Polycystic Ovary Syndrome
Treatment Polycystic ovary syndrome (PCOS) can't be cured, but the symptoms can be managed. Treatment options can vary because someone with PCOS may experience a range of symptoms, or just one. The main treatment options are discussed in more detail below. Lifestyle changes In overweight women, the symptoms and overall risk of developing long-term health problems from PCOS can be greatly improved by losing excess weight. Weight loss of just 5% can lead to a significant improvement in PCOS. You can find out whether you're a healthy weight by calculating your body mass index (BMI), which is a measurement of your weight in relation to your height. A normal BMI is 18.5-24.9. Use the BMI healthy weight calculator to work out whether your BMI is in the healthy range. You can lose weight by exercising regularly and having a healthy, balanced diet. Your diet should include plenty of fruit and vegetables, (at least five portions a day), whole foods (such as wholemeal bread, wholegrain cereals and brown rice), lean meats, fish and chicken. Your GP may be able to refer you to a dietitian if you need specific dietary advice. Medications A number of medications are available to treat different symptoms associated with PCOS. These are described below. Irregular or absent periods The contraceptive pill may be recommended to induce regular periods, or periods may be induced using an intermittent course of progestogen tablets (which are usually given every three to four months, but can be given monthly). This will also reduce the long-term risk of developing cancer of the womb lining (endometrial cancer) associated with not having regular periods. Other hormonal methods of contraception, such as an intrauterine (IUS) system, will also reduce this risk by keeping the womb lining thin, bu Continue reading >>
Combination Metformin And Oral Contraception For Polycystic Ovary Syndrome (pcos)
You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Combination Metformin and Oral Contraception for Polycystic Ovary Syndrome (PCOS) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. ClinicalTrials.gov Identifier: NCT00682890 Recruitment Status : Terminated (Lack of recruitment) Information provided by (Responsible Party): Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information The purpose of this research study is to determine if adding Metformin, a drug that reduces insulin resistance, to birth control pills will reduce the risk of developing type 2 diabetes, high blood pressure. high lipid levels and heart disease in women with PCOS Polycystic Ovary Syndrome PCOS Insulin Sensitivity Inclusion criteria: PCOS women between the ages of 18-45,< 8 periods annually, elevated serum free testosterone, normal thyroid function tests and serum prolactin, exclusion of late onset adrenal hyperplasia, acceptable health based on interview and medical history, physical exam and lab tests, ability to comply with the requirements of the study and to provide signed, witnessed informed consent. Combination Metformin and Oral Contraception for Polycystic Ovary Syndrome (PCOS) Placebo tablet and birth control pill daily metformin 2000 mg and birth control pill daily 2000 mg per day for 3 months daily birth control pill Change in Insulin Sensitivity Measures: Insulin Sensitivity Index (ISI) [TimeFrame:baseline and 3 months] Insulin sensitivity as measured by a combination of in Continue reading >>
Metformin Versus Oral Contraceptive Pill In Polycystic Ovary Syndrome: A Cochrane Review
Metformin versus oral contraceptive pill in polycystic ovary syndrome: a Cochrane review Division of Obstetrics and Gynaecology, School of Women's and Children's Health University of New South Wales, Royal Hospital for Women To whom correspondence should be addressed at: Division of Obstetrics and Gynaecology, School of Women's and Children's Health, Level 1 Women's Health Institute, Royal Hospital for Women Locked Bag 2000, Randwick, Sydney, NSW 2031 Division of Obstetrics and Gynaecology, School of Women's and Children's Health University of New South Wales, Royal Hospital for Women Division of Obstetrics and Gynaecology, School of Women's and Children's Health University of New South Wales, Royal Hospital for Women National Women's Department of Obstetrics and Gynaecology Human Reproduction, Volume 22, Issue 5, 1 May 2007, Pages 12001209, Michael F. Costello, Bhushan Shrestha, John Eden, Neil P. Johnson, Peter Sjoblom; Metformin versus oral contraceptive pill in polycystic ovary syndrome: a Cochrane review, Human