GynoFiles

This is a picture of the Goat's Rue plant, which is the original source of the insulin sensitizing medicine metformin. It is also known as French lilac, not known to Hippocrates, but it has been used since the middle ages to reduce thirst and frequent urination, before these symptoms were known to be due to diabetes specifically. Once only used as a treatment for diabetes, metformin today is one of the most widely prescribed medications used in PCOS, infertility, weight loss, and to preserve cardiovascular health in those with metabolic syndrome.Studies prove that it can reduce a pre-diabetic's chance of becoming a diabetic. It is critical to realize that radical lifestyle and diet changes might do even better in early treatment of many of these conditions including diabetes and PCOS. Its chemical mechanism of action is quite complicated, but it has an effect on skeletal muscle to enhance it's uptake of glucose (sugar). Overall it leads to fat burning, decreased new produc...

PCOS patients are often diagnosed when young, begin on a treatment plan, and often not screened for their risks of glucose intolerance, high cholesterol, abnormal other blood lipids cardiovascular disease and metabolic syndrome. Because of this part of PCOS care should revolve around nutritional management. The Collaborative Ambulatory Research Network of practicing obstetricians and Gynecologists did a survey and found that screening PCOS patients, even by these specialists was lacking. Over half had never ordered a glucose tolerance test as as a work up on their PCOS patients. Their study published in the November issue 2016 of the American Journal of Obstetrics and Gynecology pointed out that based on screening results physicians intervene with nutritional and lifestyle counseling. Based on the fact that many women are not appropriately screened, many women who need to have dietary counseling are not getting that therapy prescribed. The Androgen Excess-Polycystic Ovary Syndrome ...

The doctors Stein and Leventhatal in 1935 discovered why some women had big cysts on their ovaries, extra hair growth and troubles getting pregnant. And though we recognize their work as the beginning, their name long left the condition of Polycystic Ovaries. After it was called Stein and Leventhal's disease this has been called a disease, a condition and now a syndrome, PCOS or Polycystic Ovarian Syndrome . It begins in teen years, at which time it may mean some acne and  occasional irregular cycles. most likely it resolves with menopause and the quieting of the ovarian hormones. Obesity is an integral component of the condition for many women and it's thought to be the result of insulin resistance due to PCOS but modifiable by therapy. The most common issue with getting pregnant is chronic anovulation which leads to patients not getting pregnant. Now it has been shown in a publication by Doherty in the journal of OBSTETRICS AND GYNECOLOGY that women with PCOS have inc...

Only about 40% of women with irregular periods have PCOS. The definition has been changed, and simplified, so that your gyno can make the diagnosis earlier and more accurately. The old definitions required complex testing, and missed most teen PCOS diagnosis. The current method of diagnosis PCOS requires only two of three medical aspects of your cycle and hormonal health. The diagnosis of PCOS only require. The diagnosis only requires two out of the follow features: chronically not ovulating, presence of polycystic ovaries on ultrasound, and or clinical evidence of androgen excess. With this simplified definition 14% of all women can meet the definition and in fact many women with perfectly regular menstrual periods are surprised to learn upon visiting their gynos that they are newly classified with an important condition that can have fertility and  life long health consequences.  If you’ve got to shave your chin regularly, you may just have that sort of genetics, an...

PCOS causes infertility. It was always assumed that failure to ovulate was the main cause of not getting pregnant in women with PCOS, and it is clear that this is still a cause. Beyond not ovulating it was thought that the irregular shedding of the lining, would perhaps produce loss of a fertilized egg. But that was not established firmly. And fertility studies published in the Cochrane based review showed that miscarriages are more frequent. Traditional treatment of infertility in women with PCOS has centered on treating the lack of consistent ovulation. New studies discussed in the American Journal of Obstetrics and Gynecology in their October 2015 issue   have now shown that treatment of the lining of the uterus to make it healthy before trying for pregnancy is very important. The treatment would be fairly strait forward treatment with progesterone for several cycles before trying for pregnancy. And now the American College of Obstetriians and gynecologists has stated that for ...

PCOS: The Syndrome of Hormones, Hair and Havoc of menstrual cycles Polycystic Ovarian Syndrome (PCOS) The doctors Stein and Leventhatal in 1935 discovered why some women had big cysts on their ovaries, extra hair growth and troubles getting pregnant. And though we recognize their work as the beginning, their name long left the condition of Polycystic Ovaries. After it was called Stein and Leventhal's disease this has been called a disease, a condition and now a syndrome, PCOS or Polycystic Ovarian Syndrome . The definition has been changed so that almost 1/10 women can meet the definition and in fact many women with perfectly regular menstrual periods are surprised to learn upon visiting their gynos that they are now diagnosed with an important condition that can have fertility and  life long health consequences. If you’ve got to shave your chin regularly, you may just have that sort of genetics, and on the other hand your ovaries may be producing too much testoster...

