Check for symptoms:
- Mild obesity
- Elevated insulin levels
- Slight hirsutism
- Difficulty in conceiving
- Symptoms include irregular or no menstrual periods, heavy periods, excess body and facial hair, acne, pelvic pain, trouble getting pregnant, and patches of thick, darker, velvety skin.
Associated conditions include:
Common cause of infertility in 5- 10% women
May lead to endometrial cancer( estrogen excess)
Associated with cardiovascular disorders (diabetes and hypertension) if untreated(androgen excess)
Presence of any two of the following indicates PCOS.POLYCYSTIC OVARY SYNDROME
a) Serum testosterone, follicle stimulating hormone(FSH), prolactin and thyroid stimulating hormone(TSH) levels – elevated testosterone and decreased FSH and increased LH
b) Menstrual irregularity – ovulatory dysfunction
c) Presence of more than 10 follicles per ovary ( detected by pelvic ultrasonography)
Dose and dosage
- Spironolactone – 50 – 75 mg once/day
- Leuprolide acetate 3.75 mg IM once / day
- Topical hair removal agents : Eflornithine
- Topical acne agents : Benzoyl peroxide 2.5 – 5% cream
Tretinoin topical cream (0.02–0.1%),
Clindamycin topical cream 1%
b) Oral contraceptive agents
- Ethinyl estradiol – 0.02 – 0.03mg once/day
- Medroxyprogesterone – 5 to 10 mg once/day for 10 – 14 days every 1 to 2 months
- Ovulation inducer – Clomiphene citrate- 50 mg once/day for 5 consecutive days early in menstrual cycle for 3-6months
- Metformin 500 – 1000 mg, twice / day
- Hormone therapy that has contraceptive effects is not preferred in women who desire pregnancy
Counselling on side effects:
- Oral contraceptives – deep vein thrombosis
- Clomiphene- ovarian hyperstimulation, nausea, abdominal pain, breast tenderness
- Metformin – loss of appetite, vitamin B12 deficiency, increased abdominal gas, monitor blood glucose, periodic kidney and liver function tests
Controlling triggering factors in PCOS:
Counselling on diet, exercise, lifestyle management:
- Weight reduction through diet and regular exercise
- Take diet rich in fruits, vegetables, testosterone reducing foods, Avoid stress.
RECOMMENDED MEAL PLAN FOR PCOS?
Currently there is no scientific evidence to support one particular diet for PCOS. Evidence-based recommendations suggest that women with PCOS should focus on balance and moderation. Recommended lifestyle changes include:
Weight loss of 5-10% if overweight or obese in 3 months.
Decreased caloric intake if weight loss is desired.
Decreased intake of enriched carbohydrates.
Increased fiber intake including fruits, vegetables, and beans.
Decreased fat intake, particularly saturated fat.
Smaller, more frequent meals (every 3-4 hours) to help control blood glucose levels.
Balanced meals including carbohydrates, protein, and fat.
At least 150 minutes of moderate or vigorous activity per week.
Sleep at the same time everyday for hormonal vibrancy