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Polycystic Ovarian Syndrome (PCOS) Information

  • Polycystic ovary syndrome (PCOS, also known clinically as Stein-Leventhal syndrome), is an endocrine disorder that affects 5-10% of women. It occurs amongst all races and nationalities, is the most common hormonal disorder among women of reproductive age, and is a leading cause of infertility. The symptoms and severity of the syndrome vary greatly between women. While the causes are unknown, insulin resistance (often secondary to obesity) is heavily correlated with PCOS...
  • Medical treatment of PCOS used to be directed mainly at the symptoms (ovarian and adrenal suppression and anti-androgen therapy) and at restoring ovulation. Some medications used for these purposes are:

    Oral contraceptives (ovarian suppression): Because these cause regular menstruation, they reduce the risk of endometrial carcinoma

    Spironolactone or finasteride (anti-androgen therapy): These reduce the excessive hair growth by blocking the effects of male hormones

    Clomiphene citrate, human chorionic gonadotropin, or dexamethasone: Induce ovulation

    Low-carbohydrate diets and sustained regular exercise are also beneficial. More recently doctors and nutritional experts are recommending a low-GI diet in which a significant part of the total carbohydrates are obtained from fruit, vegetables and wholegrain sources. These diets help women with PCOS to maintain steady blood sugar and insulin levels and may assist in weight loss. A diet composed of mainly low-GI foods combined with regular exercise will also help to combat the effects of insulin resistance.

    Many women find insulin-lowering medications such as metformin hydrochloride (Glucophage?), pioglitazone hydrochloride (Actos?), and rosiglitazone maleate (Avandia?) helpful, and ovulation may resume when they use these agents. Many women report that metformin use is associated with upset stomach, diarrhea, and weight-loss. Such side effects usually resolve within 2-3 weeks. Both symptoms and weight loss appear to be less with the extended release versions. Most published studies use either generic metformin or the regular, non-extended release version. Starting with a lower dosage and gradually increasing the dosage over 2-3 weeks and taking the medication toward the end of a meal may reduce side effects. The use of basal body temperature or BBT charts is an effective way to follow progress. It may take up to six months to see results, but when combined with exercise and a low-glycemic diet up to 85% will improve menstrual cycle regularity and ovulation.

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