Reproduction, Volume 22, Issue 5, 1 May 2007, Pages 12001209, The object of this review was to compare metformin versus oral contraceptive pill (OCP) treatment in polycystic ovary syndrome. A systematic review and meta-analysis employing the principles of the Cochrane Menstrual Disorders and Subfertility Group was undertaken. Four randomized controlled trials (RCTs) (104 subjects) were included. Limited data demonstrated no evidence of a difference in effect between metformin and the OCP on hirsutism, acne or development of type 2 diabetes mellitus. There were no trials assessing diagnosis of cardiovascular disease or endometrial cancer. Metformin, in comparison with the OCP, was less effective in improving menstrual pattern [Peto odds ratio (OR) 0.08, 95% Continue reading >>
Metformin Or Oral Contraceptives For Adolescents With Polycystic Ovarian Syndrome: A Meta-analysis
Metformin or Oral Contraceptives for Adolescents With Polycystic Ovarian Syndrome: A Meta-analysis Reem A. Al Khalifah, Ivan D. Florez, Brittany Dennis, Lehana Thabane, Ereny Bassilious BACKGROUND: Polycystic ovarian syndrome (PCOS) is a common disease. There is limited evidence to support various treatment choices. This leads to variable treatment practices. OBJECTIVES: To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the use of metformin versus oral contraceptive pills (OCPs) for the treatment of PCOS in adolescents aged 11 to 19 years. DATA SOURCES: We performed literature searches through Ovid Medline, Ovid Embase, Cochrane Central Register of Controlled Trials, and gray literature resources, up to January 29, 2015. STUDY SELECTION AND DATA EXTRACTION: Two reviewers screened titles and abstracts of identified citations, assessed full text eligibility, and extracted information from eligible trials. RESULTS: Four RCTs met the inclusion and exclusion criteria. The reviewed evidence came from 170 patients. Overall, OCP treatment resulted in modest improvement in menstrual cycle frequency (weighted mean difference [WMD] = 0.27, P < .01, 95% confidence interval [CI] 0.33 to 0.21) and mild reduction of acne scores (WMD = 0.3, P = .02, 95% CI 0.05 to 0.55). While metformin resulted in greater BMI reduction (WMD = 4.02, P < .01, 95% CI 5.23 to 2.81) it was associated with decreased dysglycemia prevalence (risk ratio: 0.41, P = .02, 95% CI 0.19 to 0.86) and improved total cholesterol and low-density lipoprotein levels. Metformin and OCPs were similar in terms of impact on hirsutism. CONCLUSIONS AND LIMITATIONS: Current evidence is derived from very low to low quality evidence. Therefore, treatment choice should be guided by Continue reading >>
Pcos: Insulin And Metformin
Young women with PCOS often have elevated insulin levels and are more likely to develop diabetes. Metformin is a medication often prescribed for women with PCOS to help prevent diabetes. A lifestyle that includes healthy nutrition and daily exercise is the most important part of a PCOS treatment plan. What is insulin? Insulin is a hormone made by an organ in the body called the pancreas. The food you eat is broken down into simple sugar (glucose) during digestion. Glucose is absorbed into the blood after you eat. Insulin helps glucose enter the cells of the body to be used as energy. If there’s not enough insulin in the body, or if the body can’t use the insulin, sugar levels in the blood become higher. What is insulin resistance? If your body is resistant to insulin, it means you need high levels of insulin to keep your blood sugar normal. Certain medical conditions such as being overweight or having PCOS can cause insulin resistance. Insulin resistance tends to run in families. What can insulin resistance do to me? High insulin levels can cause thickening and darkening of the skin (acanthosis nigricans) on the back of the neck, axilla (under the arms), and groin area. In young women with PCOS, high insulin levels can cause the ovaries to make more androgen hormones such as testosterone. This can cause increased body hair, acne, and irregular or few periods. Having insulin resistance can increase your risk of developing diabetes. How can I lower my insulin levels? You can help lower your insulin levels naturally by eating fewer starches and sugars, and more foods that are high in fiber and low in refined carbohydrates. Low glycemic foods, on the other hand, don’t raise your blood sugar or insulin levels as much as foods that are high in sugar or refined carbohydr Continue reading >>
Efficacy And Safety Of Metformin Or Oral Contraceptives, Or Both In Polycystic Ovary Syndrome
