Polycystic Ovary Syndrome: Symptoms, Treatment, and Fertility

Q: Polycystic Ovary Syndrome: Symptoms, Treatment, and Fertility

Hello： (1) Polycystic ovary syndrome (PCOS) is a condition that can worsen or improve with changes in weight, so it is necessary to visit a hospital for further diagnosis to determine if PCOS is still present. <br>(2) If PCOS is confirmed to be present, weight management (if BMI

Polycystic Ovary Syndrome (PCOS)

Hello, doctor; I am 160 cm tall and weigh 68 kg.
I have been exercising regularly for about 3 to 4 hours a week for the past 8 years, doing jogging and yoga.
I do not have symptoms of acne or hirsutism, but I do experience hair loss.
I had my first menstrual period at age 11, and before I turned 16, my cycles averaged every 3 to 4 months.
Later, I was diagnosed with polycystic ovary syndrome (PCOS).
I took Mercilon tablets, but my periods stopped as soon as I discontinued the medication.
Between the ages of 14 and 16, I also took Traceton F.C.
tablets for migraine issues, and my weight peaked at 78 kg.
I exercised for 2 hours daily and spent 3 years reducing my weight to 65-68 kg.
After turning 18, due to financial issues at home, I stopped seeing a doctor.
Since then, I have had my period once or twice a year on average.
At 22, I started taking traditional Chinese medicine to regulate my body, and after a month, I experienced heavy bleeding.
The doctor helped me remove blood clots and prescribed hemostatic medication, and it took a week for the bleeding to stop.
I continued to have follow-ups from ages 24 to 26, and after 26, I took Mercilon tablets continuously for over two years, but my periods still ceased when I stopped the medication.
This past April, when I returned to Taiwan for a check-up, the doctor I originally consulted retired due to health issues, and I did not seek another doctor (currently working in Cambodia) and have not taken any medication.
I initially planned to try inositol, but due to local conditions, I could only buy Nature Made Super B-Complex, taking one tablet a day.
Since June of this year, I have been having regular menstrual periods.
Is this normal? Will my weight decrease? I had already given up on weight loss (I used to eat low oil, low salt, and low sugar, controlling my diet to one bowl of rice plus a lot of vegetables and fruits for 10 years.
After working in Cambodia, I abandoned all of that, but my weight remains the same as it was in Taiwan; it hasn't changed at all.
I have maintained a stable weight for about 15 years).
Given that I have taken medication for so long, is there still a possibility of natural conception?

Niming, 30~39 year old female. Ask Date: 2018/08/15

Dr. Lin Manying reply Obstetrics and Gynecology

Hello: (1) Polycystic ovary syndrome (PCOS) is a condition that can worsen or improve with changes in weight, so it is necessary to visit a hospital for further diagnosis to determine if PCOS is still present.
(2) If PCOS is confirmed to be present, weight management (if BMI > 27) and medication treatment remain the best approaches.
(3) With appropriate treatment for PCOS, there is still a chance for natural conception.
The Hualien Hospital of the Ministry of Health and Welfare cares about your health.

Reply Date: 2018/08/15

More Info

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age. It is characterized by a combination of symptoms that can include irregular menstrual cycles, excess androgen levels, and polycystic ovaries. Understanding the causes, symptoms, and treatment options for PCOS is crucial for managing the condition and improving fertility outcomes.

Causes of PCOS
The exact cause of PCOS is not fully understood, but it is believed to involve a combination of genetic, hormonal, and environmental factors. Women with PCOS often have insulin resistance, which means their bodies do not respond effectively to insulin. This can lead to higher insulin levels, which may increase androgen production in the ovaries. Elevated androgen levels can disrupt the normal ovulation process, leading to irregular menstrual cycles and other symptoms.

Symptoms of PCOS
Symptoms of PCOS can vary widely among individuals, but common signs include:
1. Irregular Menstrual Cycles: Women with PCOS may experience infrequent or prolonged menstrual periods, or they may skip periods altogether.

2. Excess Androgen Levels: This can manifest as hirsutism (excess hair growth in areas where men typically grow hair), acne, and thinning hair on the scalp.

3. Polycystic Ovaries: On ultrasound, the ovaries may appear enlarged and contain multiple small cysts.

4. Weight Gain: Many women with PCOS struggle with weight management, and obesity can exacerbate symptoms.

5. Skin Issues: Some women may experience oily skin, acne, or dark patches of skin (acanthosis nigricans).

Treatment Options
While there is currently no cure for PCOS, various treatment options can help manage symptoms and improve quality of life:
1. Lifestyle Modifications: Weight loss through diet and exercise can significantly improve insulin sensitivity and hormonal balance. Regular physical activity and a balanced diet rich in whole foods can help manage weight and reduce symptoms.

2. Medications: Hormonal contraceptives, such as birth control pills, can help regulate menstrual cycles and reduce androgen levels. Other medications, like metformin, can improve insulin sensitivity and may help with weight management.

3. Fertility Treatments: For women trying to conceive, medications like clomiphene citrate or letrozole can induce ovulation. In some cases, assisted reproductive technologies (ART) may be recommended.

4. Anti-androgen Medications: Drugs such as spironolactone can help reduce hirsutism and acne by blocking the effects of androgens.

5. Surgery: In some cases, laparoscopic ovarian drilling may be performed to induce ovulation.

Fertility and PCOS
Women with PCOS can still conceive, although they may face challenges due to irregular ovulation. It is essential to work closely with a healthcare provider to monitor ovulation and explore fertility options. Regular check-ups, blood tests, and ultrasounds can help assess hormone levels and ovarian function.

Your Situation
In your case, it appears that you have been managing your PCOS symptoms with a combination of medications and lifestyle changes. The fact that you have experienced regular menstrual cycles since June is a positive sign. It is essential to maintain a healthy lifestyle, as this can influence your hormonal balance and overall well-being.

Regarding weight management, it is possible to lose weight with continued effort, even if you have faced challenges in the past. A balanced diet and regular exercise are key components. If you have concerns about your weight or menstrual cycles, consider consulting with a healthcare provider who can provide personalized guidance.

As for the possibility of natural conception, many women with PCOS can conceive without medical intervention, especially if they are able to regulate their menstrual cycles and ovulation. However, it is advisable to discuss your specific situation with a healthcare professional who can assess your individual health status and provide tailored recommendations.

In summary, while PCOS can present challenges, effective management strategies are available. With the right support and treatment, many women with PCOS can achieve their reproductive goals and maintain a healthy lifestyle.

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