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Frequently Asked Questions – Polycystic Ovariest
An estimated 5 to 10% of women in the UK are thought to have polycystic ovaries. With this condition, you have multiple fluid-filled sacs on your ovaries. These cysts occur when the developing egg follicles don't release an egg and instead form swollen chambers on your ovaries. Having polycystic ovaries can affect your menstrual cycle, fertility and your health, so it is important you get prompt diagnosis and treatment.
What Causes Polycystic Ovaries?
Although further research is needed before its exact cause is understood, certain factors seem to play a role. Firstly, the condition sometimes runs in families. Secondly, if your body struggles to control your blood sugars due to insulin resistance, high levels of insulin trigger your ovaries to release extra testosterone, which explains some symptoms associated with polycystic ovaries and is why ovulation sometimes stops. Finally, if you are overweight, having extra body fat increases insulin resistance and makes the symptoms of the condition worse.
What Are the Symptoms of Polycystic Ovaries?
Symptoms usually start in your teens or early twenties and include the following:
Irregular periods or no periods at all
Hair growth on your face and stomach, while the hair on your head may thin
What Are the Complications of Polycystic Ovaries?
Not only does it affect your fertility, but having polycystic ovaries increases your risk of type 2 diabetes and heart disease. As a result, you should go for regular check-ups with your doctor to screen for these conditions. Additionally, if you have two periods or less each year, you are also more likely to develop cancer of the womb.
How Are Polycystic Ovaries Diagnosed?
Your symptoms are the first indicator that you may have polycystic ovaries, but even if you have the characteristic signs, blood tests and an ultrasound scan are still necessary to confirm your diagnosis. Your blood is usually tested for levels of testosterone, though other blood tests can also exclude conditions such as thyroid dysfunction and Cushing's syndrome that may share some of the same symptoms. Testing your blood glucose and lipid levels is also useful, as it helps to identify insulin resistance and raised blood fats early on. When it comes to an ultrasound scan, this looks for the presence of cysts on your ovaries.
Currently, to receive a diagnosis of polycystic ovaries, two out of the following must apply:
You have at least 12 cysts on your ovaries or enlarged ovaries
You have irregular or absent periods
Your symptoms or blood results suggest increased levels of male sex hormones.
How Are Polycystic Ovaries Treated?
While medications are available to help manage the symptoms of polycystic ovaries, lifestyle changes also have an important part to play in its management. For example, if you are overweight, losing weight reduces insulin resistance and will improve your symptoms and fertility.
Exercise not only aids weight loss, but it too can help to manage insulin resistance. Even if you are a healthy body weight, eating a well- balanced diet based on low glycaemic index carbohydrates may help to control insulin resistance.
For help with removing excess facial and body hair, bleaching, hair removal creams, waxing and shaving are all short-term options, though electrolysis and laser therapy offer results that will last in the longer term.
In terms of the medications available to treat polycystic ovaries, the following are all options, depending on your circumstances:
Although acne treatments containing benzoyl peroxide are available over-the-counter, if these don't improve your spots, stronger medications and creams are available on prescription.
Taking combined oral contraceptives, such as Dianette, prevents your ovaries from releasing excess testosterone, which can help to improve skin problems and excess hair.
Metformin tablets make your cells more sensitive to insulin, helping to reduce insulin resistance. As a result, your body releases less insulin, reducing testosterone production by your ovaries, so your symptoms and fertility improve.
If you are trying to conceive with polycystic ovaries, clomifene stimulates ovulation and improves your chance of pregnancy, though this drug is usually prescribed for only 6 months. You should be aware when taking it, though, that there is an increased likelihood of conceiving twins. If this fertility treatment fails, intrauterine insemination, hormone therapy, egg donation and IVF are all viable options.
An alternative option if clomifene doesn't aid conception is to undergo surgery to enhance your fertility. Laparoscopic ovarian drilling is a keyhole procedure designed to remove the ovarian tissue that secretes testosterone. Once your testosterone levels fall, ovulation should occur.