Lesson 3: Your Doctor, Your Options
PCOS
PCOS, is short for Polycystic Ovarian Syndrome. Other abbreviations for this condition include PCO – Polycystic Ovaries and PCOD – Polycystic Ovarian Disease, but they all refer to a condition that causes multiple cysts on a woman's ovaries. It is possible for a woman to have PCO and not have any of the associated symptoms, and that is why Syndrome or Disease is not included in its abbreviation. We will, in this section, be looking at the symptoms, diagnosis, and treatment options of PCOS/PCOD.
Symptoms of PCOS are extensive, but the most common ones include:
- Irregular periods
- Excessive facial or body hair
- Acne
- Obesity – excessive weight
- Hair loss on the scalp
- Recurrent miscarriages
- Chronic fatigue
- Mood swings
- Infertility
The best way to diagnose PCOS is with an ultrasound of the ovaries. In women with PCO/PCOS/PCOD, the ovaries look like they have a string of pearls in them. There are usually 10 or more cysts that are viewable by ultrasound. These cysts are not 'normal' functional cysts that many women develop throughout their reproductive lives.
A functional cyst will develop after ovulation and then go away on it's own without the need for medical intervention in most cases. Polycystic ovaries contain numerous cysts that do not go away even with medical intervention. However, even if you have many of the symptoms of PCOS, they could be due to other medical conditions, so all blood work should be done first to rule out diabetes, and thyroid dysfunction.
If the symptoms cannot be associated with any medical condition, then the ultrasound should be conducted to determine if PCOS is present. If it is determined that PCOS is present, there are different treatment options available to you. You should fully discuss all options with your partner and your doctor before making a choice.
One of the first options, though usually prescribed for women that are not trying to conceive, is the birth control pill. The pill will synthetically regulate the hormones, prevent ovulation, and allow a woman to have regular periods. This treatment option will usually help with acne and excess hair growth, but not with the excessive weight, infertility, hair loss, chronic fatigue, and mood swings.
Another option is the use of insulin lowering medications like Metformin (Glucophase) or Troglitazone (Rezulin). By using these medications, the insulin level is lowered, and so is the testosterone level. This usually results in the return of regular menstrual periods, loss of excessive hair, loss of excess weight, loss of acne, and stabilizing of moods.
Many times treatment of PCOS includes fertility medications such as Clomid or injectable medications along with insulin lowering medications. Sometimes the fertility medications are used in conjunction with IUI, IVF or other ART.
Changes in diet and exercise have also been shown to help alleviate the symptoms of PCOS. Dietary changes of the amounts of carbs and proteins consumed so they are more equal seem to help most. It has also been shown that women with PCOS have fewer symptoms if they lose just 10% of their total body weight.
What will work best for you will depend on the symptoms you have and what your individual and couple goals are.
