Polycystic ovarian syndrome: Causes and Conception options


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I dropped my e-mail address in the comment section of a blackberry messenger channel I love as I understand just how bad PCOS may be for some people. The poster mailed me and we talked, and so I was moved to share with other women in similar situations.

 

So, what is PCOS?

It means Polycystic Ovarian Syndrome.

Normally, Eggs grow in tiny fluid-filled sacs in the ovaries which are called follicles or cysts. Ovulation occurs when the egg becomes mature and the follicle opens to release it. The ovaries of women with PCOS produce higher levels of the male androgen hormone, which stops follicles from breaking open and releasing their egg resulting in irregular or absent periods. As more than one egg and follicle is stimulated each month, the ovary becomes riddled with these fluid-filled follicles then remain in the ovaries as cysts.

WHAT IS THE CAUSE?

The cause is theorized to be any one of the following or even multiple factors including….

  • Genetics. PCOS often appears to run in families.
  • Excess insulin. Researchers have noted that women with PCOS tend to have high levels of insulin (the sugar regulating hormone). Elevated insulin levels, in turn, appear to increase androgen production perpetuating the vicious cycle.
  • Being overweight or obese. While overweight women are at greater risk for PCOS and women with PCOS are at greater risk of becoming overweight, we still are not sure which one starts the cycle. It’s like the case of the chicken and the egg. Which one came first? Just a little humor in a serious list, but I digress. If you are trying to conceive it’s a good idea to start eating healthy foods and exercising. Healthy living never hurts.

DIAGNOSING PCOS?

An irregular period isn’t the only sign of PCOS (and an unpredictable cycle isn’t necessarily a sign that you have PCOS, either).

Acne.

Excessive hair growth called hirstutism.

Thinning hair called alopecia.

Uneven or dark skin patches.

Weight gain.

Pelvic pain.

Anxiety and/or  depression.

Sleep apnea.

Over half of the women with PCOS also develop Type 2 diabetes (insulin resistance) or pre-diabetes (impaired glucose tolerance) before the age of 40.

 

As many women who don’t have PCOS may well have these symptoms, it is necessary to consult your doctor if you have eight or fewer periods per year or suddenly develop any of the symptoms above — and do it before you self-diagnose or self-medicate. Your doctor has to consider whether you have had similar symptoms in the past and your family history. You will need to be physically examined for the signs listed above, and blood tests, and a pelvic exam or ultrasound to check for ovarian cysts.

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TREATMENT OPTIONS?

While conceiving with PCOS is challenging medically,  it is absolutely possible.

I’m currently replying assuming you were clinically diagnosed with this condition,  and not that you’re assuming you have the condition.

A medical practitioner who knows your medical history is best to manage this condition with you.

The best treatment for PCOS is lifestyle modifications. If you’re overweight,  losing a few kilograms will always help, even if it’s as little as 5-10% of your body weight. This may help bring hormone levels down to normal, normalize menstrual irregularities and normalize insulin levels as PCOS has been found to have a relationship with insulin and diabetes.

I would advise that you discuss the following medications with your gynecologist. Please do not use any one of them without medical prescription as you may worsen your condition:

Metformin…. For insulin management.

Clomiphene citrate or gonadotropins…. For ovulation stimulation. Gonadotropins increase the risk of multiple gestation *twin births*.

Letrozole: Stimulates follicle stimulating hormone and blocks estrogen resulting in a higher rate of ovulation than clomiphene citrate.

Ovarian drilling: A surgical procedure that research has shown helps 80% of women ovulate and at least 60% conceive.

One natural product known to work is cinnamon. One teaspoon daily may help boost chances of conception.

If you do not have a regular personal doctor to elaborate on these drug options or you would prefer affordable personalized consultations in the privacy of your home, please email me again.

Also, kindly subscribe to my blog as I would be covering similar topics as the blog grows.

Best regards,  Dr Sade.

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