Polycystic Ovarian Syndrome

[warren sinden]

A friend of mine has just been diagnosed with Polycystic Ovarian Syndrome. She says me being a male; I will never be able to understand what she is going through. I have searched google but haven’t found much. From what I understand it is a primary ovarian condition and is characterized by the presence of many minute cysts in the ovaries and excess production of androgens. I have tried to find out what is the root cause of it but no one seems to know. At the moment her greatest fear is that she won’t be able to have any children. What would the best treatment be for a woman who still wants to be able to bear children & suffers from PCOS. What are the risks after you have been treated?

[paximperium]

Here's a good site:
http://www.emedicine.com/med/topic2173.htm

It is tilted towards Physicians but it is open for all to read

[fls]

Mayoclinic.com is a nice source of information directed towards the general public.

http://www.mayoclinic.com/health/polycystic-ovary-syndrome/DS00423

Linda

[Professor Yaffle]

My sister has PCOS. Most of the time she stays on the pill and her symptoms are lessened. She is also on a low GI diet. She was diagnosed after trying to get pergnant with no success for several years. The first line of fertility treatment for her was ovarian stimulation, but that didn't work. The next line was IVF which did work for her (she now has a gorgeous 3 year old son).

[a_unique_person]

I don't know what my sister had specifically, but she has had problems with her ovaries and has been unable to get pregnant.

[warren sinden]

Here's a good site:
http://www.emedicine.com/med/topic2173.htm

It is tilted towards Physicians but it is open for all to read

Thanks Paximperium

This is what I was looking for.
For a minute I thought I was being too optimistic.

[Dr. Imago]

Some women are "cured" of PCOS after they become pregnant.

~Dr. Imago

[SkeptiChick]

Some women are "cured" of PCOS after they become pregnant.

~Dr. ImagoWhat exactly do you mean by the above?

[Delvo]

I have tried to find out what is the root cause of it but no one seems to know.That's pretty much what the word "syndrome" means: a condition defined by a related set of signs & symptoms that occur together, and maybe are known to occur more often under certain circumstances, but with unidentified cause or causes. Technically, that means a syndrome should be renamed as something like a disease or disorder or impairment or such if its cause(s) is/are determined, but sometimes the name sticks anyway.

[Faolan]

Some women are "cured" of PCOS after they become pregnant.

~Dr. Imago

WOW... I don't know whether to laugh or be angry... I'll go for laughter... anger accomplishes nothing via internet. I have PCOS, I cannot have children. Therefore no cure for me... lol

The pill doesn't work for everyone. For some, nothing does truly"cure". However, sugar intake does help lessen the side effects. Not all women have the same side effects either. Those who have difficulty experienced difficulty in conceiving, or have not been able to conceive at all, generally experience the feeling of feeling like less than a woman because they are unable to "do what a woman is intended" so to speak. The other side effects including obesity, unwanted hair, and acne also cause other emotional issues. Learning about PCOS is a good step but also be aware of the other issues that may come with it.

Unfortunately I cannot post link yet. When I needed to find out information I not only asked my GYN, but I also did a general PCOS search online and I went to the bookstore and looked in medical reference books for women.

[Faolan]

BTW .. I meant monitoring sugar intake helps lessen the effects of PCOS

[Physiotherapist]

As has already been said PCOS is a syndrome, which is a collection of symptoms and the cause cannot easily be demonstrated, as there are a lot.

Usually, it might present as:

Hormonal imbalances, (which is why the contraceptive pill is given in some cases)
Unwanted facial hair
Acne at times
Being overweight
Insulin resistance (Metformin is sometimes given for this)
Inability to become pregnant

When you become pregnant, hormone levels change, which is why it can have a positive effect on PCOS afterwards.

[warren sinden]

From what I understand, the root cause of PCOS seems to be an increase in androgen.

[SkeptiChick]

From what I understand, the root cause of PCOS seems to be an increase in androgen.
Actually, the increase in androgens is technically just another symptom. No one knows why the body is producing excess (the link provided earlier in the thread to the mayo clinic's article on the matter states this straight out, by the way), though studies are being done to try and find out.

If doctors knew what the cause was, a cure could be worked out eventually. As things stand, there is no cure (previous comments about pregnancies being a cure aside :rolleyes:). There have been advances in medications to help normalize hormonal balances though, which does at least assist in alleviating the symptoms.

[Professor Yaffle]

Does anyone know much about the link between PCOS and autoimmune diseases? I read something about people with PCOS being more likely to suffer from autoimmune thyroid disease and it intruiged me, as my sis has PCOS and there are a lot of autoimmune diseases in my family (Addison's disease, pernicious anaemia, autoimmune thyroid, coeliacs, Still's disease) as well as a lot of CFS (which also possibly has a link to autoimmune, last time I did any reading) sufferers and allergy sufferers.

[Dr. Imago]

What exactly do you mean by the above?