Efficacy and safety of metformin or oral contraceptives, or both in polycystic ovary syndrome College of Pharmacy, Chosun University, Gwangju, South Korea Correspondence: Eun Joo Choi, College of Pharmacy, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju 61452, South Korea, Tel +82 62 230 6382, Fax +82 62 222 5414, Email rk.ca.nusohc@iohcje Author information Copyright and License information Disclaimer Copyright 2015 Yang and Choi. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution Non Commercial (unported, v3.0) License The full terms of the License are available at . Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. This article has been cited by other articles in PMC. Polycystic ovary syndrome (PCOS) is an endocrinopathy that affects approximately 10% of reproductive-aged women throughout their lives. Women with PCOS present with heterogeneous symptoms including ovulatory dysfunction, hyperandrogenism, and polycystic ovaries. Therefore, lifelong individualized management should be considered. Pharmacological agents commonly used to manage the symptoms are metformin and oral contraceptive pills. Although these medications have been beneficial in treating PCOS symptoms, their efficacy and safety are still not entirely elucidated. This study aimed to report the efficacy and safety of metformin, oral contraceptives, or their combination in the treatment of PCOS and to define their specific individual roles. A literature search of original studies published in PubMed and Scopus was conducted to identify studies comparing metformin with oral contraceptives or evaluating the combination of both in PCOS. Eight clinica Continue reading >>
Role Of Metformin In The Management Of Polycystic Ovary Syndrome
Go to: Background Polycystic ovary syndrome (PCOS) is the most common endocrinological disorder affecting 4–12% of women [Diamanti-Kandarakis et al. 1999; Farah et al. 1999; Knochenhauer et al. 1998]. It has also been the most controversial medical condition and every aspect has received a lot of attention from the nomenclature to the management. Several descriptions of similar conditions took place in the 20th century and it was named Stein—Leventhal Syndrome in 1935 after the authors who described polycystic ovarian morphology in patients suffering from hirsutism, amenorrhoea and infertility [Leventhal, 1958; Stein and Leventhal, 1935]. PCOS was also called polycystic ‘ovarian’ syndrome implying that the primary pathology lies in or triggered by the ovary. Others have called it polycystic ovary disease (PCOD), which is the least used term for obvious reasons. Currently, PCOS refers to a disorder with a combination of reproductive and metabolic characteristics. This has evolved over time with controversy over the definition culminating in the latest consensus [ESHRE/ASRM, 2004] which instead of solving the issue created more controversy [Azziz et al. 2006]. In the European Society of Human Reproduction and Embryology/American Society of Reproductive Medicine (ESHRE/ASRM) consensus, at least two of the following features are needed to make the diagnosis; oligo/anovulation, hyperandrogenism, and polycystic features on ultrasound scan [ESHRE/ASRM, 2004]. The Androgen Excess Society, however, recommended that androgen excess should remain a constant feature of PCOS irrespective of the ovulatory status and morphological features of the ovaries [Azziz et al. 2006]. For almost three decades, PCOS has been regarded as a life course disease which besides its reproductiv Continue reading >>
Pcos Treatments
If a woman is not seeking to become pregnant, hormonal birth control (most often birth control pills) is a standard treatment. Birth control pills regulate periods and improve excess hair growth and acne by lowering androgen levels and protect the endometrium (inner lining of the uterus) against abnormal cell growth. Older types of birth control pills have lower risk for dangerous blood clots and are preferable over new types of birth control pills. Although metformin is not approved by the FDA for treatment of PCOS, many doctors prescribe it for PCOS patients. Metformin is a medicine that makes the body more sensitive to insulin. This can help lower elevated blood glucose levels, insulin levels, and androgen levels. People who use metformin may lose some weight as well. Metformin can improve menstrual patterns, but metformin doesn’t help as much for unwanted excess hair. Many women who are diagnosed with PCOS are often automatically prescribed metformin. However, it's