PCOS has been known for many decades to be a prominent cause of infertility, but now in a new study from Italy and the Instituto di Ricovero e Cura a Carattere Scientifico PCOS has been linked to causing pregnancy problems. In their study they showed that the PCOS women had more miscarriages, more diabetes, more hypertension, more preeclampsia, and other problems of pregnancy. They studied a group of women who were PCOS but essentially normal weight and no other confounding problems such as smoking. And they were surprised to find that low-grade chronic inflammation in their system was made even worse during the pregnancies of women without polycystic ovarian syndrome (PCOS)  according to a study published online May 29 in the Journal of Clinical Endocrinology & Metabolism . WBC counts, ferritin levels, and CRP were used to track inflammation during pregnancy. These markers, along with other markers of inflammation have already been implicated a...

Women with irregular cycles may find they have an ultrasound that appears like this. The ovaries have many small cysts and they may also produce abnormal levels of hormones. You may want to discuss with your Gyno whether you need testing for this treatable condition.

Polycystic ovarian syndrome (PCOS) occurs in about 10% of the female population. It's onset is typically in one's youth, although many will not manifest significant symptoms until they get in their 20s. Typically gynecologists have been focused on cyst formation and pain, the presence of infertility, or the presence of male hormone related side effects such as acne or abnormal hair growth patterns. As we have begun to understand more on the disease of PCOS we realized that it can be a significant factor in obesity, and obesity can worsen the condition. Now the link between abnormal metabolism and PCOS has begun to be revealed as more than just a significant problem of midline weight retention. Researchers in the Division of Weight Management, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, and as reported in Fertility and Sterility  have discovered that teenagers with polycystic ovarian syndrome (PCOS) can develop fa...

The Endocrine society has just released the new guidelines on PCOS, or polycystic ovarian condition.  Up to 10% of US woman have PCOS without being aware, and with out a diagnosis, you may not be treating the whole scope of the disease correctly. Women are most likely to have this if they have abnormal menstrual cycles, ovaries with small cysts and male hormone abnormalities. In diagnosing and treating women with PCOS, the endocrine society also points out that there are skin consequences of PCOS. Patients with PCOS have abnormal  hair growth, acne, alopecia or hair loss, acanthosis nigricans which is a skin pigment disorders, and skin tags during physical examination, according to the new guidelines.In addition to abnormal menstrual periods, and infertility, struggles with weight, diabetes and blood pressure problems all plague women with PCOS. Appropriate evaluation for this condition can help you have the best overall health as well as the best skin. At  Wo...

Teenagers have lots of growing up to do. This is true even of their ovaries! Polycystic ovaries, or ovaries with lots of little cysts, are occasionally diagnosed in teen years, but oddly, this may not be a permanent condition. Actually a new study looked at girls who had an ultrasound diagnosis of polycystic ovarian condition and then  did repeat ultrasound testing two years later. Moms do not have to worry bout this condition with the first menstrual period.It's a condition that does not develop before or during puberty, it is apparently not seen for the first two years of menstrual cycles in most girls. In general, about 50% of the teens that had polycystic ovaries on ultrasound will not have the condition in two years. Some of the teens with the polycystic ovaries will have male hormone levels that are high and with these high levels a lot of acne or excess hair growth. If the only problem found is a cystic ovary, and no other problems, the teen won't likely have to worry a...

Polycystic Ovarian disease (PCOS) and Menopsause has become a very hot topic. Since it was thought of as disordered hormone production, and lack of ovulation, and presence of ovarian cysts, it was rationalized that as a woman ages into menopause she will no longer ovulate as the natural course of events, that her ovaries will quit producing cysts, and that at least excess estrogen production will cease. So we just have not kept monitoring women in their 50s 60s and 70s for PCOS. But questions of excess hair growth of the chin, the upper lip, and on the side burns does seem to be fairly common in one's late 30s, 40s, and then into perimenopause and menopause. Your first thought is that you now have a hormone imbalance? Perhaps? Perhaps women who now notice they have excess hair have a missed diagnosis of polycystic ovaries  and that it truly didn't resolve? Maybe,  and new research backs up that women in menopause, who had PCOS previously will have free testosterone that re...

The doctors Stein and Leventhtal in 1935 discovered why some women had big cysts on their ovaries, extra hair growth and troubles getting pregnant. And though we recognize their work as the beginning, their name long left the condition of Polycystic Ovaries. After it was called Stein and Leventhal's disease this has been called a disease, a condition and now a syndrome. The definition has been changed so that almost 1/10 women can meet the definition and in fact many women with perfectly regular menstrual periods are surprised to learn upon visiting their gynos that they are now diagnosed with an important condition that can have fertility and  life long health consequences. If you’ve got to shave your chin regularly, you may just have that sort of genetics, and on the other hand your ovaries may be producing too much testosterone, or one of the other boy hormones that emanate from the ovary or the adrenal gland. The most common symptom of PCOS is hyperandrogenism (...

