Managing PCOS: Insights on Irregular Periods and Hair Loss

Q: Managing PCOS: Insights on Irregular Periods and Hair Loss

Hello Xiao Ling： 1. <br>The symptoms resemble polycystic ovary syndrome, and it seems that soy isoflavones have not been helpful. <br>If there is adenomyosis, fibroids, or endometrial abnormalities, they are usually not recommended. <br>2. <br>Treatment is typically tailored to t

Polycystic Ovary Syndrome (PCOS)

I am 23 years old, and for the past two to three years, my weight and fasting blood sugar levels have been normal.
However, in 2018, my weight (162 cm, 78 kg) and fasting blood sugar (133) were both elevated, and I also had acanthosis nigricans on my skin.
Since then, my menstrual cycle has been irregular, and I have experienced significant hair loss.
In March of last year, I had sharp pain in my lower abdomen, and an ultrasound revealed that both ovaries had polycystic ovaries, along with mild adenomyosis.
Blood tests for CA-125, E2, FSH, and LH showed no abnormalities.
I started taking Yaz birth control pills for six months, during which the pain decreased, my menstrual cycle became regular, and hair loss reduced.
After stopping for one month, I resumed taking Yaz until May of this year, but hair loss increased again.
In June, when my period was delayed, I started taking progesterone, and after a week without menstruation, I began taking estrogen and progesterone until July, and I have now stopped all medications.

I would like to ask:
1.
Will taking soy isoflavone capsules (60 mg of daidzein per day) help with my irregular menstruation and hair loss? Could it potentially worsen my adenomyosis or cause other harm (I am certain I am not pregnant)?
2.
Should I continue taking Yaz birth control pills (I currently have no plans for pregnancy)? If so, for how long should I continue? If I take them intermittently for a long time, could this suppress ovarian function?
3.
Would you recommend further testing for androgens, glycosylated hemoglobin, or other parameters?

Xiao Ling, 20~29 year old female. Ask Date: 2023/08/11

Dr. Lin Xinwang reply Obstetrics and Gynecology

Hello Xiao Ling: 1.
The symptoms resemble polycystic ovary syndrome, and it seems that soy isoflavones have not been helpful.
If there is adenomyosis, fibroids, or endometrial abnormalities, they are usually not recommended.
2.
Treatment is typically tailored to the patient's needs; if menstrual regulation is desired, low-dose contraceptive pills are recommended.
3.
Androgens are usually associated with elevated glycosylated hemoglobin.
If there are issues with high blood sugar or metabolic syndrome, it is advisable to get checked.
Additionally, dietary control and weight management are also important topics.

Reply Date: 2023/08/11

More Info

Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder that affects many women of reproductive age. Your symptoms, including irregular periods, hair loss, and the presence of polycystic ovaries, are common manifestations of this condition. Let’s address your questions one by one.

1. Soy Isoflavones and Their Effects: Soy isoflavones, such as those found in the supplement you mentioned, are phytoestrogens that can mimic estrogen in the body. Some studies suggest that they may help regulate menstrual cycles and improve symptoms related to hormonal imbalances. However, the evidence is not definitive, especially regarding their impact on endometriosis (which is what you referred to as "子宮肌腺症"). While soy isoflavones may not directly exacerbate endometriosis, their effects can vary from person to person. It’s essential to consult with your healthcare provider before starting any new supplement, especially since you have a history of hormonal issues.

2. Continuation of Birth Control Pills: Birth control pills, like the one you were taking (悅姿), are often prescribed to manage PCOS symptoms, including irregular periods and hair loss. They can help regulate your menstrual cycle and reduce androgen levels, which may alleviate hair loss. If you are not planning to conceive, continuing the pill can be beneficial. The duration of use can vary; some women take them continuously for years, while others may take breaks. It’s crucial to have regular follow-ups with your healthcare provider to monitor your condition and adjust your treatment plan as necessary. Long-term use of birth control pills does not typically suppress ovarian function permanently, but it can lead to a temporary delay in the return of regular ovulation after stopping.

3. Further Testing for Hormonal Levels: Given your symptoms and history, it may be beneficial to check your androgen levels (such as testosterone and DHEA-S) and glycosylated hemoglobin (HbA1c) to assess your insulin sensitivity. Elevated androgen levels can contribute to symptoms like hair loss and irregular periods, while HbA1c can help evaluate your blood sugar control over time. These tests can provide a more comprehensive understanding of your hormonal balance and metabolic health, which is crucial in managing PCOS effectively.

In addition to these considerations, lifestyle modifications can significantly impact PCOS management. Regular exercise, a balanced diet low in refined carbohydrates, and weight management can help improve insulin sensitivity and regulate menstrual cycles. Some women find that incorporating a diet rich in whole foods, lean proteins, healthy fats, and plenty of fruits and vegetables can help manage their symptoms.

Lastly, it’s essential to maintain open communication with your healthcare provider. They can help tailor a treatment plan that suits your specific needs and monitor your progress over time. PCOS is a manageable condition, and with the right approach, you can effectively address your symptoms and improve your overall health.

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