Polycystic Ovary Syndrome: Symptoms, Treatments, and Concerns

Polycystic Ovary Syndrome (PCOS)

Hello Dr.
Huang: I am currently living in the United States, so I am unable to access sufficient medical resources.
I would like to ask you about my situation.
During this summer vacation, when I returned to Taiwan, I had examinations at Taipei Veterans General Hospital and Taipei Medical University Hospital because I have been almost amenorrheic for over two years.
After various examinations in Taiwan, I was diagnosed with polycystic ovary syndrome (PCOS).
Previously, I had received progesterone injections at Longtan 804 Hospital to induce menstruation, and my period returned normally twice.
Later, Dr.
Wei Xiaorui at Taipei Medical University Hospital prescribed metformin to improve my insulin resistance.
Dr.
Wei also warned me that the initial side effects of the medication could include dizziness and diarrhea.
However, I have been taking this medication for nearly two months, and I am wondering why my diarrhea has not improved.
Subsequently, I purchased other brands of metformin or glucophage at the pharmacy to replace the one prescribed by the hospital because the doctor mentioned that it would take more than 3 to 6 months to see results.
Therefore, I sometimes alternate between the two brands of metformin from the hospital.
Additionally, since I stopped taking the ovulation medication and switched to metformin, my period has been delayed for quite some time.
Could it be that the medication, Roche's Ovidrel, which was prescribed by the doctor at the Veterans General Hospital, caused side effects? However, I only took Roche's Ovidrel for a little over a week.
Could you please help me determine whether this is a normal side effect or if other medications, such as Roche's Ovidrel, have affected my gastrointestinal function? Also, if I have not been diagnosed with diabetes, would taking metformin be counterproductive? I am concerned because a mosquito bite wound from last week has been slow to heal, and I am worried it might be a sign of prediabetes.
Please respond quickly.
Thank you.

Julie, 10~19 year old female. Ask Date: 2005/09/18

Dr. Huang Jianxun reply Obstetrics and Gynecology

I don't quite understand why you would take metformin if you haven't been diagnosed with diabetes.
If it's for weight loss, but you are concerned about side effects, please consult closely with your physician.

Reply Date: 2005/09/18

More Info

Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder that affects many women of reproductive age. It is characterized by a combination of symptoms, including irregular menstrual cycles, excess androgen levels (which can lead to symptoms such as acne and hirsutism), and polycystic ovaries as seen on ultrasound. Understanding the symptoms, treatments, and concerns associated with PCOS is crucial for effective management.

Symptoms of PCOS
1. Irregular Menstrual Cycles: Women with PCOS often experience infrequent or prolonged menstrual periods. Some may have amenorrhea (absence of menstruation) for extended periods, as you mentioned in your case.

2. Excess Androgens: Elevated levels of male hormones can lead to physical signs such as hirsutism (excessive hair growth in areas where men typically grow hair), acne, and oily skin.

3. Polycystic Ovaries: On ultrasound, the ovaries may appear enlarged and contain numerous small cysts, which are immature follicles that have not developed properly.

4. Weight Gain: Many women with PCOS struggle with weight gain or obesity, which can exacerbate other symptoms.

5. Insulin Resistance: Many women with PCOS have insulin resistance, which can lead to higher insulin levels and may increase the risk of developing type 2 diabetes.

Treatments for PCOS
1. Lifestyle Modifications: Weight loss through diet and exercise can significantly improve symptoms and restore regular menstrual cycles. Even a modest weight loss of 5-10% can have a positive impact.

2. Medications:
- Metformin: This medication is often prescribed to improve insulin sensitivity and can help regulate menstrual cycles. It is commonly used in women with PCOS, even those who are not diabetic. Side effects can include gastrointestinal issues, which may improve over time.

- Hormonal Contraceptives: Birth control pills can help regulate menstrual cycles, reduce androgen levels, and improve symptoms like acne and hirsutism.

