Saturday, February 11, 2012

PCOS

Recently, I've helped a friend who I met on the internet do a little diggin about PCOS or Polycystic Ovary Syndrome also known as PCOD or Polycystic Ovary Disease. I wanted to share some links and information that we've found.

There is no known cause of why PCOS occurs in women. However, androgens or male hormones, that are normally present in women tend to be much higher in women with PCOS causing an imbalance of hormones. Symptoms may consist of long, irregular cycles, or absence of periods. However, this is not always the case and some women continue to have regular cycles. Other symptoms may or may not include weight gain, decreased breast size, deepening of the voice, increase in hair on chest, face, inner thighs, and even around the areolas called hirsutism, thinning of the hair on the head, reproductive abnormality (usually infertility) and acne. It is very common for those who have PCOS that their female relatives (usually mother or sisters) also have a history of PCOS. Also 50% of women with PCOS have endometreosis, a completely different fertility issue that probably will need to be dealt with.

Not only does this effect a women's reproductive system but it puts women at much higher risk for obesity, high blood pressure, high LDL-C (bad cholesterol) and low HDL-C (good cholesterol), heart disease (at least a 7x increase risk), diabetes (by the age of 40, almost 40% of women will develop diabetes), and it is even thought to have a higher incidence of endometrial and breast cancer.

So what happens fertility wise in women with PCOS? Many times its hard to conceive due to long irregular periods and even more commonly the ovaries do not release an egg during ovulation due to the follicles not properly maturing. Instead the ovaries develop cysts on them. Ultrasound will commonly reveal a "string of pearls" on the ovaries (as shown below) which is not normal.



If you are concerned that you have symptoms of PCOS you may be wondering what tests should be performed.

Blood tests:

- Estrogen levels (usually low levels in PCOS)
- FSH levels
- LH levels (Sometimes a reversed FSH:LH ratio level is discovered. Normal is 2:1 ratio)
- Total Testosterone
- Free Testosterone
- Androstenedione
- DHEAs levels
- Thyroid function tests
- B-endorphin levels


Sometimes a seminal fluid analysis will also be advised for the husband.

Many times a laprascopy, hysteroscopy, and a selective hysterosalpingogram may be recommended as well.


How is PCOS treated? Well it depends what reproductive world you are in. Most of the time doctors will try to control PCOS symptoms with birth control. Please note: this DOES NOT treat the underlying cause of PCOS but rather the symptoms. If trying to conceive Clomid, Metformin and other drugs may be suggested.

In the NaPro world there is a surgical procedure called Ovarian Wedge Resection that is used to treat PCOS. NaPro will also treat PCOS with hormone management for the rest of you life which is very important. Please note there are graphic images on the Ovarian Wedge Resection site and you will need to scroll about half way down. Another NaPro website is Dr. Hilger's website that discusses PCOS and leads to other useful links.

Links I found to be helpful:

PubMed Health on PCOS

Soulcysters - Message Board

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