DrLisaFish: next?
womenshealthADM: from angel: Is 33 too late to find out if someone has PCOS - even after 2 children (and 3 miscarriages)?
DrLisaFish: PCOS can be diagnosed at any age prior to menopause, so 33 is fine for diagnosis. Most women are diagnosed in their 20s or 30s,but often they have had symptoms since they started having menstrual periods. We also know that as women get older, if they gain weight, the symptoms of PCOS may become more apparent.
DrLisaFish: next?
womenshealthADM: Who has a question?
Mathilda: I have been diagnosed with PCOS and am trying to get pregnant. My doctor just wants to use injectables instead of using Met to regulate cycles. What do I do?
DrLisaFish: Fertility treatment in PCOS can be difficult and there is data showing that metformin is very helpful both as a single treatment and to assist in other treatments such as clomid to help women become pregnant. It is reasonable to use metformin first and on that in a series of women, 85% of them had more regular ovulation. If that's not successful, then other treatments can be added to the metformin.
DrLisaFish: next?
womenshealthADM: mish your question
mish: I have excessive periods, weeks at a time, and hair loss. My doctor has put me on birth control (levlin), but that is it. Should I seek other treatment. Also he wants to do a D & C, due to the excessive bleeding for five weeks now, while on the pill.
DrLisaFish: Many women with PCOS have heavy bleeding because they are not cycling regularly and the uterine lining can build up and then can have breakthrough bleeding which can continue. It can be helpful to use progesterone for a period of 10 days to allow the uterine lining to slough and that usually helps get rid of the excessive irregular bleeding. Some women take the progesterone every month or several months to prevent that problem.
DrLisaFish: next
womenshealthADM: tc your next
tc: I have endo and only one ovary. I tried clomid for several months with no luck. My doctor wants to try glucaphage before going to follistim. Why?
DrLisaFish: Glucophage is the trade name for metformin and that is a very helpful medication to improve ovulation in someone with PCOS. I think that is a good recommendation--to try met first and then add additional treatments if needed.
DrLisaFish: next?
womenshealthADM: Paula your next
PaulaPCOSA: My last couple cycles, I have gone through the hormone changes with my cycle I think (I get the breast tenderness etc.) but then no periods. Is this normal in PCOS? I've never had it happen before the last few months.
DrLisaFish: I would say that's not typical for PCOS however there are hormone fluctuations that can occur without ovulation and that may be what's happening.
DrLisaFish: next?
womenshealthADM: mish your question
mish: Would seeing a RE (reproductive endocrinologist) be advisable with the few symptoms I do show? What different could they do from my gyn? If the ovaries are the main source of these problems, why not just remove them, if you are not seeking to have more children?
DrLisaFish: PCOS can be treated by a wide variety of physicians. Many primary care doctors are familiar with the syndrome and able to treat it; most gynecologists are familiar with it; most endocrinologists and reproductive endocrinologists would have more specialty knowledge in that area.
For women who have finished having children, removal of the ovaries is an OPTION, although a rather drastic one and something that would need to be discussed carefully with their physician. If the ovaries are removed prior to menopause, then discussion of hormone replacement would be needed as well.
DrLisaFish: next?
Dmerck: I have been on 4 cycles of clomid, one month of BC with Glucaphage then last month had follicles and they gave me a shot of Pregnyl to release the eggs, but nothing happened. Why didn't I have a mature egg? Is there any thing out there that can get rid of the cysts?
DrLisaFish: You are receiving advanced treatment options for ovulation and unfortunately they are not always successful on every cycle. The fact that you developed eggs and were given medication to release them means that you have had some success with treatment. It may take another several months of treatment before you have success in becoming pregnant.