PCOS: The Syndrome of Hormones, Hair and Havoc of menstrual cycles Polycystic Ovarian Syndrome (PCOS) The doctors Stein and Leventhatal in 1935 discovered why some women had big cysts on their ovaries, extra hair growth and troubles getting pregnant. Their original series of patients had 7 cases, ,they performed their now abandoned practice of ovarian wedge resection (their thought was to help eggs ovulate by allowing them to get to the surface of the ovary) on all 7. Out of these 7 women, all began to have regular cycles and 2 did become pregnant from the treatment. And though we recognize their work as the beginning, their name long left the condition of Polycystic Ovaries. After it was called Stein and Leventhal's disease this has been called a disease, a condition and now a syndrome. The definition has been changed so that almost 1/10 women can meet the definition and in fact many women with perfectly regular menstrual periods are surprised to learn upon visiting their g...

The first reason to lose weight when pregnancy planning, if you are obese is that  obesity is associated with subfertility, as well as miscarriages. growth disorders for the fetus, birthing problems, diabetes and hypertension, just to name a few of the issues. You can find a lot about risk factors for birth defects on March of Dime s site, but you may have to ask your gyno about your overall fitness to become pregnant as obestity for one issue is not covered there. It is not known exactly why obese patients have trouble conceiving. Women who are obese and have polycystic ovarian disease (PCOS) are less likely to ovulate and conceive. But women who are obese without PCOS are also less likely to ovulate than the average person due to increased insulin resistance (your body not responding to insulin as normal women do), and that treating this will increase fertility.   Miscarriages also called Spontaneous abortions ( SAB) and recurrent SAB are also associa...

A new study questions whether it is best Essentially gynos thought that it really was not likely for a woman without periods to get pregnant easily, because most likely she won't be ovulating, so it would be impossible to conceive. So traditional thinking has us kick starting ovulation by either bringing on a period, or bringing on a period followed by giving ovulation inducing medicine like clomid or follistim or similar medications. Many women who do not have regular period,s but still want a baby, liked this system, thinking that shedding off that lining with a period take fer is a way of getting a fresh start to one's cycle and therefore the best way to get pregnant. In a newly published large NIH/NICHD grant study that whole premise has been challenged. The study, headed up by Dr. Michael Diamond, looked at women with polycystic ovarian syndrome (PCOS). These women were given progesterone to make them bleed or just given the fertility medicine right away without waiting...

 UNCC Gardens More cases of fatty liver disease have been diagnosed recently. Essentially this is a form of liver disease that can lead to severe disorder of the liver, including the classic fat deposits, but also a loss of liver function. A significant percentage of fat women are diagnosed with fatty liver and those women need to realize that the need to lose weight fairly promptly. And it turns out that in a study done in Perth, Australia a Dr. Ayonrinde has discovered that polycystic ovarian syndrome (PCOS) can affect more than the ovaries and hair growth. It has been known that insulin levels and blood fats are altered in girls and women with PCOS, and it is known that many struggle with their weight. But actually we are now showing that these girls have higher serum leptin and lower serum adiponectin levels which contributes to body fat and thicker waist lines. These findings have not yet been linked to a consistent plan for women or young girls with PCOS. It may be th...

Polycystic ovaries have many effects on the rest of our boidies. For some women they lead to the medical conditions of diabetes, hypertension and gall bladder disease. For some they lead to unwanted acne or hair growth. They may make weight increase and polycystic ovaries may make it more difficult to loose weight. But when it comes to menopause: There is actually improvement! There are fewer eggs surviving in our ovaries as we get older, so as a women gets older the contribution of each little cyst begins to diminish!Polycystic patients who may have never had regular cycles, unlike their friends who are reportting more period problems, may actually see their cycles normalize for the first time. Of course a bit of weight loss, adherence to nutritional recommendations overall, and more exercise may also be the reason some women are 'cured' of their polycystic ovaries as they age, so there is much we need to know about!

In a study of about 100 women published in the July 2011 issue of Fertility and Sterility by Dr. Gwinnett Ladson and colleagues at the departments of Ob Gyn at different universities it has been found that there is a racial influence on PCOS. In their study black and non-black women had about the same levels of infertility and conception, but their metabolism and hormone issues were actually very different. You couldn't tell these differences by lining them all up and taking a good physical. Levels of acne and numbers of patients with excess body hair were about the same whether you were black or non-black with PCOS. But what was very different were their hormone levels and their metabolism. This group of researchers also found that they had different liver function! The black women had lower estrogen, higher resting blood pressure, they out performed in exercise studies, had worse cholesterol, and higher insulin levels. The overall profile of hormones was actually more severe...

Danish researchers working with researchers at the University of Barcelona have been studying girls born smaller than average size. They have been studying their body size, their fat cells, their fat hormones like leptin and adiponectin and watching how they develop from birth, to age 2, 4, 6 and 8. Because prior research shows that reduced fetal growth can actually trigger both early puberty, and early onset of adrenal gland maturity, but small ovaries, they have been trying to then determine what happens to their physiology after that.  In a study published in the July 2011 issue of Fertility and Sterility they published the interesting result of a group of about 30 girls. On the surface being born tiny didn't affect their body type much. The girls grew height, they gained muscle and they developed healthy bones at the same rates. But when they looked more closely they saw physiological changes. The fat hormone leptin began to run higher in girls born small, the fat hormone a...