Polycystic Ovarian Syndrome (PCOS)
What is it? and How is it treated?
Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder of reproductive aged women that can present with a wide variety of overlapping symptoms. For some, PCOS presents as: irregular periods and infertility, others experience weight gain and hair loss, still others suffer with body hair growth, acne and insulin resistance. The truth is that many combinations of all these symptoms, are associated with PCOS and close to 6,000,000 women in the US between the ages of 18 and 44 deal with them daily.
PCOS is different than many other disorders because there is no single test to establish its diagnosis. Instead, there are some specific clinical and laboratory criteria required to make the diagnosis. The most widely accepted method to diagnose PCOS is as follows:
A woman must demonstrate at least 2 of the 3 following symptoms
- -Irregular menstrual periods
- -Polycystic appearing ovaries on ultrasound
- -Elevated androgen levels (blood tests or evidence of extra body hair growth)
How is PCOS diagnosed at Los Angeles Reproductive Center?
At the Los Angeles Reproductive Center (LARC), PCOS is addressed in an organized and stepwise manner. First, patients sit for a consultation with either Dr. Kalan or Winkler to review their medical history including information about their menstrual history, familial patterns, medication and supplement use, reproductive history and more. Next, the doctors perform a thorough physical evaluation to asses height, weight, fat distribution, hair pattern, skin pigmentation thyroid size and more. Additionally, a pelvic examination with ultrasound is used evaluate the uterus and ovaries. Because several different pathologies can mimic the symptoms of PCOS, several entities must be excluded before a diagnosis of PCOS can be made. Some of these other diagnoses include:
- Thyroid disorders
- Pituitary tumors
- Ovarian tumors
- Genetic conditions
- Hypothalamic amenorrhea
- Congenital adrenal hyperplasia (CAH)
- Excessive adrenal gland hormone production
Treatment of PCOS at the Los Angeles Reproductive Center
For all PCOS patients experiencing care at LARC, education, diet, exercise and lifestyle modification, form the foundation from which treatment begins. This includes education about the syndrome, caloric intake, and overall healthy eating. Further, consultation with a dietician and or physical trainer/therapist familiar with PCOS can be arranged.
Next, treatment plans depend on each patient’s desires. For those who are interested in conception, ovulation induction with an oral medication such as clomiphene citrate or an aromatase inhibitor may be appropriate. For patients who do not respond to the oral ovulation induction agents, gonadotropins and IVF (in vitro fertilization) are reasonable steps with great success rates.
For patients who are looking to control their cycles and but do not want to conceive, oral contraceptive pills, androgen blockers or a hormone releasing IUD may be the answer.
Some patients are concerned about diabetes risk and thus glucose controlling medication such as metformin can play a role (in addition to standard diet and lifestyle modifications).
Still other patients who want to control hair growth may be interested in antiandrogen treatments like spironolactone and/or can be referred to an expert in hair removal such as electrolysis or laser hair removal.
Importantly, the doctors and staff at Los Angeles Reproductive Center understand that each patient with PCOS has her own specific challenges and desires. At LARC, we have the experience and expertise to address each of those challenges and desires to ultimately help our patients overcome PCOS. We enjoy partnering with our patients to achieve their goals. Whether it is PCOS, infertility, fertility preservation or a combination of them all, we are here for you!! If you have questions about PCOS or other reproductive topics, feel free to contact us, we are happy to chat with you.