WOW... I don't know whether to laugh or be angry... I'll go for laughter... anger accomplishes nothing via internet. I have PCOS, I cannot have children. Therefore no cure for me... lol

Perhaps "cure" was the wrong word.

The problem is getting pregnant, which is difficult with PCOS (much like women with endometriosis). If you are able to get pregnant, probably it's the pregnancy related hormonal changes that occur which directly alter the prior abnormal physiology of the ovary, allow the disease to "rest" during the pregnancy, and then subsequent "reset" the normal physiology post-partum.

There have been many reports of women who've undergone spontaneous remission of their PCOS following pregnancy. Women who get pregnant with PCOS also find it easier to get pregnant thereafter. This may represent a milder form of the disease, and as is pointed out requires that you can actually become pregnant.

Faolan, I suggest you talk with a reproductive specialist who is familiar with letrozole, especially if you've failed clomiphene therapy. Getting pregnant may significantly diminish your symptoms, and may also induce a remission post-partum. Whether or not it completely goes away is unsure, but there are reports of women who've had full remission of PCOS post-pregnancy.

~Dr. Imago

[SkeptiChick]

Perhaps "cure" was the wrong word.

The problem is getting pregnant, which is difficult with PCOS (much like women with endometriosis). If you are able to get pregnant, probably it's the pregnancy related hormonal changes that occur which directly alter the prior abnormal physiology of the ovary, allow the disease to "rest" during the pregnancy, and then subsequent "reset" the normal physiology post-partum.

There have been many reports of women who've undergone spontaneous remission of their PCOS following pregnancy. Women who get pregnant with PCOS also find it easier to get pregnant thereafter. This may represent a milder form of the disease, and as is pointed out requires that you can actually become pregnant.

Faolan, I suggest you talk with a reproductive specialist who is familiar with letrozole, especially if you've failed clomiphene therapy. Getting pregnant may significantly diminish your symptoms, and may also induce a remission post-partum. Whether or not it completely goes away is unsure, but there are reports of women who've had full remission of PCOS post-pregnancy.

~Dr. ImagoI would put forth that perhaps, instead of it being a milder form of the disease, these women have simply been misdiagnosed.

Especially in this day and age of HMO's bullying doctors into providing substandard examination... *cough cough*

[Professor Yaffle]

I thought it was fairly well established that after a pregnancy a significant percentage of women with PCOS experience regularisation of their cycle and an increase in fertility after a pregnancy?

[SkeptiChick]

I thought it was fairly well established that after a pregnancy a significant percentage of women with PCOS experience regularisation of their cycle and an increase in fertility after a pregnancy?

I have PCOS, and in all the explanations from doctors, and all the research I've done on the matter, this thread is the absolute first thing I've heard about pregnancy "curing" it, or even having a measurable effect on it.

I was even lucky enough to be able to have a child (miracle child). Guess what? Still have PCOS, and its just as bad as it ever was.

[fls]

I have PCOS, and in all the explanations from doctors, and all the research I've done on the matter, this thread is the absolute first thing I've heard about pregnancy "curing" it, or even having a measurable effect on it.

I was even lucky enough to be able to have a child (miracle child). Guess what? Still have PCOS, and its just as bad as it ever was.

Weird. I was taught that as well, but I can't find a reference for it.

It's a good thing we had this little chat. :)

Maybe Dr. Imago has a reference.

Linda

[Professor Yaffle]

I have been having a look, and haven't been able to find any proper research on it (yet). All I have found is that it is asserted (without reference or attribution) on a few information sites about PCOS


Despite the problems that can present themselves to PCOS sufferers looking to get pregnant, a successful pregnancy is entirely possible and has been experienced by numerous women with PCOS. In fact, for many women, getting pregnant the second time around is much easier. Furthermore, it is not unusual for PCOS sufferers to notice that their menstrual cycles begin to regulate themselves after a pregnancy.


http://www.womens-health.co.uk/pcos5.asp


Although getting pregnant can be problematic for women with PCOS, many have found it easier to get pregnant the second time around. Additionally, some women have found that their menstrual cycles regulate themselves after a pregnancy.


http://www.pregnancy-info.net/infertility_PCOS.html

ETA - I am starting to suspect it might be an anecdotal, experience related thing, not based on research. I found this study which showed that menstrual regularity improved with age, and that previous pregnancy had no influence on this effect.
http://humrep.oxfordjournals.org/cgi/content/abstract/15/1/24


...patients showed a highly significant linear trend (P < 0.001) for a shorter menstrual cycle length with increasing age. Logistic regression analysis for body mass index, weight loss, hirsutism, previous treatment with clomiphene citrate or gonadotrophins, previous pregnancy, ethnic origin and smoking showed no influence on the effect of age on the regularity of the menstrual cycle.

[Dr. Imago]

Maybe Dr. Imago has a reference.

Reference? Hey, there is still some debate as to whether or not PCOS is actually a discrete syndrome and not actually a manifestation of some other endocrinologic disorder. ;)

~Dr. Imago