Polycystic Ovary Syndrome (PCOS)

Don’t Suffer With Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a very common problem in which a woman’s hormones are out of balance. Women with PCOS grow many small cysts on their ovaries. That is why it is called polycystic ovary syndrome. The cysts are not harmful, but lead to hormone imbalances.

Symptoms of PCOS can start as early as a woman’s teen years and include weight gain, trouble losing weight, extra hair on the face and body, thinning hair on the scalp, irregular periods, depression and fertility problems.

Women no longer have to suffer with symptoms of PCOS, though. Treatments are available to help address its symptoms and reverse the condition.

Risk Factors

The main risk factor for polycystic ovary syndrome (PCOS) is a family history of PCOS. It can be passed down from either your mother’s or father’s side. Experts think that a combination of genes plays a part in PCOS. If you have the syndrome, your sisters and daughters have a 50 percent chance of developing PCOS too.

A family history of diabetes may also increase your risk for PCOS because of the strong relationship between diabetes and PCOS. About half of women with PCOS have a problem with how the body uses insulin. Research on this risk factor is ongoing.

In addition, the use of the seizure medicine valproate (such as Depakote) has been linked to an increased risk of PCOS.

Managing Hormones

At Draelos Metabolic Center, managing hormones is an integral part of our endocrinology effort with patients. Health professionals work with patients to make lifestyle changes that not only manage PCOS, but many other conditions related to diet and exercise, including diabetes. These lifestyle changes, along with hormone replacement and control options, can significantly improve a patient’s quality of life.

Hormones are chemical messengers that trigger many different processes, including growth and energy production. Often, the job of one hormone is to signal the release of another hormone. For reasons that are not well understood, in PCOS the hormones get out of balance. One hormone change triggers another, which changes another. This makes a vicious circle of out-of-balance hormones. For example, the body may have a problem using insulin, called insulin resistance. When the body doesn't use insulin well, blood sugar levels go up. Over time, this increases your chance of getting diabetes.

Medications

As part of polycystic ovary syndrome (PCOS) treatment, medicines can be used to help control reproductive hormone and insulin levels. These include:

  • Combination estrogen and progestin hormones in birth control pills or skin patches. These hormones correct irregular menstrual bleeding or absent menstrual cycles. They may also improve your androgen-related acne problems, male-type hair growth, and male-pattern hair loss.
  • Synthetic progestin. If you are not able to use the hormone estrogen, talk to your doctor about using progestin shots or pills for part of your cycle. The progestin makes your endometrial lining build up and shed, similar to a menstrual period. This monthly shedding is what prevents uterine cancer. Some prescription progestins raise androgen levels. There are three prescription progestins that do not increase androgen levels and are best for PCOS treatment. The combination birth control pills that contain these progestins are drospirenone (Yasmin, or "Yaz"); norgestimate (Ortho-Cyclen and Ortho Tri-Cyclen Lo); and desogestrel (Mircette, Desogen, Ortho-Cept, and Cyclessa). Possible side effects include headaches, fluid retention, and mood changes.
  • Androgen-lowering spironolactone (Aldactone), which is a diuretic. It is often used with estrogen-progestin therapy. This improves hair loss, acne, and abnormal hair growth on the face and body (hirsutism).
  • Metformin (Glucophage). This diabetes medicine is a newer PCOS treatment for controlling insulin, blood sugar levels, and androgen levels. This lowers your diabetes and heart disease risks and helps restore regular menstrual cycles and fertility. Metformin has been shown to be a useful treatment for many of the problems in PCOS. Taking metformin may improve fertility, reduce miscarriages and gestational diabetes and reduce long-term health problems. The use of metformin in pregnancy remains controversial although the risk appears to be small. Metformin is only FDA-approved for the treatment of diabetes, so the use of this medicine for treating PCOS symptoms should be discussed with your doctor.
  • Clomiphene citrate (Clomid, Serophene) (fertility medicines) and gonadotropin injections (LH and FSH). Clomiphene can be combined with metformin if metformin has not triggered ovulation. Combining the two treatments can make it more likely that clomiphene will work.
  • Eflornithine (such as Vaniqa) is a prescription skin cream that slows hair growth for as long as you use it regularly. Talk to your doctor about whether it is right for you.

Note: Some medicines used to treat abnormal hair growth may increase your risk for insulin-related metabolic problems, so it is important to discuss medicine side effects with your health care provider.