important to have a reason for taking metformin and not be on it just because of a diagnosis of PCOS. Discuss with your doctor the reason why you are taking metformin and whether it is providing a benefit to you. Clomiphene (Clomid) is an oral medication that is the most common treatment used to induce ovulation. The use of both metformin and clomiphene has about the same fertility results as clomiphene use alone. A benefit is that metformin may help reduce the risk for ovarian hyperstimulation syndrome (see also "What is ovarian hyperstimulation syndrome (OHSS) during assisted reproductive technology (ART) fertility treatments. Other treatments to stimulate ovulation include another oral medication called letrozole (Femara) and gonadotropins which are hormones that are given by injection. In vitro fert Continue reading >>
Ocs Plus Metformin For The Treatment Of Pcos
Oral Contraceptives Plus Metformin for the Treatment of the Polycystic Ovary Syndrome Would the combination of levonorgestrel ethinyl estradiol plus metformin be effective for the treatment of patients with the polycystic ovary syndrome? Response from Robert L. Barbieri, MD The polycystic ovary syndrome (PCOS) is defined as the presence of both ovulatory dysfunction and hyperandrogenism. In women with PCOS, oligo- or anovulation manifests itself as irregular cycles with oligo- or amenorrhea. Hyperandrogenism can be identified by physical examination, ie, the presence of hirsutism or by laboratory tests that demonstrate an elevated circulating concentration of a major androgen, ie, free testosterone, total testosterone, and/or androstenedione. A third criterion for the diagnosis of PCOS is to exclude other causes of hyperandrogenism, such as nonclassic adrenal hyperplasia resulting from a 21-hydroxylase defect or an androgen-producing adrenal or ovarian tumor. PCOS occurs in approximately 5% to 7% of women of reproductive age.[ 1 , 2 ] This makes PCOS the most common endocrinopathy of women. Women with PCOS have both abnormally elevated luteinizing hormone (LH) secretion[ 3 , 4 ] and hyperinsulinemia as a result of insulin resistance.[ 5 ] The combination of hypersecretion of LH and insulin causes ovarian androgen overproduction.[ 6 ] In turn, ovarian androgen overproduction causes hirsutism and prevents normal ovarian follicle growth, preventing regular ovulation. PCOS can be treated by lowering LH hypersecretion (oral contraceptive pills or GnRH agonist analogues) or by reversing the hyperinsulinemia that is caused by insulin resistance (weight loss or metformin). An intriguing idea is to use oral contraceptives plus metformin in combination to simultaneously attack t Continue reading >>
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Best Birth Control For Pcos: 3 Options
The vaginal ring costs as much as the skin patch, or $30 to $35 for a months supply. The ring is also covered by most insurance plans. Will any form of hormonal birth control work? Combination birth control whether in the form of a pill, ring, or patch is the most popular and recommended form of treatment for PCOS. If youre unable to take the combination pill or use other combination methods, your doctor may recommend the progestin-only pill. There are also other alternatives, including: Progesterone therapy: You can take progesterone for 10 to 14 days every one to two months. This treatment doesnt prevent pregnancy or improve androgen levels, but it can help manage your symptoms. Progestin-containing intrauterine device (IUD): IUDs that contain progestin can help ease the symptoms of PCOS in the same way combination or progestin-only pills do. Metformin: This medication for type 2 diabetes, brand name Glucophage , lowers insulin and androgen levels and improves insulin resistance. Insulin resistance commonly occurs with PCOS, and metformin might be used to treat this. It isnt approved by the U.S. Food and Drug Administration to treat PCOS specifically, so this is considered off-label use. But research has shown that it may help restart ovulation and lead to regular periods. Off-label drug use means that a drug thats been approved by the FDA for one purpose is used for a different purpose that has not been approved. However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So, your doctor can prescribe a drug however they think is best for your care. Using birth control to protect against pregnancy Although PCOS is the leading cause of infertilit Continue reading >>
Metformin And Pcos Health Benefits Or Side Effects
