The first step in diagnosing PCOS is to have a complete history and physical examination performed by a trained health care provider. A careful history and physical examination can detect whether androgen excess is causing male-pattern hair growth (hirsutism), acne or hair loss and whether ovulation is occurring normally. Physical examination also can detect high blood pressure and increased abdominal obesity as risk factors for diabetes and cardiovascular disease in individuals who are overweight.
In vitro fertilization represents the third-line treatment for infertility in women with PCOS 9. However, if the initial assessment demonstrates a bilateral tubal occlusion and/or concentration of recovered motile sperm less than or equal to 5 million, this treatment becomes the first option along with lifestyle changes. The risk of OHSS is the main complication of the highly complexity treatment in women with PCOS. Thus, to minimize this side effect, ovarian stimulation should be initiated with low doses of gonadotropins (100 to 150 IU of FSHr) and the pituitary should be suppressed with a gonadotropin-releasing hormone (GnRH) antagonist because this method is associated with a reduced risk of OHSS compared with an agonist (29 randomized control trials (RCTs); OR 0.43; 95% CI: 0.33 to 0.57) 32. If the patient presents with clinical and ultrasound signs of OHSS, final oocyte maturation should be performed with a GnRH agonist and embryos should be frozen and transferred in a subsequent cycle 33,34. Infertile women with PCOS may present with better general oocyte and embryo quality rates; however, the clinical pregnancy and live birth rates are similar to those observed in normo-ovulatory women without PCOS 35.
Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects about 5 to 10 percent of women during their childbearing years. Typically, the ovaries contain multiple small cysts, which are often slightly enlarged. About 1 in 5 women have polycystic ovaries appearing on ultrasound scans but do not have the other features of this syndrome. These cysts do not require surgical removal. Polycystic ovaries make more male hormones (androgens) than do normal ovaries. The exact cause for PCOS is not known, but sometimes it is hereditary.
Cirugía. La intervención quirúrgica también es una opción y generalmente se recomienda solo si las otras opciones no generan resultados. La capa exterior de los ovarios (llamada corteza) se vuelve más gruesa en el caso de las mujeres con SOP y se cree que esto puede estar relacionado con la anulación de la ovulación espontánea. La incisión ovárica es una cirugía en la cual el médico realiza varias "perforaciones" en la superficie del ovario mediante láser o con una aguja muy fina la cual se calienta con electricidad. La cirugía suele restablecer la ovulación, pero solo durante 6 a 8 meses.
Second-line therapy, when clomiphene citrate fails to lead to pregnancy, is either exogenous gonadotropins or laparoscopic ovarian surgery. [2, 3] If gonadotropins are used, a low-dose regimen is recommended, [3] and patients must be monitored with ultrasonography and laboratory studies. [2] Note that gonadotropin therapy is expensive and is associated with an increased risk of multiple pregnancy and ovarian hyperstimulation syndrome. [2]

Polycystic ovary syndrome represents 80% of anovulatory infertility cases. Treatment initially includes preconception guidelines, such as lifestyle changes (weight loss), folic acid therapy to prevent the risk of fetal neural tube defects and halting the consumption of tobacco and alcohol. The first-line pharmacological treatment for inducing ovulation consists of a clomiphene citrate treatment for timed intercourse. The second-line pharmacological treatment includes the administration of exogenous gonadotropins or laparoscopic ovarian surgery (ovarian drilling). Ovulation induction using clomiphene citrate or gonadotropins is effective with cumulative live birth rates of approximately 70%. Ovarian drilling should be performed when laparoscopy is indicated; this procedure is typically effective in approximately 50% of cases. Finally, a high-complexity reproduction treatment (in vitro fertilization or intracytoplasmic sperm injection) is the third-line treatment and is recommended when the previous interventions fail. This option is also the first choice in cases of bilateral tubal occlusion or semen alterations that impair the occurrence of natural pregnancy. Evidence for the routine use of metformin in infertility treatment of anovulatory women with polycystic ovary syndrome is not available. Aromatase inhibitors are promising and longer term studies are necessary to prove their safety.
Once a diagnosis of PCOS is confirmed, it is imperative to assess women for CAD risk factors. Despite the many reasons women seek medical care for PCOS, the greatest long term risk for these women is CAD. This is generally not viewed or even recognized as a concern by women seeking care in the first place. The link between PCOS and CAD is multi-faceted. C-reactive protein (CRP) is higher in age matched PCOS women and is linked to BMI[10] with some ethnic variation in this risk[11]. The prevalence of MS in PCOS women is as high as 40% with increased prevalence of hypertension, dyslipidemia and abnormal glucose metabolism, all before age 30[12]. PCOS women aged 20-40 already demonstrate poor vascular function measured by brachial artery vascular flow[13]. No single blood test can predict or quantify this CAD risk. Although no standard recommendation for assessment of CAD risk factors exists, measurement of glucose metabolism, blood pressure screening, lipid screening and carotid intimal media thickness measurements have been suggested[14].
When the syndrome was first described in 1935 by American gynecologists Irving Stein, and Michael Leventhal, it was considered a rare disorder. Today as many as five million women in the United States may be affected, according to the Department of Health and Human Services, but researchers are still just beginning to uncover the disorder’s full impact.
Also he's "out of work" because nobody wants a drug runner that the police have got eyes on. If I had to guess, his dealer cut him off until the trial is over. Junkies are crazy paranoid and don't want people with heat near them, either out of paranoia they're informants, or paranoia that Lurch's phones been tapped for evidence. Neither of those things happen often, but junkies be crazy. His "boss going to hospital" event was eerily close to his arrest.
The prescription cream eflornithine HCl can slow the growth of new hair when applied as directed on the face and other areas – but it won’t remove existing hair. 20,21 Your doctor may also prescribe a medication called an anti-androgen. In the United States, a medication called spironolactone is used to slow new hair growth. In other countries, cyproterone acetate is widely used but it is not available in the United States.  
Anecdotally, oral contraceptives are among the most common agents used to treat menstrual irregularities in women with PCOS. However, there are few studies examining their effect on menstrual cycles in women with PCOS. Cyproterone acetate plus ethinyl estradiol has been extensively studied, but it is not available in the United States. Studies suggest that the following agents may improve menstrual irregularities (e.g., oligomenorrhea): spironolactone (in an open-label study),22 acarbose,24 rosigli-tazone,32 and metformin.10,11,32,47,51 Metformin is probably the best choice because it may improve insulin resistance in addition to improving menstrual irregularities.

