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Pregnancy Bliss | Reproductive Health Answers

 

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Long term issues with polycystic ovaries

 

Most women affected by polycystic ovaries will present seeking help with regard to the early features which tend to be menstrual irregularities, body hair issues, sub-fertility and excessive body weight. However, polycystic ovarian syndrome can and often does cast a shadow on the woman’s long term health. We have already mentioned Type 2 diabetes. In addition to that there is increased risk of:

• Cardiovascular disease: This is partly due to high cholesterol (and other lipids) levels prevalent in this condition
• Increased risk of stroke
• Higher rates of depression
• Increased risk of cancer of the lining of the womb (endometrial cancer)

 

Treatment for Polycystic Ovaries

 

Now that we are clear about the nature of the condition, we know that we cannot talk about cure. There is no cure for polycystic ovaries.  That statement is not a license for despair; far from it. The management strategy for polycystic ovaries is aimed at tackling the presenting features. This therefore has to be tailored to the individual. A woman with menstrual problems will have these dealt with and her treatment will differ from one presenting with inability to conceive.

 

Most issues that occur in polycystic ovaries can be effectively managed.

 

Obesity and Polycystic Ovarian Syndrome:

 

It is estimated that roughly 50% of women affected by polycystic ovaries will have obesity as a clinical feature. There is consensus in that effectively managing obesity is the holy grail of managing polycystic ovaries.

 

However, this is the one problem that tends to pose the greatest challenge both to the woman and her doctors. There is no magic bullet for this. The basics of weight loss apply here just as well. These are a sustained restriction of calorie intake and an equally sustained physical activity program. Successful weight loss in polycystic ovaries tends to pay huge dividends. It can lead to a resolution of many of the vexing features including menstrual irregularities and even sub-fertility via improved ovulation. Professional help in getting the weight down is often required.

 

 

 

 

 

 

 

 

Hirsutism with Polycystic ovarian syndrome

 

Increased body hair and particularly facial hair is a real issue for any woman. Hormone treatment for this tends to have modest results at best and even these take a long time to be manifest. The best results for facial hair are obtained by using laser hair removal. Repeated treatment can achieve permanent results. Frustratingly for many women this treatment beyond their financial means

 

Infertility and Polycystic Ovarian Syndrome

 

As mentioned earlier, for those women with polycystic ovaries who are also clinically obese, achieving body weight reduction back to their ideal normal weight may be sufficient to get them to ovulate regularly, have regular periods and achieve conception.

 

Most women with polycystic ovaries, overweight or otherwise, who are struggling to conceive, do require medical help. There are two broad types of treatment. These are either medical or surgical. Occasionally, it is a combination of the two.

 

Medical treatment consists of ovulation induction medication. Clomiphene citrate (Clomid) is the most popular. This is very effective. However, there is increased risk of multiple pregnancy, usually twins.

 

Surgical treatment consists of laparoscopic ovarian drilling. This, as mentioned is done via keyhole surgery. Tiny holes are drilled in both ovaries and this has been shown to significantly improve ovulation and therefore conception rates among women with polycystic ovaries. Laparoscopic ovarian drilling is almost as good as Clomiphene discussed above. For some selected individuals, it may be better in that it allows for the visual assessment of the pelvis and if other co-existing medical conditions which may confound the picture such as endometriosis are found, they can be dealt with thereby potentially improving the outcome.

 

Points to remember about polycystic ovaries:

v Polycystic Ovarian Syndrome (PCOS) is not an acquired condition and cannot be cured. However, associated problems can be managed effectively.

v Obesity, erratic menstruation, increased body hair, oily skin and fertility problems are the commonest presenting features of polycystic ovaries but they do not all occur in every affected woman.

v Some affected women may experience loss of scalp hair and male-type baldness

v The main underlying hormonal abnormalities are increased androgen activity (masculinising) and insulin resistance.

v Successful weight reduction to normal body mass index in polycystic ovaries can lead to a resolution of most, if not all, of the presenting problems.

v There is increased risk of Type 2 diabetes, cardiovascular disease (including hypertension), stroke and cancer of the lining of the womb later in life.

v Sub-fertility associated with polycystic ovaries is usually effectively overcome using ovulation induction medication such as Clomiphene or surgically via laparoscopic ovarian drilling.

v There is no firm evidence to suggest that Polycystic Ovarian Syndrome is hereditary.

 

 

Last update: June 12, 2011

Many, probably most women affected by Polycystic Ovarian Syndrome will be overweight or obese. Successfully achieving a normal body weight leads to a resolution of most of the problems experienced by these women including erratic periods and sub-fertility.