Medical management of PCOS is aimed at the treatment of metabolic derangements, anovulation, hirsutism, and menstrual irregularity. The use of insulin-sensitizing drugs to improve insulin sensitivity is associated with a reduction in circulating androgen levels, as well as improvement in both the ovulation rate and glucose tolerance. [3] The Endocrine Society has published a clinical practice guideline on hirsutism evaluation and treatment in premenopausal women. [51] ACOG notes that eflornithine in conjunction with laser treatment is superior to laser therapy alone in treating hirsutism. [3]

This therapeutic modality is also considered a second-line treatment for the infertility of women with PCOS. However, because it is an invasive method that requires general anesthesia and has a higher cost and potential complications, this technique should be used in cases of anovulatory women with CC-resistant PCOS who require laparoscopy for another reason (pelvic pain, adnexal mass, etc.). This technique can be performed using monopolar electrocautery or laser techniques, with both exhibiting a similar efficacy and the goal is between 4 and 10 punctures because a larger number may favor the development of premature ovarian failure 25,29. The mechanism of action of ovarian drilling in the treatment of infertility in women with PCOS is suggested to be based on the decreased secretion of androgens and consequent reduction of peripheral aromatization of these compounds into estrone. Furthermore, the follicular microenvironment becomes more estrogenic, which facilitates follicular growth 30. Regarding the efficacy of ovarian drilling, observational studies demonstrated that the ovulation rate was between 54 and 76% in the 6 months after the procedure and 33 and 88% in the 12 months after the procedure. During these periods, the spontaneous pregnancy rate ranged between 28 and 56% and 54 and 70%, respectively 31.

Bergmann J, Luft B, et al. [62] Randomised, placebo controlled double blind study. Three months or 3 menstrual cycles. Women with fertility disorders, (n = 67). Two sub-groups. Herbal extract Phyto-Hypophyson® by Steril-Pharma GmbH Herrsching, Germany; contains Vitex agnus-castus plus Chelledonium majus and Silybum marianum (St Mary’s thistle) in homeopathic form. Additional herbal extracts have reported activity in hepatic function. There are no reports for direct reproductive effects. 150 drops per day (7.5 ml per day). Primary outcome for participants with amenorrhoea: at least one spontaneous menses. Oligomenorrhoeic subgroup - clinical outcomes were significantly improved in the treatment arm at 82% compared to 45% in placebo arm P = 0.021. When the amenorrheic group were included in analysis, differences were not significant p = 0.19. Diagnosis for anovulatory amenorrhoea is not well described. Non-statistically significant take home baby rates were complicated by insufficient sample size. 366 patients are required to have a 95% chance, as significant at the 5% level, an increase in take home baby rates from 6% in the placebo group to 18% in the experimental group. The authors conclude that this preparation may be useful if given 3–6 months, yet they only tested for 3 months.
Pwedeng magrekomenda ang doktor ng mga lifestyle changes bilang PCOS treatment. Kasama dito ang pag-ehersisyo, para sa kahit maliit na pagbawas sa timbang. Ang kawalan ng kahit limang porsyento ng ating timbang ay makakatulong na sa pagbuti ng ating kondisyon. Bilang ehersisyo, tingnan ang pagtakbo, pagbisikleta, paglangoy, o ang mga simpleng routine na kinabibilangan ng mga push-up, crunches, stretching exercises, at iba pa.
Randomisation for 206 women 12 were excluded due to failure to respond (treatment group n = 7, control n = 5). 2. Endometrial thickness monitored by ultrasound. Endometrial thickness in the clomiphene alone group was 8.5 mm (±1.9) compared to 12.9 (±2.3) in the clomiphene plus Cimicifuga racemosa group (p < 0.001). The miscarriage rate per pregnancy for the clomiphene alone group was 5 out of 33 (15.2%) and 6 out of 71 (8.5%) in the clomiphene plus Cimicifuga racemosa group.
Pre-clinical and clinical evidence was found for Vitex agnus-castus for lowered prolactin, improved menstrual regularity and treatment of infertility. Vitex agnus-castus contains a variety of compounds which bind to dopamine type 2 (DA-2) receptors in the brain; reduce cyclic adenosine mono phosphate (cAMP) and lowered prolactin secretion (Table 1). This was demonstrated in studies using recombinant DA-2 receptor proteins, and basal and stimulated rat pituitary cell cultures [38–41]. Prolactin lowering effects were found in normal and ovariectomised rats [49]. Additional agonistic opiate effects were observed in studies using human opiate receptors cell cultures [70].

she's only playing dress up as a heroin addict because she knows she always has a safety net. those are the kids that go the hardest, the ones that are so privileged they think nothing really bad is ever going to happen to them. but she's already ruined her appearance and job opportunities, so i don't know where this weird superiority complex for being "poor" comes from? even if her daddy does save her she can't just get a top notch face lift like courtney love. no one cares. she's already so fucked and doesn't know it.