Three RCTs corroborate the positive fertility effects for Cimicifuga racemosa in women with PCOS, used in conjunction and when compared with the pharmaceutical Clomiphene citrate (clomiphene), [65, 68, 71] (Table 2). Results were reported for 441 women and show improved pregnancy rates when Cimicifuga racemosa was added to clomiphene during one menstrual cycle. In a study including women with PCOS (n = 147), pregnancy rates for the group receiving combined therapy (clomiphene 150 mg plus Cimicifuga racemosa 20 mg per day (Klimadynon®)) were 43.3% compared to 20.3% for women receiving only clomiphene [65] (Table 2). In another study using similar methodology (n = 100) pregnancy rates were 34.8% for the group treated with Cimicifuga racemosa plus clomiphene compared to 17.2% for women treated with clomiphene alone [68] (Table 2). Another study included women with PCOS and infertility (n = 100) compared Cimicifuga racemosa (Klimadynon®) and clomiphene over three months for hormone concentrations and pregnancy rates. Pregnancy rates were higher in the women in taking Cimicifuga racemosa compared to clomiphene, 14% and 8% respectively; however differences were not statistically significant. This study found significant effects for lowered luteinising hormone for women with PCOS receiving Cimicifuga racemosa compared to clomiphene (p = 0.007) [67]. Findings from clinical studies concur with laboratory and animal studies; however potential risks for bias include performance and collection bias due to lack of blinding (Table 2).


Women with PCOS have been shown to have higher levels of advanced glycation end products (AGEs) in their blood. AGEs are compounds formed when glucose binds with proteins, and are believed to contribute to certain degenerative diseases and aging. One small study found that cutting down on dietary AGEs significantly reduced insulin levels in women with PCOS. Foods high in AGEs include animal-derived foods and processed foods. Applying high heat (grilling, searing, roasting) increases levels.
Dok. Magandang tanghali po. May PCOS din po ako. 19 years old po ako nung nalaman kong may sakit akong Polycystic. Nagkaroon po ako ng kalive in nun dati aman po e okay yung regla ko tas nung nagsasama na kami nung bf ko hndi na ko nagkakameron akala namin buntis ako 1year akong hndi niregla nun. Hiwalay na kami ng ka live in ko ngayon . Niresetahan ako ng doktor ko ng Provera 5 days kong iinumin tas magtake din daw ako ng althea pills pag nagkaregla na. Okay aman sya nagkakaregla naman na ako. Kaso lang pahinto hinto yung pag inom ko kasi mejjo mahal yung pills . At dahil nga pahinto hinto yung pag inom ko ng pills hndi na din ako nagkakamens . Kaya nagtatake ulit ako ng provera.
There have been many studies on PCOS in the past several years; however, most are fairly small. Also, many studies examine medication effects on surrogate markers (e.g., androgen levels) rather than clinical outcomes (e.g., hirsutism). The study results are often conflicting, and in a recent systematic review, only 33 of 115 possible studies met basic inclusion criteria (e.g., randomized controlled trials), suggesting that many of the data in the literature may have methodologic flaws.1
Nigga u wot?? Seriously, read through at least one of her threads before virtue signaling. She is NOT a "sweet woman." She talks shit about everyone once they stop giving her money or ass pats. She claims her dad is the absolute worst and yet brags when he buys her a new grandma bra or when they smoke weed together. She HAS been to rehab, but dropped it once she realized it wasn't a cool place to hang out with druggies.
Cirugía. La intervención quirúrgica también es una opción y generalmente se recomienda solo si las otras opciones no generan resultados. La capa exterior de los ovarios (llamada corteza) se vuelve más gruesa en el caso de las mujeres con SOP y se cree que esto puede estar relacionado con la anulación de la ovulación espontánea. La incisión ovárica es una cirugía en la cual el médico realiza varias "perforaciones" en la superficie del ovario mediante láser o con una aguja muy fina la cual se calienta con electricidad. La cirugía suele restablecer la ovulación, pero solo durante 6 a 8 meses.
On rare instances, if I'm in a dire hurry (of the 'ward rounds start in five minutes, I haven't had a single bite to eat since yesterday 1600 and my blood sugar is tanking like Luna's mu opioid receptors' kind), and the person in front of me is taking utter eternities to count out $3.50 for a shitty sandwich or whatever the fuck they bought, I sometimes just pay for my shit and theirs so that I can go to work and listen to the Munchie crop of the day. So I've known a few people who try to game people in a hurry by doing this counting out cash trick on them. At the same time I have been pretty dubious of Luna's stories and I think that almost all the time, it's a cover for stealing.
OGTT with 75-g glucose and hourly glucose and insulin measurements has been compared to clamp techniques. Insulin sensitivity calculated by mathematical transformation of measurements has shown good correlation with glucose disposal using clamp techniques[48]. Although the OGTT is easy to perform, these calculations are more complex and make this particular calculation less desirable for clinical use. However these data show that 1 and 2 h levels are often needed to diagnose IR and stress the potential for false negative results with fasting measurements alone. In patients undergoing clamp and OGTT no correlation was observed between fasting glucose/insulin ratios and IR on the clamp[48].
The diagnostic workup should begin with a thorough history and physical examination. Clinicians should focus on the patient's menstrual history, any fluctuations in the patient's weight and their impact on PCOS symptoms, and cutaneous findings (e.g., terminal hair, acne, alopecia, acanthosis nigricans, skin tags).19 Patients should also be asked about factors related to common comorbidities of PCOS.

