WOMENS-HEALTH Messages for July, 1997: Re: Polycystic Ovaries

Re: Polycystic Ovaries

From: R.Daniel (anonymous@obgyn.net)
Wed, 30 Jul 1997 22:51:24 -0500 (CDT)

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In reply to: JCrosmer: "Polycystic Ovaries"

At Wed, 30 Jul 1997, JCrosmer wrote: >
>I was diagnosed with Polycystic Ovaries 7 years ago and did very well
>with Birth Control pills at first; however, for the past year and a half
>I've tried several different pills and I either get severe migraines or
>gain weight. Recently, my primary care physician took me off birth
>control pills, the only problem is that I don't menstruate when I'm not
>taking birth control pills. Additionally, my mother has been told by an
>Ob/Gyn that if I don't menstruate then I'm at risk for cancer. Is this
>true? Most of the research I've done has not stated this to be true
>information. Thanks!

Your mothers OBGYN is correct. When you have polycystic ovaries (PCO), you produce estrogen and never produce progesterone which matures the lining of the uterus. Prolonged unopposed estrogen stimulation is the cause of endometrial cancer. Taking OCP's (Oral contraceptive pills) provides you with both estrogen and progesterone in a cyclic fashion. This will protect the endometrium as well as causing you to have menstrual flow. It will also assure that you won't have an occasional time when you do ovulate which would put you at risk for pregnancy. If you aren't being exposed to pregnancy or if you wouldn't care if you got pregnant, then provera 10 mg daily for 10 days every monthe will also be protective against endometrial cancer.

If you want to get pregnant, you should be evaluated and probably started on something like clomiphene citrate so that you can ovulate.

The lack of menstuation per se is not bad or harmful. It is the associated prolonged unopposed estrogen stimulation that is bad and can cause cancer. When I was a resident, I reviewed all cases of endometrial cancer in women under age 35 that had been treated at Indiana U. Hospital for the previous 25 years. Every one of them had PCO. Having PCO means that you need periodic exposure to progesterone from one source or another, i.e. pills, natural (as caused by ovulation inducing agents), injection, or whatever form.

I would recommend that you see an ObGyn if your PCP does not understand this problem. Even if your PCP is an ObGyn, then you need to see anothe rObGyn.

-- R.Daniel Braun, MD

"Heisenberg might have slept here" Unknown or Indecisve

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