Basic Treatment

Hormonal Imbalances:  Polycystic ovarian syndrome (PCOS)—Diagnosis and Treatment

What is PCOS?

Polycystic ovarian syndrome (PCOS) is common among reproductive-aged women. Women with PCOS experience irregular menstrual periods and frequently have oily skin, acne, and growth of facial hair usually involving the upper lip and chin. About half of women with PCOS are overweight. The ovaries of women with PCOS show multiple, small cysts often 20 or more on an ultrasound. In PCOS, an excess of testosterone affects the ovaries, preventing women from ovulating monthly, and also causes these cosmetic problems. Irregular periods often cause infertility in women with PCOS.

Woman with PCOS may only have a few menstrual periods each year, and therefore may have trouble getting pregnant. In fact, PCOS is the most frequent cause of infertility in reproductive-aged women. Women with PCOS also may be at an increased risk for miscarriage because of hormonal imbalances.

Diagnosis

Physicians diagnose PCOS by the patient's history, and frequently use ultrasound and blood testing to confirm the diagnosis. Women with PCOS often have high insulin levels; while they are not diabetic, high insulin levels can contribute to menstrual irregularities and cosmetic problems.

Treatment

Avandia is no longer used to treat insulin resistance in PCOS patients due to black box warnings by the FDA. Instead we will often add Actos 15 mg twice daily alone, or in combination with Glucophage to ameliorate insulin resistance. It is associated with few side effects but women on this medication should have their liver function tests obtained after 3 months of therapy. Additionally the medication, although not known to cause birth defects, is stopped once the patient finds out she is pregnant.

Learn more about PCOS (PDF File)