130mg of methadone?!!!! That's 520mg morphine. That's an insane dosage even for someone with tolerance - I have been on high dose opioids for pain for a decade and I'm scraping 250mg morphine equivalent dose. For context: the equivalent fentanyl patch would be 250mcg per hour strong. Even people with severe pain from tumours get by on no more than 100-150mcg per hour.

Patients with PCOS who are infertile but desire pregnancy should be referred to a reproductive endocrinologist for further evaluation and management of infertility. Morbidly obese women with PCOS should also be referred for pregnancy risk [2] ; metabolic surgery may be considered in morbidly obese women with PCOS, because many features of this syndrome are reversible with successful weight loss. In vitro fertilization (IVF) is reserved for women with PCOS and unsuccessful gonadotropin therapy or those with other indications for this procedure. [2]
Couples with infrequent sexual intercourse may experience some benefit from the use of kits for ovulation monitoring (urinary luteinizing hormone excretion); however, this technique can underestimate the fertile window. The evaluation of cervical mucus throughout the menstrual cycle demonstrated similar efficacy to urinary kits for monitoring the ovulation and high rates of false positives in cycles are noted using the hCG 24. Thus, this method has not been routinely used in clinical practice, mainly when US is available.
 PCOS seems to be inherited. Female relatives or children of patients with PCOS are at increased risk for having PCOS. Environmental risk factors, including low birth weight, rapid weight gain in infancy, early pubic hair and puberty development, childhood obesity, excess adult weight, and unhealthy lifestyle, are also important and may interact with genes to lead to PCOS (called epigenetics). 
Quitar el vello. Puedes probar con cremas depilatorias para el vello facial, remoción de vello con láser o electrólisis para eliminar el vello excesivo. Puedes conseguir cremas y productos depilatorios en farmacias. Los procedimientos de depilación como la eliminación de vellos con láser o electrólisis son llevados a cabo por médicos y probablemente los seguros de salud no cubran estos gastos.
This was originally developed as a blood pressure medication and diuretic for hormonal forms of high blood pressure (hypertension) and fluid retention. “Turns out, in high doses, it’s very good at blocking male hormones,” explains Dunaif. For that reason, it’s used to target excess hair growth, a symptom of PCOS that can be particularly embarrassing.
A study supervised by Columbia University School of Nursing professor Nancy Reame, MSN, PhD, FAAN, and published in the Journal of Behavioral Health Services & Research, identifies the PCOS complications that may be most responsible for psychiatric problems. While weight gain and unwanted body hair can be distressing, irregular menstrual cycles is the symptom of PCOS most strongly associated with psychiatric problems, the study found.
Hi dok bru . kailan ko LNG po nalaman na may pcos ako ng mag patingin ako sa doctor 3 buwan po kase akong di dinatnan tas nag kasakit po kase ako dun ko LNG po napag pasyahan na mag patingin sa ob gyn na ultrasound po ako at lumabas po sa resulta ng ultrasound ko na may pcos ako . binigyan po ako ng pampa regla 10 days ko po ininom hanggang sa mag ka roon na ako at nung datnan na po ako almost 2weeks po akong meron tas bumalik po ako sa ob gyn as doctor na pinag konsultahan ko kse nga po almost 2weeks po akong may period then binigyan po ako ng pampatigil after ko pong mainom young gamot nag stop na po ang mens ko. At sabe po ng doctor ko bumalik ako pag tumigil na ang period ko pero di na po ako naka balik para sa next na check up ko sabe po reresetahan ako ng gamot for 6 months na gamutan pero di pa po ako naka balik for follow check up ngayun jan. 12 2016 ko po nalaman na may pcos ako . 20 year old pa LNG ako. Ano po ba mang yayari kung hanggang ngayun di po ako nag pupunta sa ob ko . ano po ang maipapayo nyo saken. Ellaine
Pre-clinical and clinical evidence was found for Vitex agnus-castus for lowered prolactin, improved menstrual regularity and treatment of infertility. Vitex agnus-castus contains a variety of compounds which bind to dopamine type 2 (DA-2) receptors in the brain; reduce cyclic adenosine mono phosphate (cAMP) and lowered prolactin secretion (Table 1). This was demonstrated in studies using recombinant DA-2 receptor proteins, and basal and stimulated rat pituitary cell cultures [38–41]. Prolactin lowering effects were found in normal and ovariectomised rats [49]. Additional agonistic opiate effects were observed in studies using human opiate receptors cell cultures [70].

Unfortunately, awareness of the condition is not widespread and many physicians do not perform the necessary diagnostic tests or recognize that PCOS has broad and potentially devastating consequences. According to the non-profit support organization, PCOS Challenge, Inc., PCOS awareness and support organizations receive less than 0.1 percent of the government, corporate, foundation, and community funding that other health conditions receive.

