Polycystic Ovary Syndrome

Gynaecologist and Obstetrician, Anovulation, Dr JFA Potgieter

Polycystic ovary syndrome (PCOS) is a condition resulting from an imbalance in a woman’s hormones. When the body produces excess levels of androgens, or male hormones, symptoms such as ovarian cysts, irregular periods, acne, and facial hair growth may occur.

A woman with PCOS may also experience insulin resistance, in which the body doesn’t effectively use insulin, a hormone that regulates blood sugar. Left untreated, insulin resistance can put a woman at risk for type 2 diabetes.

PCOS affects several aspects of a woman’s health, including the reproductive system, as well as the skin and hair. As a result, Dr. Potgieter often uses a multidisciplinary approach in managing the disease.

Treatment of PCOS involves lifestyle modifications, such as dietary changes and exercise, as well as medications that address the hormonal imbalance.

Reduce Sugars and Carbohydrates:
Many women with PCOS also have insulin resistance, in which the body doesn’t use the hormone insulin effectively. Insulin, which is produced by the pancreas, enables the body to use glucose, or sugar, from food for energy. It also helps keeps blood sugar levels in check. To lower blood sugar, Dr. Potgieter may recommend a diet low in sugar and other simple carbohydrates.

The ideal diet consists of a variety of foods from various food groups—healthy carbohydrates, such as vegetables and fruits; lean meats, such as poultry; fish; and high fiber grains. Doctors advise focusing on foods that are low in sugar and fat and have a low glycemic index. Low glycemic index foods cause the body to release insulin slowly and steadily, making it easier for your body to use food as energy rather than store it as fat. Foods high in fiber also help control blood sugar levels.

Because carbohydrates are broken down into sugar, it’s helpful to limit the amount you consume. Try to avoid refined carbs, which are found in processed foods, especially white flour, rice, potatoes, and sugar. You should also avoid sugary drinks, including soda and juice.

Manage Weight
Many, but not all, women with PCOS are overweight. Over time, they may become obese. That can lead to many health problems, including infertility, type 2 diabetes, and cardiovascular disease.

Exercise Regularly
Regular exercise has many benefits in treating PCOS. It helps you combat obesity by burning calories and building muscle mass, which decreases insulin resistance. Exercise can also help lower cholesterol levels and those of other hormones, such as testosterone.

Birth Control Pills
Birth control pills, which contain the hormones estrogen and progesterone, can help regulate your menstrual cycle. They may also help mitigate many of the symptoms of excess androgen production, such as acne and unwanted facial and body hair.

Birth control pills that contain a combination of estrogen and progesterone are commonly prescribed and are generally safe for women who do not smoke or have a blood-clotting disorder. The pill does carry a risk of blood clots, especially in smokers. Talk to Dr. Potgieter about whether it’s right for you.

Anti-Androgens
Dr. Potgieter may prescribe anti-androgen medications, such as spironolactone, to block the action of male hormones, or androgens, such as testosterone. Anti-androgen medications may also cause irregular menstrual cycles. If you become pregnant while taking them, they may harm your unborn child, so the medications may be prescribed in combination with birth control pills.

Although rare, some anti-androgen medications have potentially serious side effects, including electrolyte problems, liver disease, or low white blood cell counts, which can increase your risk for infection. Dr. Potgieter may recommend having regular follow-up visits and blood tests to ensure your body is responding to the medication.

Metformin
Many people with PCOS have insulin resistance, which can cause excess androgen production, irregular periods, obesity, and diabetes. Metformin is a type 2 diabetes medication prescribed to treat people with these problems. It belongs to a class of medication known as biguanides, which decrease the liver’s production of glucose and helps the muscles and body use insulin more efficiently.

Metformin is taken by mouth, usually once or twice a day, and works best when used in combination with a healthy diet and exercise. Metformin can help regulate the menstrual cycle and even promote weight loss. A common side effect is upset stomach, but most people can cope with this by gradually increasing the dose and taking metformin with food.