WOMENS-HEALTH Messages for October, 1998: pcos

pcos

From: amy (anonymous@obgyn.net)
Thu, 8 Oct 1998 13:48:55 -0500 (CDT)

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I am a College of Nursing student from the University of North Dakota. I have some information regarding Polycystic Ovary Syndrome (PCOS).

PCOS as first described by Stein and Leventhal in 1935 included infertility, menstrual disorders, hursitism, and obesity association with enlarged ovaries (Yong et al, 1997). In addition, anovulation,hyperandrogenism, adult onset diabetes and acne are the most commonclinical findings in patients with PCOS (Genazzani, et al, 1997). Women with PCOS are profoundly insulin resistant, and the resultant hyperinsulinemia exacerbates the reproductive abnormalities of the syndrome. Agents that ameliorate insulin resistance and reduce circulating insulin levels could provide a new therapeutic modality for PCOS (Legro, 1998). As of yet, we do not understand why one woman who demonstrates polycystic ovaries on ultrasound has regular menstrual cycles and no signs of excess androgens while another develops PCOS.

Infertility treatments include weight loss diets, ovulation medications, ovarian drilling surgery, and IVF. Other symptoms have been managed by anti-androgen medication (birth control pills, spironolactone, flutamide or finasteride) (Perloe, 1998).

There is increasing evidence that PCOS can be reversed by treatment with medicines used for the treatment of adult onset diabetes, metformin (Glucophage), or troglitazone (Rezulin). These medications have been shown to reverse the endocrine abnormalities seen in PCOS within two to three months (Perloe, 1998).

I have a good friend who suffers from PCOS. I hope this information gives you some ideas on treatment options if you have not already tried these. My good friend says that Glucophage has helped her a lot.

Genazzani, Alessandro D., Genazzani, Andrea R., Gamba, Ombretta, Petraglia, Felice, Volpe, Annibale, Battaglia, Cesare (1997). A long-term treatment with gonadotropin-releasing hormone agonist plus a low-dose oral contraceptive improves the recovery of the ovulatory function in patients with polycystic ovary syndrome. Fertility and Sterility. March; 67(3): 463-468.

Legro, R.S., Finegood, D., Dunaif, A. (1998) A fasting glucose to insulin ratio is a useful measure of insulin sensitivity in women with polycystic ovary syndrome. Journal of Clinical Endrocrinology Metabolism. August; 83(8): 2694-8.

Perloe, Mark M.D. (1998) Treatment of polycystic ovary syndrome with insulin lowering medications. Available at: http://www.ivf.com/pcostreat.html

Yong, E.L., Ng, S.C., Chan, C., Kumar, J., Teo, L.S., Ratnam, S.(1997) Responses of polycystic ovarian syndrome and related variants to low-dose follicle stimulating hormone. Int. Journal of Gynecology and Obstetrics. June 57(3): 305-11.

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