Polycystic Ovary Syndrome: Symptoms, Diagnosis, and Treatment Options

Polycystic Ovary Syndrome (PCOS)

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 told by a gynecologist that I have elevated androgen levels.
If I go to the hospital for a gynecological examination, do I need to have my blood drawn on the third day of my menstrual cycle? If I am diagnosed with this condition, I understand that it cannot be cured, but can medication be prescribed to help manage the androgen levels? I have heard that some people take Diane-35 or diabetes medications.
Are these medications something that must be taken for a lifetime?

PENNY, 30~39 year old female. Ask Date: 2015/08/10

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.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/08/10

More Info

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects women of reproductive age. It is characterized by a combination of symptoms that can vary widely among individuals. Understanding the symptoms, diagnosis, and treatment options for PCOS is crucial for managing the condition effectively.

Symptoms of PCOS
The symptoms of PCOS can include:
1. Irregular Menstrual Cycles: Women with PCOS often experience irregular periods or may have fewer menstrual cycles than normal. Some may have heavy bleeding, while others may have very light periods.

2. Weight Gain: Many women with PCOS are overweight or obese, which can exacerbate other symptoms.

3. Excessive Hair Growth (Hirsutism): Increased levels of male hormones (androgens) can lead to excessive hair growth on the face, chest, and back.

4. Acne and Oily Skin: Hormonal imbalances can also cause skin issues, including acne and oily skin.

5. Thinning Hair: Some women may experience thinning hair or male-pattern baldness.

6. Infertility: PCOS is one of the leading causes of infertility in women due to irregular ovulation.

7. Darkening of the Skin: Some women may develop dark patches of skin, particularly in the neck, groin, and under the breasts.

Diagnosis of PCOS
Diagnosis typically involves a combination of clinical evaluation and laboratory tests. A healthcare provider may perform:
- Medical History and Physical Exam: Discussing symptoms, menstrual history, and family history of PCOS or related conditions.

- Blood Tests: These tests can measure hormone levels, including androgens, and check for insulin resistance or other metabolic issues. It is often recommended to have blood tests done on the third day of your menstrual cycle for more accurate hormone level readings.

- Ultrasound: A pelvic ultrasound can help visualize the ovaries and check for the presence of cysts.

Treatment Options for PCOS
While there is no cure for PCOS, various treatment options can help manage symptoms:
1. Lifestyle Changes: Weight loss through diet and exercise can significantly improve symptoms and restore normal menstrual cycles. Even a modest weight loss of 5-10% can have a positive impact.

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

- Anti-androgens: Medications such as spironolactone can help reduce excessive hair growth and acne.

- Metformin: This medication, commonly used to treat type 2 diabetes, can improve insulin sensitivity and may help with weight loss and menstrual regularity.

3. Fertility Treatments: If pregnancy is desired, treatments such as ovulation induction with medications like clomiphene citrate or letrozole may be recommended.

4. Hair Removal Treatments: For hirsutism, options include laser hair removal, electrolysis, or topical treatments.

Long-term Management
It is important to note that while some treatments may need to be continued long-term, others may be adjusted based on symptom management and individual health goals. For instance, hormonal treatments may be used for as long as needed to manage symptoms effectively. Regular follow-ups with a healthcare provider are essential to monitor the condition and adjust treatment as necessary.

In conclusion, if you suspect you have PCOS, it is advisable to consult with a healthcare provider for a thorough evaluation and personalized treatment plan. They can guide you on the best course of action based on your specific symptoms and health status.

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