Footsteps to fertility foundation

PCOS Care with Footsteps To Fertility Centre

Polycystic ovary syndrome (PCOS) is the most common reproductive disorder in women of childbearing age.

It is a result of ovarian dysfunction that manifests with irregular periods or no periods (irregular ovulation or no ovulation) and varying degrees of increased androgen effects (i.e. high testosterone or increased hair growth and/or acne) as well as polycystic appearing ovaries (multiple small follicles in the ovaries).

 

PCOS is a result of ovarian dysfunction that manifests with irregular periods or no periods (irregular ovulation or no ovulation) and varying degrees of increased androgen effects (i.e. high testosterone or increased hair growth and/or acne) as well as polycystic appearing ovaries (multiple small follicles in the ovaries).

At Footsteps To Fertility Centre , we provide support to women diagnosed with PCOS to help them overcome the syndrome and decrease the impact of its associated health problems.

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How is PCOS diagnosed?

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PCOS is diagnosed by the inclusion of any two of the parameters above, along with exclusion of other diseases that would present with similar findings.

There is no single test or symptom that would indicate that a person has the disease, but the diagnosis of PCOS is made by a combination of symptoms and blood testing.

It can be associated with other diseases, such as thyroid disease and elevated prolactin hormone levels (the hormone that makes the breast milk). Women should be tested for the presence of these disorders if they have PCOS type symptoms.

Additionally, PCOS patients are at an increased risk for pre-diabetic conditions that can be diagnosed by an elevated insulin level and/or elevated glucose level (glucose intolerance) or even may have diabetes at the time of the diagnosis of this condition.

It is therefore very important to screen patients for diabetes at the time of diagnosis of PCOS. Patients who are overweight or obese are at a higher risk for having or developing diabetes in the future.

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PCOS Treatment

If the initial work up is diagnostic of PCOS and other diseases are all eliminated by testing, the treatment options are discussed.

Our goal is to provide individualized and effective care, diagnosis and treatment for all women with polycystic ovarian syndrome.

PCOS and Menstruation

Lack of ovulation can lead to an abnormal overgrowth of the uterine lining (endometrial hyperplasia), which increases the risk of uterine cancer.

Menstrual abnormalities can be treated with medications that might include oral contraceptives to regulate the menstrual cycle.

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PCOS and Hormones

The goal of PCOS treatment is to decrease the amount of androgens in the bloodstream, thereby decreasing the clinical effects of androgens on the body such as facial hair growth and acne. The most common treatment is low-dose oral contraceptives. Oral contraceptives decrease androgens in a variety of ways.

For PCOS and facial hair, it is recommended to combine medical treatment with mechanical hair removal methods such as electrolysis, waxing, or laser hair removal.

PCOS and Insulin Resistance

Insulin resistance and hyperinsulinemia (elevated blood insulin levels) are common in women with PCOS.

These metabolic abnormalities can lead to impaired glucose tolerance and Type 2 diabetes mellitus. Some women achieve positive results by going on the type of diet used for diabetes prevention.

Metformin, an insulin-sensitizing medication, is used for the treatment of patients with PCOS. The goals of treatment include improving insulin resistance and lowering insulin levels. An improvement in ovulatory function can also be obtained.

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PCOS and Fertility

Women with PCOS are either oligo ovulatory or anovulatory, meaning that they ovulate less often than normal or not at all. If ovulation does not take place, there is no opportunity for egg-sperm interaction and pregnancy to occur. The goal of treatment for infertility in PCOS is to cause ovulation to occur predictably.

If ovulation or pregnancy is not attained with these more conservative treatments, they can be combined with gonadotropin therapy (FSH or human menopausal gonadotropin – HMG – injections. However, gonadotropin therapy may include side effects such as increased multiple pregnancy rates and ovarian hyperstimulation syndrome (OHSS).

Surgical treatment of PCOS

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Surgical treatment of PCOS involves destruction of some of the ovarian tissue (laparoscopic ovarian stromal cauterization) to allow ovulation and regular menstrual cycles.

This type of treatment is no longer preferred because of the high success rate with the medical approach.

In some cases, surgical approach can be useful, but this type of treatment should be individualized.

Surgical treatment does not improve metabolic parameters (such as elevated insulin or glucose levels) and also does not decrease the risk of diabetes.

Weight loss and exercise should be routinely recommended to patients with PCOS because most patients tend to be overweight or obese.

Weight loss of 10-15% of the body weight is sufficient enough to allow ovulation in most cases.

Additionally, the risk of developing diabetes, high cholesterol and heart disease also significantly decreases with weight loss and establishment of normal weight.

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