Paeonia lactiflora in combination with Cinnamomum cassia Aqueous extract Unkei-to Paeonia lactiflora and Cinnamomum cassia combination was investigated for steroid hormonal effects on cultured human granulosa cells (obtained from women undergoing IVF). Cells were incubated with different doses for 48 hours [42] One clinical trial investigated the effects of Paeonia lactiflora and Cinnamomum cassia combination (Unkei-to) [57]. This single arm study included amenorrheic women aged 17–29 years (n = 157) with a sub group of women with hyper-functioning oligo/amenorrhoea (n = 42). Ovulation occurred in 61.3% of primary amenorrheic women and in 27.3% of secondary amenorrheic women following two months of treatment [57]. 1. Increased granulosa production of oestradiol [42].
One time when I was in a&e this junkie was having withdrawals and literally shitting and puking everywhere. The stench was unreal to the point they had to move other patients out of the area, as it was making people sick. The nurses were fucking pissed off and disgusted, of course they couldn't say anything in front of him, but they were bitching about it when they came into my room. The world is not there to entertain and 'ooh' and 'aww' over your projectile shit, Tuna. Stop being a disgusting adult baby.
High cholesterol and triglyceride levels increase the risk of cardiovascular disease. Getting your cholesterol and triglyceride levels in an optimal range will help protect your heart and blood vessels. Cholesterol management may include lifestyle interventions (diet and exercise) as well as medications to get your total cholesterol, LDL, HDL, and triglycerides in an optimal range.
Ang eksaktong dahilan nagiging sanhi ng hormonal kawalan ng timbang ay hindi kilala. Gayunman, genetic predisposition ay itinuturing bilang isa sa mga nangungunang mga dahilan para sa PCOS. Katangi-kalakip na kondisyon na nakikita sa PCOS matataas na antas ng mga lalaki hormones at insulin na humahantong sa iba't-ibang mga sintomas na kaugnay sa ito sindrom.
Not necessarily. I've been on Benzos off and on since I was 13 (12 years) for panic attacks, social anxiety, etc. and I'm fine. There are also Benzos that give less of that 'floaty feeling' like Ativan. Not to start a discussion about what addiction is or isn't but I think how a drug makes you think and feel and want is completely personal and genetic.

Hirsutism is a bothersome hyperandrogenic manifestation of PCOS that may require at least six months of treatment before improvement begins. According to a 2015 Cochrane review, the most effective first-line therapy for mild hirsutism is oral contraceptives.32 Spironolactone, 100 mg daily, and flutamide, 250 mg twice daily, are safe for patient use, but the evidence for their effectiveness is minimal.32 Other therapies include eflornithine (Vaniqa), electrolysis, or light-based therapies such as lasers and intense pulsed light. Any of these can be used as monotherapy in mild cases or as adjunctive therapy in more severe cases.33
Goodman, N. F., Cobin, R. H., Futterweit, W., Glueck, J. S., Legro, R. S., & Carmina, E. (2015). American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society disease state clinical review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome - part 1. Endocrine Practice, 11, 1291–300.
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