What is polycystic ovarian syndrome (often called PCOS) and how should it be treated? #1005/14

A:

Polycystic Ovarian Syndrome (PCOS) is a common cause of infrequent bleeding and menstrual irregularity that is associated with androgen excess (hirsutism, acne, male pattern balding), anovulation, obesity and infertility. Ultrasound reveals polycystic-appearing ovaries with at least thirteen 2 to 9 mm preantral folicles [Nelson A. and Baldwin S. IN Hatcher Contraceptive Technology 20th ed. 2011, p543]. Women with PCOS are at greater risk of developing diabetes, endometrial hyper­plasia and endometrial cancer. Long-term lifestyle changes to lose weight are important.CONTRACEPTION: Progestins from the levonorgestrel intrauterine device (LNG) IUD, Depo-Provera injections, and progestin-only pills provide substantial endometrial protection against endometrial cancer and good contraceptive efficiency. If a woman desires a monthly period and treatment of acne, combined pills may be more appropriate unless a woman is at increased risk for blood clots (thrombosis).

Robert A. Hatcher MD, MPH

Emeritus Professor of Gynecology and Obstetrics

Emory University School of Medicine

Atlanta, GA

October 30, 2014, December 10, 2014, December 14, 2014

To learn more about the advantages and disadvantages of birth control pills, Depo-Provera and the Mirena IUD; go to: www.managingcontraception.com and click on Choices 2013 edition.  You can also order this wonderful new educational book from our website or by calling 404-875-5001.  Do you have your copy yet?  It is now available in English and Spanish.

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Key Words:  polycystic ovarian syndrome (PCOS), bleeding, androgen excess, acne, male pattern balding, obesity, infertility, ultrasound, ovaries, risk, diabetes, endometrial hyperplasia, endometrial cancer, weight loss, contraception, progestin, LNG-IUD, monthly period, combined pills, blood clots

 

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January 1, 2015