- Ovulation Induction Agents: If pregnancy is desired, medications like Clomiphene citrate (Clomid) can be used to stimulate ovulation.

3. Monitoring and Follow-Up: Regular follow-ups with your healthcare provider are essential to monitor symptoms and adjust treatment as necessary.

Concerns and Considerations
1. Side Effects of Medications: It’s important to note that switching between different brands of metformin may not significantly change the side effects experienced. If gastrointestinal issues persist, it may be worth discussing with your healthcare provider whether to adjust the dosage or consider alternative medications.

2. Impact on Menstrual Cycles: After switching from ovulation induction medications to metformin, it is not uncommon for menstrual cycles to be irregular initially. It may take time for your body to adjust to the new medication.

3. Diabetes Risk: Metformin is generally safe for women without a diabetes diagnosis, especially if they have insulin resistance. However, if you have concerns about symptoms like slow-healing wounds, it is crucial to discuss these with your healthcare provider, as they may warrant further investigation for diabetes or other conditions.

4. Long-Term Health: Women with PCOS are at a higher risk for developing type 2 diabetes, cardiovascular disease, and endometrial cancer. Regular monitoring of blood sugar levels, lipid profiles, and overall health is recommended.

Conclusion
Managing PCOS requires a comprehensive approach that includes lifestyle changes, medication, and regular monitoring. It’s essential to maintain open communication with your healthcare provider to address any concerns and adjust treatment plans as necessary. If you experience persistent side effects or have new symptoms, do not hesitate to seek medical advice. Your health and well-being are paramount, and effective management of PCOS can lead to improved quality of life and reproductive health.

Similar Q&A

Understanding Polycystic Ovary Syndrome: Symptoms, Diagnosis, and Treatment Options

Hello Dr. Lu, I seem to have Polycystic Ovary Syndrome (PCOS) with the following symptoms: 1. My menstrual cycle occurs every month, but the flow has been decreasing, lasting about 5-7 days. 2. I have an overweight body type, along with excessive body hair. 3. I was previously t...

Dr. Lü Lizheng reply Obstetrics and Gynecology
1. If blood tests are required, you need to come to the hospital on days three to five of your menstrual cycle. 2. Treatment is still possible; weight loss is an effective treatment. There are many other pharmacological treatment options available, please consult a gynecologist...

Understanding Polycystic Ovary Syndrome: Symptoms, Fertility Impact, and Treatment

Hello, I experience severe swelling in my lower body and breasts during my menstrual period, and my cycles are irregular, occurring approximately every 30-45 days. I strictly control my diet, but my weight continues to increase. After consulting with a physician, I was informed t...

Dr. Zhan Deqin reply Obstetrics and Gynecology
1. Polycystic ovary syndrome (PCOS) can sometimes lead to menstrual irregularities, anovulation, or may affect fertility, but many individuals exhibit no obvious symptoms and are only diagnosed during ultrasound examinations or blood tests. 2. Ovulation can be induced, or laparos...

Understanding Polycystic Ovary Syndrome: Causes, Symptoms, and Treatments

What is polycystic ovary syndrome?

Dr. Mao Yikun reply Obstetrics and Gynecology
Polycystic ovary syndrome (PCOS) is simply described as chronic anovulation and hyperandrogenism, first proposed by Stein and Leventhal in 1935. It is a syndrome characterized by irregular menstruation, hirsutism, infertility, and obesity, accompanied by enlarged and cystic ovari...

Understanding Polycystic Ovary Syndrome: Symptoms and Diagnosis Insights

Hello Doctor, my parents have been urging me to see a metabolic specialist to check for any issues, as they believe I have gained too much weight. I have been married for a year and seven months, and I gained about 8-10 kg within three months after marriage, with gradual increase...

Dr. Huang Jianzhong reply Obstetrics and Gynecology
Q: Am I at a high risk for polycystic ovary syndrome? A: This is a significant question. Prepare the relevant information and visit a medical center to schedule an appointment with the obstetrics and gynecology department for infertility consultation.