Re: Glucophage - vomiting and other PCO issues
From: =?iso-8859-2?q?Zalányi Sámuel ?= (anonymous@obgyn.net)
Fri, 13 Jul 2001 17:54:02 +0200
Hi Sandy,
Yours is a typical medication for the US (suppose you live there). But I have several reservations about it. First: no BCP is good for PCOSers, because it aggravates the glucose metabolic disturbance at the core of PCOS. Diabetes is actually a contraindication to BCPS, the other contraindication is your age. In order to regulate your cycle it is enough to take a progestin or natural progesterone for 10-14 days every cycle (see aniother post of mione today).
Second: spironolactone is not a very specific antiandrogen, better ones are available in the US too (finasteride), but it may absolutely superfluous because metformin decreases your androgen levels.
As for your daughter, it is uncomfortable to suggest what tests she should get, lets visit the endo and we can discuss the tests.
Sam
> >>
> >> Fourth- My 12yr old daughter is showing signs of PCOS and I have an
> >> appointment with a pediatric endo. I am worried about what exams or
> >> tests she might have to have. She is (as all young girls are) very
> >> upset at the mention of having to go. It would put us all a little more
> >> at ease if we knew what test are necessary for her. Specifically an
> >> exam that would need her to completly undress or that would be invasive.
> >> Please reply.
> >>
> >> I am on a lot of meds. Does this sound within reason? Synthroid
> >> ..15mg.daily(for hypothroidism) Spironlactone 100mg.2x daily.
> >> Ortho-cyclen28 and Glucophage 1,000mg. 2x daily (for PCOS) I really
> >> like my dr. and trust him, I just wanted to gauge my meds. with other
> >> PCOS patients.
> >>
> >> Dr. Sam PLEASE RESPONG, and I would welcome comments from anyone who
> >> has simular issues?
> >>
> >> Thank you for your time,
> >> SandyB.
> >>
>
> Dear Dr. Sam,
> Thanks for your interest, to answer your questions:
>
> DIAGNOSIS:My current Dr.(a reproductive endo.) diagnosed me with PCO in
> April of 2000. He told me, "You have every symptom in the book, it's a
> shame you have not been diagnosed years ago."
>
> HISTORY-In years past, I would ask my endo(treating me for
> hypothyroidism since '92) and ob/gyn(since '87) if their could be
> something else wrong, maybe an original "domino" being the cause of my
> symptoms. Both told me on numerous occasions that this was just my
> genetic makeup and nothing else was wrong. Also, after a routine eye
> exam showed borderline pressure levels, further tests showed damaged
> optic nerves(the optomotrist suspected the Dexamethasone that the
> earlier dr.s had prescribed for me for 5 years before the PCO
> diagnosis,as the cause. My eyes continue to show damaged optic nerves
> and my pressure flucuates, but the condition has not worsened much. That
> diagnosis is Glucoma suspect)
>
> CURRENT MEDICATIONS-My current dr. is treating the PCO with
> spironlactone, glucophage, and orth-cyclen. The glucophage Rx is new,
> starting this June.
> I also take synthroid for the hypothroidism.(dosages in first letter)
>
> PATIENT HISTORY-I am 37 years old and have been married for 18 years. I
> have 2 daughters(10 and 12)and do not wish to have any more children. My
> mother is NOT PCO.
>
> FERTILITY HISTORY-After a miscarriage and 3 years of trying to conceive,
> I used birth control pills to successfully get pregnant(2 times) by
> regulating myself for many months and trying to conceive in the first
> month after going off of them instead waiting the reccommended 3
> months(at that time).
>
> SYMPTOMS-Some of my symptoms are irregular periods all my life, scant as
> teen and into my 20's, and heavy and very long after my 2nd child in
> '90. My periods would be 6 weeks long with some light days and some
> very heavy days, but never stopping during that 6 weeks. This continued
> for 2 years. I had an inter-utrine biopsy, and cervical biopsy(years
> apart) and they turned out ok. I was put on bcp's to regulate my
> periods. My body responds well to the ortho-cyclen. OTHER SYMPTOMS
> include: excessive body hair, acne(very painful-under arms- kept 15-20
> at all times before med.s- rarely since meds.), skin tags, elevated
> hormones(testostrone,and others) overweight(excessively around my
> middle), ovarian cysts(over a dozen cysts from ultrasound), mood swings,
> nervousness, anxiety.
>
> My.Dr. say my elavated cholestrol is related to PCO because of insulin
> issues.
> I have NEVER tested postive for diabetes, but it runs in my family.
> Since I wrote you, I went back down to 1 dose of glucophage(1000 a day)
> for another week to give my body a chance to adjust. I am on the 2nd
> day of moving back up to 2 doses, and so far so good. I hope it stays
> this way. My dr. had instructed my to take the glucophage for 1 week
> at a 1000 and to go to 2000 starting the 2nd week. (My pharmasist
> advised me to try the extra week)
>
> I apoligize for the length of this message, I hope I answered your
> questions effectively.
>
> I look forward to your reply,
> Thanks again for your time,
> SandyB.
>
> P.S. Please respond also about my daughter mentioned in first letter.
> :)Thanks!
>
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