Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The diagnosis of PCOS is generally made on the basis of clinical signs and
symptoms as discussed above. The doctor will want to exclude other illnesses
that have similar features, such as low thyroid hormone blood levels
(hypothyroidism) or elevated levels of a milk-producing hormone (prolactin).
Also, tumors of the ovary or adrenal glands can produce elevated male hormone
(androgen) blood levels that cause acne or excess hair growth, mimicking
symptoms of PCOS.
Other laboratory tests can be helpful in making the diagnosis of PCOS. Serum
levels of male hormones (DHEA and
testosterone) may be elevated. However, levels
of testosterone that are highly elevated are not unusual with PCOS and call for
additional evaluation. Additionally, levels of a hormone released by the
pituitary gland in the brain
(LH) that is involved in ovarian hormone production are elevated.
The cysts (fluid filled sacs) in the ovaries can be identified with
imaging technology. (However, as noted above, women without PCOS can have many
cysts as well.) Ultrasound, which passes sound waves through the body to create
a picture of the kidneys, is used most often to look for cysts in the ovaries. Ultrasound imaging employs no
injected dyes or radiation and is safe for all patients including pregnant
women. It can also detect cysts in the kidneys of a fetus. Because women without PCOS can have ovarian cysts, and because ovarian cysts are not part of the
definition of PCOS, ultrasound is not routinely ordered to diagnose PCOS. The
diagnosis is usually a clinical one based on the patient's history, physical
examination, and laboratory testing.
More powerful and expensive imaging methods such as
computed tomography (CT
scan) and magnetic resonance imaging (MRI) also can detect cysts, but they are
generally reserved for situations in which other conditions that may cause
related symptoms, such as ovarian or
adrenal gland tumors are suspected. CT scans require X-rays and sometimes
injected dyes, which can be associated with some degree of complications in
certain patients.
High blood pressure, also known as hypertension, is a repeatedly
elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
Acne is a localized skin inflammation as a result of overactivity of oil glands at the
base of hair follicles. This inflammation, depending on its location, can take the form
of a superficial pustule (contains pus), a pimple, a deeper cyst, congested pores, whiteheads, or blackheads. Treatments vary depending on the severity of the acne.
Ovarian cysts are fluid-filled, sac-like structures within an ovary. Causes of ovarian cysts are numerous. Symptoms of an ovarian cysts may be pain in the belly or pelvis. Treatment of an ovarian cysts depends on type of cyst.
Cysts are saclike structures that can occur throughout the body and usually contain a semisolid, liquid, or gaseous substance. Infections, tumors, genetic conditions, chronic inflammatory conditions, and wear and tear can cause cysts. Though some cysts may be palpable, others may not produce any symptoms. Treatment depends upon the location and cause of the cyst.
Cholesterol is naturally produced by the body, and is a building block for cell membranes and hormones. Low-density lipoprotein (LDL) cholesterol is the "bad" cholesterol, conversely, high-density lipoprotein (HDL) cholesterol is the "good" cholesterol. High cholesterol treatment includes lifestyle changes (diet and exercise), and medications such as statins, bile acid resins, and fibric acid derivatives.
Normal vaginal bleeding (menorrhea) occurs through the process of menstruation. Abnormal vaginal bleeding in women who are ovulating regularly most commonly involves excessive, frequent, irregular, or decreased bleeding. Causes of abnormal may arise from a variety of conditions.
A miscarriage is any pregnancy that ends spontaneously before the fetus can survive. Miscarriage usually occurs before the 13th week of pregnancy. The cause of a miscarriage cannot always be determined. The most common causes of a miscarriage in the first trimester are collagen vascular disease (lupus), hormonal problems, diabetes, chromosomal abnormalities, and congenital abnormalities of the uterus.
Insulin resistance is the diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues. Causes of insulin can include conditions such as stress, obesity, metabolic syndrome, and steroid use. Some of the risk factors for insulin resistance include fatty liver, heart disease, strokes, peripheral vascular disease, high cholesterol, and smoking. Treatment for insulin resistance are lifestyle changes and if necessary, medication.
Cushing's syndrome, sometimes referred to as hypercortisolism, is a hormonal disorder caused by prolonged exposure to high levels of the hormone cortisol. Symptoms may include obesity, thinning arms and legs, a rounded face, and increased fat around the neck. Some causes of Cushing's syndrome is from taking glucocorticoid hormones such as prednisone for inflammatory diseases. Treatment for Cushing's syndrome depends on the cause.
Obesity is the state of being well above one's normal weight. A person has traditionally been
considered to be obese if they are more than 20 percent over their ideal weight.
That ideal weight must take into account the person's height, age, sex, and
build.
The main features of metabolic syndrome include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for clotting. Patients are most often overweight or obese. Lifestyle modification such as the Mediterranean diet, exercise, and quitting smoking are the preferred treatment of metabolic syndrome.
Dandruff (seborrhea) is a skin disorder that results from neither too much moisture nor too much oil. Dandruff can be treated with shampoos that contain tar, salicylic acid, zinc, selenium sulfide, or ketoconazole.
Infertility is the diminished ability to conceive a child. The primary cause of infertility in men is a sperm disorder. In women, the primary cause of infertility is an ovulation disorder. Most forms of infertility can be treated. Conventional infertility therapies include drugs or surgery.
Amenorrhea is a condition in which there is an absense of menstrual periods in a woman. There are two types of amenorrhea, 1) primary and 2) secondary. Treatment of amenorrhea depends on the type (primary or secondary). In prmiray, surgery may be an option and in secondary amenorrhea medication or lifestyle changes may be treatment options.
Diabetes insipidus is a condition in which the patient has frequent urination. Symptoms of diabetes insipidus include irritable, listless, fever, vomiting, or diarrhea due to the loss of large volumes of urine. There are three types of diabetes insipidus, central, nephrogenic, dipsogenic, and gestational. Treatment depends upon the type of diabetes insipidus.
Menstruation (menstrual cycle) is also referred to as a "period." When a woman menstruates, the lining of the uterus is shed. This shedding of the uterine linking is the menstrual blood flow. The average menstrual cycle is 28 days. There can be problems with a woman's period, including heavy bleeding, pain, or skipped periods. Causes of these problems may be amenorrhea (lack fo a period), menstrual cramps (dysmenorrhea), or abnormal vaginal or uterine bleeding. There are a variety of situations in which a girl or woman should see a doctor about her menstrual cycle.
Trying to get conceive, or become pregnant can be challenging, frustrating, and an emotional rollercoaster for some couples. There are things you can do to chart progress, which may ultimately lead to a successful healthy pregnancy, or, when necessary, lead to discussions with a fertility specialist. Being aware of your menstrual cycle, charting your fertility pattern, knowing the reasons for infertility, and treating infertility are key points to discuss with your partner and physician.
Women's health is an important topic area to guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur. Educating yourself so that the transitions into different phases of life is key to a healthy, happy, and productive life.
Cholesterol occurs naturally in the body. High blood cholesterol levels increase a person's risk of developing heart disease, heart attacks, strokes, TIAs, and more. In addition to medication (fibrates, statins, bile acid sequestrants, and niacin), lifestyle changes can be made to lower blood cholesterol levels
Fast food consumption and lack of exercise are just a couple of causes of childhood obesity. Health effects of childhood obesity include type 2 diabetes, heart attack, stroke, high cholesterol, asthma, sleep apnea, gallstones, fatty liver disease, GERD, depression, and eating disorders.
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