Heather: Is the Hormone Foundation doing any research on the hypothalamus' role in PCOS (i.e. non regulation of the pituitary and thyroid?
DrRobertJaffe: The Hormone Foundation does not in itself carry out research. We communicate the research of endocrinologists and other experts, and interpret that in a way that we hope the public can understand. Although there are a number of endocrinologists who constitute the board of the Hormone Foundation and who do do research, the research is not performed as a part of the Hormone Foundation's activities.
However, down the line, the Hormone Foundation hopes to provide funding for new investigators to initiate research studies that will lead to improvement in the health of the public.
DrRobertJaffe: next?
Mathilda: I know insulin resistance can cause PCOS, but if not insulin resistance then what causes it?
DrRobertJaffe: The cause of PCOS is still not known definitively. There seems to be a familial predisposition in some individuals to PCOS; therefore at least some cases of PCOS may represent a genetic disorder.
The ultimate cause of PCOS is something that many investigators are studying particularly because it's the most common hormonal disorder of reproductive aged women.
DrRobertJaffe: next?
womenshealthADM: from angel: Are abnormal hormonal tests absolute proof?
DrRobertJaffe: There is no "absolute proof" of PCOS, but hormonal tests frequently help us to make the diagnosis. Those tests are an increase in male type hormones, the androgens, and an increase in the pituitary hormone called LH which stands for lutenizing hormone; that hormone stimulates androgen production from the ovary.
DrRobertJaffe: next?
womenshealthADM: who has a question?
Lenke: I heard yesterday that something about the ring finger being some type of PCOS give away trait? Is there any truth to this?
DrRobertJaffe: I have not heard of that before, if that's true, it's news to me.
DrRobertJaffe: next?
womenshealthADM: mish your question
mish: Is there a better birth control pill than others, to help with PCOS?
DrRobertJaffe: Well, the birth control pill is used in PCOS for a couple of reasons:
(1) In women who have excess hair growth, the birth control pill often helps because it inhibits the production of LH from the pituitary and because LH stimulates androgens, and androgens cause hair growth and acne, the use of the birth control pill can help that. We frequently use the birth control pill together with what are called anti-androgens because they both work in different ways to block new hair growth formation.
(2) By using birth control pills in women with PCOS we allow them to shed the lining of the uterus thereby preventing excess buildup of the lining because the excess buildup, if not counteracted, can increase the risk of cancer of the uterus.
DrRobertJaffe: next?
womenshealthADM: What are your views on natural progesterone vs. progestins for the treatment of PCOS?
DrRobertJaffe: In all likelihood, natural progesterones will work as well as synthetic progestins for PCOS, but there have been to date no published studies on the use of natural progestins. The reason for using either natural progesterone or synthetic progestins in PCOS is for the same reason that we would use birth control pills that is, to prevent the excess buildup of the lining of the uterus caused by unopposed stimulation by estrogen.
Lenke: What are your thoughts on metformin instead of birth control/anti-androgens?
DrRobertJaffe: Well, if the woman has increased insulin resistance then metformin is a useful form of treatment because in a significant number of women, if they have increased insulin resistance, it will not only help to restore normal menstrual cycles and to decrease androgens, but it should have the long-term benefit of helping to reduce the risk of the development of diabetes and the increased risk of cardiovascular disease.
DrRobertJaffe: In summary, polycystic ovary syndrome which is the commonest disorder of reproductive aged women has several major problems associated with it. These include irregular and often absent menstrual cycles, infertility, excess hair growth, and very frequently increased weight. Over the long-term, those women who have increased insulin resistance may be at increased risk for the development of diabetes and cardiovascular disease.
womenshealthADM: Thank you for coming tonight Dr. Jaffe. I'm sure this will help many women.
DrRobertJaffe: Thank you!
womenshealthADM: Thank you very much Dr. Jaffe! Have a great evening!
More About PCOS
More About Dr. Lisa Fish and Dr. Robert Jaffe
