Polycystic Ovary (cont.)
What conditions can be associated with PCOS?
Women with PCOS are at a higher risk for a number of illnesses, including
high blood pressure, diabetes, heart disease, and
cancer of the uterus
(endometrial cancer). Much of this risk can be reversed by exercise and
weight
loss. Additionally, it is important for women with PCOS to have regular periods.
If a woman does not have regular periods, her risk of cancer of the uterus
(endometrial cancer) is increased. Medication is generally prescribed to induce
regular periods. Obesity is a complication of PCOS. Reducing the medical risks
from PCOS-associated obesity requires hard work on the part of the woman with
PCOS and is often frustrating. For more information about obesity and
management, please read the Obesity article.
What treatments are available for PCOS?
Treatment of PCOS depends partially on the woman's stage of life. For younger
women who desire birth control, the
birth control pill, especially those with
low "androgenic" (male hormone-like) side effects can cause regular periods and
prevent the risk of uterine cancer. For women who do not require birth control,
treatments that cause a woman to have a period four times a year is all that is
required.
For acne or excess hair growth, a water pill (diuretic) called spironolactone
may be prescribed to help reverse these problems. The use of spironolactone
requires occasional monitoring of blood tests because of its potential effect on
the blood potassium levels and kidney function. Propecia, a medicine taken by
men for hair loss, is another medication that blocks the effect of male hormones
on hair growth. Both of these medications can affect the development of a male
fetus and should not be used if the woman desires to become pregnant.
For women who desire pregnancy, a medication called
clomiphene (Clomid) can
be used to induce ovulation (cause egg production). In addition,
weight loss can
normalize menstrual cycles and often increases the
possibility of pregnancy in
women with PCOS. Other, more aggressive, treatments for
infertility (including
injection of gonadotropin hormones and assisted reproductive technologies) may
also be required in women who desire pregnancy and do not become pregnant on
Clomid therapy. Obesity that occurs with PCOS needs to be treated because it can
cause numerous additional medical problems. Consultation with a dietician on a
frequent basis is helpful until just the right individualized program is
established for each woman.
Metformin (Glucophage) is a medication used to treat type 2 diabetes. This
drug affects the action of insulin and is useful in reducing the symptoms of
PCOS.
Finally, a surgical procedure known as ovarian drilling can help induce
ovulation in some women who have not responded to other treatments for PCOS. In
this procedure a small portion of ovarian tissue is destroyed by an electric
current delivered through a needle inserted into the ovary.
- Polycystic ovarian syndrome (PCOS) is an illness characterized by irregular
or no periods, acne, obesity, and excess hair growth.
- Women with PCOS are at a higher risk for obesity, diabetes, high blood
pressure, and heart disease.
- With proper treatment, risks can be minimized. Ideal treatment is directed
to each of the manifestations of PCOS.
References: American Association of Clinical Endocrinologists Polycystic Ovary Syndrome
Writing Committee; American Association of Clinical Endocrinologists Position
Statement on Metabolic and Cardiovascular Consequences of Polycystic Ovary
Syndrome. Endocr Pract. 2005 Mar-Apr;11(2):126-34. No abstract available. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks
related to polycystic ovary syndrome. Fertil Steril. 2004 Jan;81(1):19-25. Schroeder BM; American College of Obstetricians and Gynecologists. ACOG releases guidelines on diagnosis and management of polycystic ovary
syndrome. Am Fam Physician. 2003 Apr 1;67(7):1619-20, 1622. No abstract available.
Previous contributing medical author: Carolyn J. Crandall,
MD
Last Editorial Review: 4/24/2007
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