Metformin and PCOS Health Benefits or Side Effects If you have Polycystic Ovary Syndrome ( PCOS ) and have been prescribed metformin, chances are you have a lot of questions and concerns about taking this medication. The majority of women with PCOS have high insulin levels which cause weight gain, cravings, and even dark patches on your skin. Over time, exposure to high insulin levels can make you insulin resistant or turn into type 2 diabetes . Metformin works to lower your insulin and reduce your risk for diabetes. This article will show you what you need to know about taking metformin if you have PCOS. Metformin is one of the oldest andmost studied drugs available in the United States. Other names for metformin include Glucophage, Glucophage XR, glumetza, and fortamet. Although its not labeled for use in women with PCOS, metformin is one of the most common medications used to manage the condition. Metformin has been studied in girls as young as 8 years of age, with some researchers recommending it to prevent the onset of PCOS. Metformin works as an insulin-sensitizer to reduce your production of glucose. Metformin lowers blood glucose and insulin levels in three ways: 1. It suppresses the liver's production of glucose. 2. It increases the sensitivity of your liver, muscle, fat, and cells to the insulin your body makes. 3. It decreases the absorption of carbohydrates you consume. The average dose of metformin for women with PCOS is 1,500 mg to 2,000 mg daily. Besides lowering your glucose and insulin levels, metformin may provide other health benefits to women with PCOS. Metformin can enhance ovulation and regulate menstrual cycles. This means if you are sexually active, you should use birth control to prevent pregnancy, even if you havent been getting your period re Continue reading >>
Polycystic Ovarian Syndrome Fertility Treatment With Metformin (glucophage)
How Metformin Is Used for Polycystic Ovaries Polycystic ovarian syndrome is a common cause of anovulation and infertility in women. These women do not ovulate (release eggs) regularly and therefore have irregular menstrual periods. The ovaries have many small cysts (2-7 mm diameter) called antral follicles, giving the ovaries a characteristic "polycystic" (many cysts) appearance on ultrasound. A relatively new method of treating ovulation problems in women with polycystic ovarian disease is to use an oral medication called metformin (brand name is Glucophage). Metformin has traditionally been used as an oral drug to help control diabetes. Then, some smart doctor figured out that polycystic ovarian syndrome treatment with metformin can be very effective. If Glucophage alone does not result in ovulation and pregnancy, we often use: If the combination therapy is not effective, we can try: Metformin Use with IVF Treatment We also use Glucophage in women going through in vitro fertilization for PCOS, and for those with very high antral follicle counts - if their ovaries are "polycystic" by ultrasound. We find that some women with polycystic ovaries respond with a "smoother" response to the injectable FSH medication if they have been taking Glucophage. Risks and Side Effects of Metformin / Glucophage In about 25% of women Glucophage causes side effects which may include abdominal discomfort, cramping, diarrhea and nausea. The side effects may be severe enough to make the woman stop the Glucophage medication. We are not aware of any serious complications resulting from Glucophage treatment. Another oral medication used for diabetes called Troglitazone has been associated with liver failure and death in rare cases. This has been publicized on television shows, in newspapers, et Continue reading >>
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Adding Metformin To Oral Contraceptive May Be Beneficial For Women With Pcos
Adding metformin to oral contraceptive may be beneficial for women with PCOS Combining metformin with oral contraceptives lowered LDL and tumor necrosis factor levels, mitigated triglyceride increases and enhanced beta cell and endothelial function in some women with polycystic ovary syndrome, results from two studies suggest. In one open-clinical trial, researchers randomly assigned 50 women with polycystic ovary syndrome (PCOS) to receive 30 mcg ethinylestradiol and 2 mg chlormadinone acetate or the same regimen plus with 875 mg of metformin daily. The women were followed for 12 months. The researchers noted reductions in carotid stiffness index among women receiving oral contraceptives only compared with those receiving combination therapy after 12 