they can help treat PCOS. The body becomes more sensitive to insulin, which leads to lower levels of insulin and androgen. As these levels reach a normal range, the ovaries may respond to normal signals and ovulate.
Obesity can also lead to higher levels of insulin and androgen, which makes weight control very important for women with PCOS. But there’s no magic bullet. A program of regular exercise combined with a healthy low-fat diet rich in fresh fruits, vegetables and whole grains is the best way to lose weight or maintain a healthy weight. For some women, simply reaching a healthy weight can cause normal ovulation to resume.
Treatment of PCOS really centers around the goals of the woman. Birth control pills are a great way to regulate menstrual cycles and lower the risk of uterine cancer. Reversing hair growth may require a combination of birth control pills, along with medications, such as spironolactone, which block the action of androgen. Infertility in women with PCOS is linked to abnormal ovulation and is usually managed with fertility drugs to stimulate ovulation.
You and your doctor have taken an excellent, proactive approach to your medical condition. This will help control the problem and prevent complications.