TREATMENT OF PCOS

Just as the symptoms of each woman with PCOS may be different, the treatment of PCOS may vary as well. Treatment at our center is directed at both correcting the basic underlying hormonal and metabolic conditions seen with PCOS as well as at attempting to reverse the physical manifestations of the disorder. We understand how the effects of the hormonal imbalances seen with PCOS may cause physical symptoms of major concern to women with PCOS. Our efforts are aimed at quickly and efficiently diagnosing and correcting these imbalances. Only through such efforts may women expect the findings such as excess hair growth, acne, excess weight gain and irregular menstrual cycles to be resolved.

Treatment Details

  Although there is no cure for PCOS, there are options available which can address the short term and long term problems associated with this syndrome.  This requires a multifaceted approach to treatment, tailored to the clinical scenario.   

During the patient’s initial consultation, the presumptive diagnosis of PCOS and associated problems are discussed.  However, once the diagnosis is confirmed, the patient returns to discuss at length, an individualized and specific approach to treatment that focuses on education, support and a healthy lifestyle. In fact,  the first  thing addressed is a change in lifestyle, since the majority of patients are overweight.  This  includes sound nutritional management, exercise and behavior modification. Patients tend to be anxious about their problems and this is an opportunity for the clinician to reassure them that even small changes (as little as 5-10%) in weight can lead to significant improvement in their psychological, metabolic and reproductive parameters. 

In addition to the approaches we have detailed, there are often a number of  medical and non-medical therapies used to treat the irregular cycles like birth control pills, abnormal hair growth with hormones, creams, laser or cosmetic therapy, infertility with oral or injectible medications as well as intrauterine insemination (IUI) or in-vitro fertilization (IVF).
 

MAKING A DIAGNOSIS

Women at our center are subject, in nearly all instances to a review of any past blood or ultrasound studies they may have had performed. When vital studies such as blood tests looking at the hormones involved in PCOS have not previously been performed, we urge women to have these studies carried out. We maintain an in-house, specialized hormone laboratory and are able to carry out your blood work in our center with results usually available within 24 hours. By studying what PCOS has done to a woman's ovaries and hormones, we can arrive at a plan for the rapid treatment and potential resolution of these disorders.

The basic panel of studies we require include:

Blood tests:

  • Pituitary hormones
    • FSH
    • LH
    • Prolactin
    • TSH (thyroid test)
  • Adrenal hormones
    • DHEA sulfate
    • 17 hydroxyprogesterone
    • Androstenedione
    • Cortisol
  • Ovarian hormones
    • Estradiol
    • Progesterone
    • Testosterone

Additional tests may be ordered depending upon your individual case.

In nearly all instances, we will require either a copy of a prior ultrasound report of your ovaries or we will carry out our own ultrasound using our highly advanced 3-D and 4-D ultrasound machines.

We may also desire to perform a procedure called an endometrial biopsy. Because of the known potentially harmful effects of long standing PCOS on the uterus, as well as the much higher than normal occurence of precancer or cancer of the uterine lining, we are very cautious about assuring that a precancerous condition does not go unrecognized.

TREATMENT OPTIONS

Our Center offers the most advanced PCOS treatment options available. Because we receive dozens of phone calls daily from well read, highly motivated women seeking answers about PCOS, we offer the following list of therapies that we have utilized in the past 12 months to deal with a variety of PCOS related afflictions. This list is not meant to suggest that any particular therapy may be used for you, but is provided to let those that may be interested know that, "YES" we do offer that:

 


  • Hirsutism (excess hair growth):
    • Oral contraceptives
    • Spironolactone
    • Dexamethasone
    • Flutamide
    • Electrolysis
    • Laser
  • Acne
    • Oral contraceptives
    • Dexamethasone
    • Flutamide
    • Dermatologic referral
  • Irregular menses
    • Oral contraceptives
    • Glucophage (insulin sensitizers)
    • Progesterone
    • Aromatase inhibitors
  • Weight gain
    • Dietary management
    • Glucophage
    • Dexamethasone