The advantages of CC use are low cost, oral administration, few side effects (flushing, headache, visual disturbances and abdominal discomfort), the induction of monofollicular development in most cases 16 and a low rate of multiple gestations (2 to 13%) 17. The initial dose is 50 mg/day for five days (starting between the second and fifth day of the menstrual cycle) and may be increased to 150 mg/day 17,18; however, doses greater than 100 mg/day usually do not offer additional benefits (may be useful in obese women) 18. The ovulation rate may reach 75 to 80% 19 with a conception rate of 22% per cycle 20 and a cumulative pregnancy rate between 60 and 70% in six cycles 9. There is no evidence that the administration of human chorionic gonadotropin (hCG) in the mid-cycle increases ovulation rates (OR 0.99; 95% CI: 0.36-2.77) or clinical pregnancy (OR 1.02; 95% CI: 0.56-1.89) 21,22. CC treatment should be limited to six ovulatory cycles and US monitoring is not mandatory (it is recommended only in the first ovulatory cycle to adjust the dose based on the ovarian follicular growth and development and for endometrial assessment) 17,18. Additional cycles of ovulation induction with CC (maximum of twelve cycles) may be individually evaluated based on the cost-effectiveness and age of women and after discussion with the couple 9. The incidence of ovarian hyperstimulation syndrome (OHSS; increased capillary permeability with consequent third-space fluid sequestration and hemoconcentration) associated with the use of CC is low, approximately 1 to 6% 17,23.
Treatment of PCOS depends partially on the woman's stage of life. For younger women who desire birth control, the birth control pill, especially those with low androgenic (male hormone-like) side effects can cause regular periods and prevent the risk of uterine cancer. Another option is intermittent therapy with the hormone progesterone. Progesterone therapy will induce menstrual periods and reduce the risk of uterine cancer, but will not provide contraceptive protection.
2. Two studies investigated the ovulation rates, number of corpus luteum and follicle characteristics in rats with polycystic ovaries following exposure to various doses of Tribulus terrestris[46, 47].	2. Equivalence of Tribulus terrestris and three ovulation induction pharmaceuticals evaluated ovulation in women with oligo/anovular infertility (n = 148) [60].G	2. No oestrogenic effects in female reproductive tissues [51].

yeah, the constant nitpicking about things she can't help is annoying. people are desperate for milk so they'll try to make a topic out of everything. for example, that anon who was saying how gross her arm looks because it has stretch marks and loose skin. what's she supposed to do about that? shes a shitty person but i gaurentee none of the anons on this thread are perfect or even attractive enough to be such nitpickers
3. Serum hormones during follicular phase oestradiol, LH and FSH. Luteal progesterone measured day 21–23 of the cycle. Serum LH was 8.0 (±0.9) in the clomiphene group and 5.7 (±0.9) in the clomiphene plus Cimicifuga racemosa group (p < 0.001) and oestradiol was 228.3 (±30.2) in the clomiphene alone group and 299.5 (±38.9) \in the clomiphene plus Cimicifuga racemosa group (p = 0.01)
Milewicz A, Gejdel E, et al. [64] Randomised placebo controlled, double blind, trial. Three months. 52 women with latent hyperprolactinaemia and luteal phase defects. Participants stratified for cycle length, height (cm) and weight (kgs) and randomised. Baseline differences between arms were not significant p = 0.63, p = 0.48 and p =0.37 respectively. 37 complete case reports: Treatment arm n = 17, placebo n = 20. Vitex agnus-castus extract 20 mg in the commercial preparation of Strotan® Hersteller: Pharma Stroschein GmbH, Hamburg, Germany. 1 capsule per day or placebo. Serum prolactin concentration at 15 and 30 minutes following intra venous TRH (200mcg) stimulation. Luteal phase length, number of days. Measurements on menstrual cycle days 5 to 8 and 20 for FSH, LH, oestradiol, progesterone, DHEAs, thyroid stimulating hormone (TSH), T3, T4, testosterone. No significant changes in prolactin before and after in either group. In this study 52 women were eligible to participate, statistical analyses were performed on data from 37 women.
The clinical presentation of PCOS is variable. Patients may be asymptomatic or they may have multiple gynecologic, dermatologic, or metabolic manifestations. Patients with PCOS most commonly present with signs of hyperandrogenism and a constellation of oligomenorrhea, amenorrhea, or infertility.19,22 Workup for PCOS is sometimes prompted by an incidental finding of multiple ovarian cysts after ultrasonography.
Cushing's syndrome, sometimes referred to as hypercortisolism, is a hormonal disorder caused by prolonged exposure to high levels of the hormone cortisol. Symptoms may include obesity, thinning arms and legs, a rounded face, and increased fat around the neck. Some causes of Cushing's syndrome is from taking glucocorticoid hormones such as prednisone for inflammatory diseases. Treatment for Cushing's syndrome depends on the cause.
The goal of further evaluation of suspected PCOS is twofold: to exclude other treatable conditions that can mimic PCOS and to detect and treat long-term metabolic complications. Anovulation is common after menarche, so it is reasonable to delay workup for PCOS in adolescents until they have been oligomenorrheic for at least two years.28 If an adolescent is evaluated for PCOS, it has been suggested that she meet all three of the Rotterdam criteria before being diagnosed with the condition28  (Table 119).

