Diagnosis and Treatment of Polycystic Ovarian Syndrome (PCOS)
Many of the symptoms of polycystic ovarian syndrome (PCOS)-including excessive body and facial hair, thinning head hair, weight gain, acne, and infertility-are so devastating and apparent to the sufferer that early diagnosis is a possibility.
Diagnosis of PCOS
There is no single method to determine polycystic ovarian syndrome. A doctor may:
- Check to see if the ovaries are enlarged or if cysts are present. This line of undeveloped eggs occurs like a "string of pearls"
- Check blood pressure and body mass index
- Use ultrasounds, MRIs and biopsies to determine whether cysts exist in the ovaries and whether the endometrium has become thick
- Use blood tests to check levels of glucose, insulin, thyroid function, male hormone levels, and egg-stimulating hormone levels
There is no cure for polycystic ovarian syndrome but management of the disease depends on many factors including:
- The severity of the symptoms
- The risk of heart disease and diabetes
- If physical appearance is key or resumed menstruation
- Whether or not a woman wants to get pregnant
Treatments for PCOS
- Facial creams to remove hair have proven effective
- Anti-androgen medications reduce male hormone levels and hair growth
- Birth control pills decrease male hormones, control the menstrual cycle, and clear acne
- Diabetes medications are not yet approved for treating PCOS but they affect insulin levels, lowering male hormone levels, reducing hair growth, and they may stimulate ovulation to occur
- Fertility medications stimulate ovulation but there is a risk of multiple births. Metformin, a drug that suppresses insulin production, taken along with fertility drugs may help ovulation to occur on lower doses of the stimulants.
- Ovarian drilling is done to stimulate egg production and release. A needle carrying a current is used to destroy parts of the ovary. This reduces the production of male hormones and 50 percent of cases have achieved conception. There is a risk that scarring of the ovary may inhibit egg release and if too much of the ovary is destroyed it can trigger early menopause.
- In vitro fertilization (IVF) is the process by which a woman's eggs are removed, fertilized in the lab and then placed back into the uterus to implant.
- In vitro maturation (IVM) may be used if there has been a poor response to medications or if there are cost considerations. The results are not as promising as IVF. It has a lower pregnancy success rate and a higher miscarriage rate. Follicles are removed from the ovary and matured in the lab.
- Lifestyle changes have marked effects on polycystic ovarian syndrome. Weight loss affects insulin levels, glucose levels, and hormone levels.
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