A cream called eflornithine (Vaniqua) may be pre- Surgery:
scribed to rub on affected areas of skin. Some re- Rarely, your doctor may suggest surgery to control search trials suggest that it can reduce unwanted hair PCOS symptoms and improve fertility, for example growth, although this effect quickly wears off after laparoscopic ovarian drilling. This is a type of keyhole procedure used to destroy the testosterone-producing Drugs taken by mouth can also treat hair growth. They tissue on your ovaries. As levels of testosterone fall, work by reducing the amount of testosterone that you your PCOS symptoms improve and ovaries start to re- make, or by blocking its effect. Drugs include: Cyproterone acetate is an antitestosterone drug. This is commonly combined with oestrogen as a special Preventing long-term problems
contraceptive pill called Dianette. Dianette is com- A healthy lifestyle is important to help prevent the pos-sible long term complications of PCOS, for example, Polycystic
monly prescribed to regulate periods, to help reduce hair growth, to reduce acne, and is a good contracep- you should: eat a healthy diet, exercise regularly, lose weight if you are overweight or obese, and not smoke. The combined contraceptive pill Yasmin (a combina- tion of ethinylestradiol and drospirenone) has been shown to help if Dianette is not suitable. Syndrome
Other medications are sometimes advised by a spe- Support organisations:
cialist if the above treatments do not help. PCOSupport Organziation Polycystic Ovarian Syn-drome Association, PO. Box 3403, Englewood CO Drugs taken by mouth to treat hair growth take 3-9 months to work fully. You need then to carry on taking them otherwise hair growth will recur. Removing hair Information for Patients
by the methods above may be advised whilst waiting Polycystic ovary syndrome. NHS National Library for Health Metformin
Clinical Knowledge Summaries, 2007. www.cks.nhs.uk, ac- This medicine increases the sensitivity of muscle cells to insulin (reduces insulin resistance). This means your body needs less insulin to control your blood Long-term consequences of polycystic ovary syndrome sugar levels. Reduced insulin levels in the blood (Green-top 33). London (UK): Royal College of Obstetricians means your ovaries will produce less testosterone. As and Gynaecologists (RCOG), 2003. www.rcog.org.uk, ac-cessed 2 February 2010 the testosterone levels drop symptoms such as excess hair and irregular periods will improve, and Lord JM, Flight IH, Norman RJ; Metformin in polycystic ovary your ovaries will start to release eggs (improve fertil- syndrome: systematic review and meta-analysis. BMJ. 2003 ity). Fertility medicines including clomifene can stimulate CONTACT DETAIL:
your ovaries to release eggs. You can take these for up to a year. If clomifene makes you ovulate but you South Tyneside NHS Foundation Trust,
don't become pregnant after 6-12 months, your doctor might suggest hormone therapy or surgical treatment. Harton Lane,
You can also consider assisted conception, such as IUI (intrauterine insemination) IVF (in vitro fertilisa- South Shields,
Tyne and Wear
South Tyneside Foundation NHS Trust
NE34 0PL.

0191 4041000
Tel 0191 404 1000 (Main Switchboard)
Being overweight or obese is not the underlying cause of PCOS. However, if you are overweight or Irregular or absent periods occur in about 7 obese, excess fat can make insulin resistance worse. Polycystic ovary syndrome (PCOS) is one of the High levels of insulin can contribute to further weight most common female endocrine disorders affecting Excessive hair (hirsutism) particularly on the gain producing a 'vicious cycle'. Losing weight, al- though difficult, can help break this cycle. The term polycystic ovaries describes ovaries that Thinning of scalp hair or male-pattern bald- Are any tests needed?
These cysts are egg-containing follicles that have not Tests may be advised to clarify the diagnosis, and to developed properly due to a number of hormonal Difficulty in maintaining a healthy body Blood tests may be taken to measure hormones. . It is estimated that 20 - 30% of women in the UK Fertility problems (difficulty conceiving) An ultrasound scan of the ovaries may be advised. have polycystic ovaries. But only 10 - 15% have An ultrasound scan is a painless test that uses sound Diagnosis
waves to create images of structures in the body. If you are diagnosed with polycystic ovary syndrome PCOS can be diagnosed by any combination of The scan can detect the typical appearance of PCOS (PCOS) it means that your hormones are not in bal- blood test results, an ultrasound scan or from a with the many follicles (small cysts) in slightly ance. The three types of hormones made by your history of symptoms. Sometimes the cysts may not ovaries are the ones most affected. They are called be seen during a scan but a diagnosis can still be Also, you may be advised to have an annual screen- oestrogens, androgens, and progesterone. made using symptoms and blood test results. ing test for diabetes or prediabetes (impaired glucose These hormones affect a lot of things that go on in tolerance). A regular check for other cardiovascular your body, including when you have your period, Causes for PCOS
risk factors such as blood pressure, and blood cho- when your ovaries release eggs, how hair grows on lesterol, may be advised to detect any abnormalities PCOS and insulin resistance
your face and body, and the condition of your skin. Insulin is a hormone made in the pancreas which as early as possible. Exactly when and how often the helps the body use energy from food. Insulin resis- checks are done depends on your age, your weight, Polycystic ovary syndrome (PCOS), formerly known tance occurs when the body does not respond to and other factors. After the age of 40, these tests are as the Stein-Leventhal syndrome, is a condition normal levels of insulin and this results in more where at least two of the following occur, and often insulin production. High levels of insulin encourage the body to store fat which can lead to weight gain. Treatment
At least 12 follicles (tiny cysts) develop in your As weight goes up, insulin resistance increases. The symptoms of PCOS can be controlled using a Insulin also promotes the production of testoster- combination of lifestyle changes, cosmetic measures The balance of hormones that you make in the one in the body. Testosterone is often thought of and medication. Studies show that physical activity ovaries is altered. In particular, your ovaries as a male hormone but women need a small and weight loss are the most effective ways to im- make more testosterone (male hormone) than amount. However, having even slightly higher prove insulin resistance and symptoms. Losing just amounts can upset the balance of hormones in the five to ten per cent of body weight may be all that's You do not ovulate each month. Some women body and lead to acne, excess hair and irregular needed to correct the hormonal imbalance, thus re- periods. Irregular periods may result in infertility. storing ovulation and fertility, and helping improve In PCOS, although the ovaries usually have many Long term health concerns associated with PCOS follicles, they do not develop fully and so ovulation are linked to insulin resistance and include heart often does not occur. If you do not ovulate then you Hair growth is due to the increased level of the hor- mone testosterone . Unwanted hair can be removed Therefore, it is possible to have polycystic ovaries Hereditary factors
by waxing, hair-removing creams, electrolysis, and without the typical symptoms that are in the syn- Your genetic makeup is probably important. PCOS laser treatments. These need repeating every now is not strictly inherited from parents to children, but and then, although electrolysis and laser treatments may be more long-lasting (not normally available on

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