months (P=.02). Systolic arterial pressure also increased among the combination group during the first 6 months compared with women receiving oral contraceptives alone (P=.02). Results indicated that LDL and tumor necrosis factor (TNF) levels declined in the combination arm during follow-up (P<.01). Triglycerides levels also increased by 75% in the oral contraceptive-only group compared with 33% in women receiving oral contraceptives and metformin. Combination therapy, however, did not appear to improve arterial function and structure in this population. A second study involved 19 overweight women (mean age, 24.9 years; mean BMI, 33.7) who had PCOS. Researchers selected an oral contraceptive containing 35 mcg of ethinyl estradiol and 0.18/0.215/0.25 mg of norgestimate (Ortho-Tricyclen, Ortho-McNeil) and randomly assigned participants to a 3-month treatment course of metformin plus oral contraceptive or oral contraceptive alone. Women receiving combination therapy demonstrated considerable weight loss by the studys conclus Continue reading >>
New Risks Of Birth Control Pills For Pcos - Pcos Nutrition Center
New Risks of Birth Control Pills for PCOS By Angela on November 1, 2017 under PCOS Treatment Birth control pills have long been demonstrated as a first-line treatment option for women with Polycystic Ovary Syndrome (PCOS) who suffer from painful or irregular or absent periods.Some women may take Oral contraceptive pills (OCPs) to help lower androgen levels and improve unwanted dermatological symptoms. Despite its benefits, OCPs have been associated with adverse health effects in women, as early as the teenage years . Some professions question if birth control pills are just a Band-Aid and dont address the root cause of the syndrome. Women who go off OCPs still find that their period is irregular or absent, sending many to fertility clinics for help. If you are a woman with PCOS or are a parent of a young girl with PCOS, you may be asking if the pill is really a good idea or if there are other options to consider. This article reviews the risks and benefits of birth control pills for women with PCOS and alternative treatments. There are several benefits for women with PCOS to take birth control pills. A big benefit is the ability of OCPs to reduce high testosterone levels and improve the balance of reproductive hormones. Women with PCOS who take OCPs see their periods regulate and may even see a reduction in unwanted dematological symptoms like acne and hair growth. Regular menstural cycles can also reduce the risk for developing endometrial hyperplasia and ovarian cancer, by preventing the uterine lining from becoming too thick. Despite the benefits, recent studies indicates that birth control pills should be used with caution, especially in adolescents with PCOS. The reason? OCPs have been found to increase levels of LDL, Triglyceride, and C-reactive protein (CRP), a Continue reading >>
Effect Of Combined Metformin And Oral Contraceptive On Metabolic Factors And Endothelial Function In Overweight And Obese Women With Polycystic Ovary Syndrome
Effect of combined metformin and oral contraceptive on metabolic factors and endothelial function in overweight and obese women with polycystic ovary syndrome 1Department of Internal Medicine, School of Medicine, Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia 4Capital Area Health Network, Richmond, VA 1Department of Internal Medicine, School of Medicine, Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia 2Department of Obstetrics and Gynecology, School of Medicine, Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia 1Department of Internal Medicine, School of Medicine, Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia 2Department of Obstetrics and Gynecology, School of Medicine, Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia 1Department of Internal Medicine, School of Medicine, Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia 2Department of Obstetrics and Gynecology, School of Medicine, Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia 3Department of Pharmacy, School of Pharmacy, Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia 4Capital Area Health Network, Richmond, VA 5Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA Address all correspondence and reprint requests to: Paulina A. Essah, M.D., M.Sc., Capital Area Health Network, 719 N. 25th Street, Richmond, VA 23223, Tel: 804-780-0840, FAX: 804-780-0862, ten.tsacmoc@hasseap The publisher's final edited version of this article is Continue reading >>
