Keith Roach, To Your Health 5:40 p.m. ET March 2, 2017

Dear Dr. Roach: My daughter has just been diagnosed with polycystic ovary syndrome. She is in her mid-20s, exercises regularly and watches what she eats, but still puts on weight. She does not want to go on birth control. Where do we start? I know there is no cure.

B.M.

Dear B.M.: Polycystic ovary syndrome is very prevalent, affecting 6 to 8 percent of women, but it is variable in terms of both the types of symptoms and their severity. The most common symptoms are menstrual irregularities and consequences of high male hormones (such as excess body hair and acne). Being overweight or experiencing weight gain is important, as is the metabolic risk from diabetes and abnormal cholesterol levels. Lesser-known symptoms that are seen regularly in women with PCOS include depression, anxiety and eating disorders. The polycystic appearance of the ovaries themselves is demonstrated in women with PCOS, but also can be seen in normal women and therefore is not needed for diagnosis. Diagnosis is made after a careful history and physical exam, and by laboratory testing ( also necessary to exclude some other causes.)

Treatment of PCOS is intended to reduce symptoms, to reduce the risk of heart disease and diabetes, to manage fertility (including contraception, if needed, and helping women get pregnant, if desired) and to reduce risk of abnormal growth of the lining of the uterus (the endometrium) associated with abnormal hormone levels. The primary treatment is with lifestyle changes, so I agree with getting regular exercise and a prudent diet. If these are inadequate, it is reasonable to consider medication treatment.

For women with symptoms of high androgen (male hormone) levels, birth-control pills are the most prescribed treatment, and your daughters doctors should discuss your daughters concerns about taking them. They provide many benefits in women with PCOS, especially by reducing male hormone effects (acne, excess body hair) and reducing risk of abnormal endometrial growth (and possibly cancer). Of course, they have side effects, including risk of blood clots.

For women who cannot take birth control pills, metformin, which reduces insulin levels, has some benefits. It helps with weight gain and menstrual irregularities, and it probably reduces diabetes risk. It does not help with the body hair.

PCOS is a large topic that I cant cover fully. I recommend starting with the information on the American Congress of Obstetricians and Gynecologists FAQ page at tinyurl.com/z7we7er.

Dear Dr. Roach: My primary-care physician and gynecologist are recommending I take Fosamax. What is the alternative to taking Fosamax?

K.J.

Dear K.J.: If there are no other treatable causes, such as low vitamin D or high parathyroid hormone levels, then I think Fosamax or another bisphosphonate is a good choice. There are others, but Fosamax has been well-studied.

Email questions to ToYourGoodHealth@med.cornell.edu.

Read or Share this story: http://detne.ws/2lEO9qW

Go here to read the rest:
Doc: Pill's hormone regulation benefits women with PCOS - The Detroit News

Comments are closed.