Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.
Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome is defined as endocrinologic diseases among reproductive-age women caused by undeveloped follicles clumping on the ovaries that interferes with the function of the normal ovaries associated with a high risk for metabolic disorder(1) as resulting of enlarged ovaries(2), leading to hormone imbalance(excessive androgen and anti-müllerian hormone (AMH) )(1)(3)(4)(5), induced Hirsutism(6)(7), reproductive disorder(10(12)), risks of type 2 diabetes(9)(10)(11), metabolic syndrome(10)(12) and early cardiovascular disease(8)(13), acne(10)(14), endometrial cancer(18)(19),weight gain and obesity(15)(16)(17). The syndrome effects over 5% of women population or 1 in 20 women.
Unfortunately, according to studies, women with PCOs after the reproductive age, are associated to continuously increase risk of type II diabetes, with no increasingaltered glucose tolerance(20), CVD and hypertension(21).
The prevention and management
Polycystic ovary syndrome (PCOS) is unpreventable in Western medicine. Early diagnosis and treatment may reduce risk of its complications, including infertility, metabolic syndrome, obesity, diabetes, cardiovascular diseases, stroke, etc.
Although PCOS cannot be completely avoided, strengthening immunity has shown a significant reduction of chronic inflammatory diseases(266)(267)(268).
Types of Conventional treatments
(Supplement pages)
There is no medical treatment for PCOs (induced weight loss for obese PCOs is primary objective). If pregnancy is not the concern, oral contraceptive medicine are prescribed. If pregnancy is a concern, the below have found to be most frequent treatment used conjunction with artificial insemination.
A. Fertility Drugs
1. Metformin
a) The effectiveness of metformin
Metformin, an oral anti-diabetic drug used to treat type II diabetes(652)(653) used widely in treating PCOs to induce weight loss in subjects with obesity,and infertility, improved insulin resistance(654)(655) by suppressing the production of endogenous glucose(656)(658) by the livcer(659)(661) and induced weight loss in obese patients(657)(658) through a reduction in calorie intake(657), as it makes insulin working more effective without changing the level of insulin in the body(659) by enhancing insulin-stimulated glucose disposal in skeletal muscle(659), which can lead to a lowering thyroid-stimulating hormone(660) and improved ovarian angiogenesis and follicular development(664) inhvolved PCOs pregancy(662)(663).
b) Side effects
i) Gastrointestinal upset(666)(667), especially for patient with disequilibrium of 2 genetic variations in OCT1(665), are mostly diarrhea(666)(667). Some patient may also experience nausea, vomiting, and decreased appetite(669).
ii) Reduce intestinal absorption of group B vitamins and folate in chronic therapy(668), may lead to accelerate the progression of vascular disease(668).
iii) Abdominal pain or cramps(669).
(iv) Metformin may have a growth-static effect on several cancers, including endometrial cancer, according to pre-clinical experiments(671)
2. Chomiphene (Clomid)
a) The effectiveness of chomiphene
It is considered as a fertility medication(670). The effectiveness of clomiphere is to induce ovulation(672) for natural conception for women with or without PCOs with luteal phase defect by stimulating the function of pituitary gland in series of hormone production(673), including LH, FSH. However, combination of metformin and clomiphene citrate may have some effects in improved pregnancy rates but not significantly improve the live birth rate over that of clomiphene citrate alone in women with polycystic ovary syndrome(674). Acupuncture, herbal medicine andclomiphene combination used for treatment of infertility on women with PCOs have shown to improve the pregnancy rate and reduce early abortion rate (675), according to Zhongguo Zhen Jiu. 2015 Feb;35(2):114-8.
b) Side effects
i) Abdominal pain and cramps(676).
ii) Breast tenderness(676)
iii) Ovaries edema(677)(678)
iv) Central nervous symptoms such as nervousness, sleeplessness, headaches, visual disturbances, vertigo(682), irritability, mood swings, feeling down(680)
v) Bloating(682) and hot flushes(681).
vi) Nausea, vomiting and dermatitis(683)
(vi) Women with BRCA mutation carriers may be at increased risk of invasive epithelial ovarian cancer (IEOC)(669).
(v) Risk of ovarian cysts(676)
(vi) Risk of ovarian cancer(684)(685)
(vii) Risks of melanoma and thyroid cancer(679).
3. Human Chorionic Gonadotropin (HcG)
a) The effectiveness of HCG
Human Chorionic Gonadotropin (HcG) is a hormone secreted by specialized cells called trophoblasts and later by the placenta following implantation(686)(687). The drug has been used conjunction of IVF for treatment of infertility to induce ovulation by stimulating the release of mature egg(688)(689), approximate 36 hour after taking it. HCG not only pinpoint the best time for sexual intercourse with success conception or assisting intrauterine insemination in egg retrieval(690)(691). The medicine also used for treatment to obese women with PCOs for weight loss(692)(693)(694) with controversy.
b) Side effects
Although side effects of HCG is not common, but some women may experience(697)
i) Headaches
ii) Irritability
iii) Restlessness, slight
iv) Water retention
v) Breast tenderness
vi) Depression
Other risks may include
(vii) Obstetrical complications, adverse perinatal outcomes, structural congenital abnormalities, chromosomal abnormalities, imprinting disorders, and childhoodcancer(697)
(Vii) Ectopic pregnancy(689)
(viii) Blurred vision and scotomas(695).