There are also experts who suggest taking more of a lifestyle treatment approach rather than medication, which some call a “Band-Aid” to symptoms. One such expert is Amy Medling, a certified health coach who is founder of PCOS Diva and author of Healing PCOS: A 21-Day Plan for Reclaiming Your Health and Life with Polycystic Ovary Syndrome. She stresses that some women don’t feel well on some of these drugs (she was one of them), so looking at other ways to manage PCOS will get them to a more balanced place. “I hear from many women who are frustrated and hopeless and feel underserved by the mainstream way of managing PCOS,” says Medling.
Oligomenorrhoea was defined as menstrual cycle length that extended beyond 35 days (day one being the first day of menses). Amenorrhoea was defined as no menstrual period for three to six months or more [19]. This review was focussed on hypothalamic, pituitary and ovarian causes of menstrual irregularity with associated elevated gonadotropins including LH and prolactin and arrested folliculogenesis typically observed in polycystic ovaries. Hyperprolactinaemia is usually considered a unique cause for oligo/amenorrhoea; however in the present case it was included due to the potential co-existence for elevated prolactin, LH and PCOS, [32, 35].
PCOS contribuye a equilibrar los niveles hormonales, ayudando por ejemplo a la regulación de los ciclos y disminuyendo visiblemente otros síntomas como el crecimiento de vello o el acné. Ten en cuenta que el vello que ya tenías no desaparecerá por sí mismo aunque regules tus niveles hormonales, pero sí que se atenuará el ritmo con el que sale el vello y podrás recurrir a métodos para eliminar el que quede, como por ejemplo la depilación láser.
Ano nga ba ang PCOS? Ito ay isang hormonal disorder kung saan nagkakaroon ang babae ng mga maliliit na cyst sa kanyang obaryo. Naglalaman ang mga cyst na ito ng mga immature egg cells na hindi kayang mag-trigger ng proseso ng obulasyon. Ibig sabihin, bababa ang lebel ng female hormones tulad ng estrogen at progesterone, at tataas ang lebel ng male hormones katulad ng androgen. Ang imbalance na ito ay magdadala ng iba’t ibang sintomas at epekto sa katawan.
Na nakakaapekto sa isa sa 10 mga kababaihan ng childbearing edad, ang polycystic ovarian sindrom ay nagiging mas at mas karaniwang mga araw na ito. Kung magdusa ka mula sa ito, alam sa iyo nang eksakto kung paano ito ailment maaaring makaapekto sa iyong pisikal at mental na estado. Habang pagpipilian sa paggamot na inirerekomenda ng mga doktor ay madalas na kung ano ang resort namin sa, maaari rin naming magbigay ng ilang mga remedyo sa bahay ng isang subukan sa paggamot sa ito kalagayan.
If Chief goes to jail or gets probation, then she may have to. Or otherwise will eventually have to at some point. When addicts' junkie luck runs out and they begin to lose their basic comforts/necessities, they start to do things that they told themselves they'd never do. Nobody started out on heroin telling themselves that they'd do anything for the drug.
Many women with PCOS have decreased sensitivity to insulin, the hormone that regulates glucose (sugar) in the blood. This condition, known as insulin resistance, is a major risk factor for type 2 diabetes. Women with PCOS often have type 2 diabetes, which occurs more frequently in women with PCOS. Signs of insulin resistance include weight gain (especially around the waist), acanthosis nigricans (skin thickening around the neck, armpits, belly, button, and other creases), and skin tags.
Traditionally, women with polycystic ovary syndrome (PCOS) have been treated with therapies aimed at relieving specific PCOS symptoms or health risks. Newer treatments being investigated at the University of Chicago Medicine and elsewhere also aim to address what may be a root cause of PCOS: insulin resistance. Many of these new therapies are designed to lower insulin levels, thus reducing production of testosterone.
PCOS is due to a combination of genetic and environmental factors.[6][7][15] Risk factors include obesity, not enough physical exercise, and a family history of someone with the condition.[8] Diagnosis is based on two of the following three findings: no ovulation, high androgen levels, and ovarian cysts.[4] Cysts may be detectable by ultrasound.[9] Other conditions that produce similar symptoms include adrenal hyperplasia, hypothyroidism, and high blood levels of prolactin.[9]