(ix) Multiple pregnancy, miscarriage, ovarian hyperstimulation syndrome (OHSS)(696)
4. Human menopause gonadotropin(HMG)(Menotropin)
a) The effectiveness of HMG
HMG contains natural FSH and LH, is a purified form of urine of post menopausal women(699). By stimulating production of LH and FSH to right levels, the drug induces ovulation and develop mature follicles(700). The medication may be also used if chomiphere therapy and other medication have been failed to induce ovulation(701).
b) Side effects
i) Risk of multiple pregnancy, and spontaneous abortion(702)
ii) Ovarian enlargement (Caused by over stimulation)(705)
iii) Ovarian hyper stimulation syndrome (OHSS)(703)(704)
iv) Risk of miscarriage(704)
v) Risk of ovarian cancer(706)(707)
vi) Shortness of breath, dizziness, pelvic pain, nausea, and vomiting(708).
5. Dexamethasone
a) The effectiveness of dexamethasone
Dexamethasone is a synthetic member of the glucocorticoid class of steroid hormones and a prescribed medication for fertility to induce ovulation(709) for artificial insemination(710)by suppressing the androgen levels(711), resulting in increasing the chance of fertility(710).
b) Side effects
i) Risk of miscarriage(710)
i) Risk of bone growth at different developmental stages(713)
Other side effects, according to Rxlist(712) include
sleep problems (insomnia), mood changes;
acne, dry skin, thinning skin, bruising or discoloration;
slow wound healing;
increased sweating;
headache, dizziness, spinning sensation;
nausea, stomach pain, bloating;
muscle weakness; or
changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).
6. Surgery
Surgery is not commonly performed. If necessary, PCOs infertility can be treated by either a laparoscopic surgery also is known as ovarian drilling(714)(715), the surgical procedure is not proven to be effective for women with PCOs infertility if used alone with potential surgical risks(714) or wedge resection(716), only to PCOs patients did not conceive with standard ovulation induction protocols(717). It is to your benefit to forgo this type of expensive treatment in favour of other such as IVF.
B. Oral Contraceptive
Only if pregnancy is not the concerns
1. The benefits of oral contrecptive
a. Reduce total testosterone levels and acne(718)
b. Improve lipid profiles, hsCRP levels, insulin resistance and hyperandrogenism(719)(720)
b. Regular menstrual cycle(720)
c. Lower androgen hormone levels(720) and lessen the amount of excess hair growth (also called “hirsutism”)(720)(721).
d. Decreased mentrual Cramps, or No Cramps(722)
e. Reduce risk of colorectal and endometrial cancers(723), ovarian cancer(724), and ovarian cysts(725).
2. Risks and side effects
a) Risks
i) Risks of blood clots(728), stroke(728), heart disease(726), cervical cancer(724) and breast cancer(727)(723)
ii) Hypertension(726) and increase heart rate(726) caused by thickening of blood in arteries.
b) Side effects
i) Bleeding and spotting(729)
ii) Weigh gain(730)(731)(732)(inconclusive result)
Remember the most effective long term treatment for PCOs can be done naturally at comfort at your own home.
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The reproductive medincine and surgery center of |Virginia. PLC)
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(PubMed)
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1, Gokce AI, Yildizhan B, Cim N.(
PubMed)
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PubMed)
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PubMed)
(727) Correlation of age at oral contraceptive pill start with age at breast cancerdiagnosis by Imkampe AK1,
Bates T.(
PubMed)
(728) Cerebral vein thrombosis in women using short course oral contraceptiveconsumption by Sasannejad P1, Mellat Ardekani A2, Velayati A1, Shoeibi A1, Saeidi M1, Foroughipour M1,Azarpazhooh MR1.(
PubMed)
(729) Phase 3 study of desogestrel and ethinyl estradiol combined oralcontraceptive for pregnancy prevention by Kroll R1, Howard B, Hsieh J, Ricciotti N.(
PubMed)
(730)Oral contraceptives use and weight gain in women with a Central European life-style by Lech MM1, Ostrowska L.(
PubMed)
(731) Weight and body composition changes during oral contraceptive use in obese and normal weight women by Mayeda ER
1, Torgal AH, Westhoff CL.(PubMed)
(732) An exploratory analysis of associations between eating disordered symptoms, perceived weight changes, and oral contraceptive discontinuation among young minority women by Hall KS1, White KO, Rickert VI, Reame NK, Westhoff CL.(
PubMed)
