i wonder if luna's dad knows about how much she complains about him. all he would have to do is google her name to see how much she hates him. if i were her dad and i saw the shit she says about me, i'd kick her to the curb. poor dude is letting her have what she wants, when she wants it, and she STILL talks about him like he's a monster. maybe he's a piece of shit but damn, at least he's trying. what an ungrateful brat
2. amenorrhoea n = 30. Oligomenorrhoea group: Treatment n = 17. Placebo n = 20. Amenorrhoea group. Treatment n = 16. Placebo n = 14. For oligomenorrhoea: Shortened menstrual cycle of at least 4 days. Earlier ovulation of at least 3 days. For anovulatory oligomenorrhoea: Mid luteal progesterone increase (>50% 5–10 days before menstruation. Secondary clinical outcomes, pregnancy rates and take home baby rates. At 6 months following conclusion of treatment, the take home baby rate with treatment was 18.7% compared to 6.4% in placebo group. Not statistically significant.
Weight loss is also a key first step if you’re planning a pregnancy. It may improve your ability to get pregnant by restoring ovulation3 or make your body more responsive to fertility treatments if that is what is determined you need. In fact, up to 75 percent of women with PCOS who were able to reduce their body weight also had better glucose control and improved androgen hormone levels, helping to restore ovulation and fertility,2,3 experts say.
Metformin has been the mainstay of treatment for IR and IGT in PCOS women over the past decade. Metformin is a biguanide that acts principally on the liver to inhibit hepatic gluconeogenesis. It also inhibits acetyl-CoA carboxylase activity and suppresses fatty acid production. Metformin acts on skeletal muscle to inhibit lipid production and acts peripherally on adipose tissue to stimulate glucose transport and uptake. Metformin reduces insulin levels and promotes improved insulin receptor activity. Metformin may also have direct and indirect effects on the ovary with respect to insulin action and steroidogenic enzymatic activity. In the endothelium, metformin seems to improve nitric oxide vasodilatory effects. Many other mechanisms of action have been studied in both animal and human models but consistent effects are not always demonstrated with local tissue concentrations that result from therapeutic doses.
Debido a los cambios hormonales, las mujeres con PCOS tienen un mayor riesgo de desarrollar ciertas afecciones de salud serias como la diabetes tipo 2, la hipertensión (presión arterial alta) y trastornos del corazón y los vasos sanguíneos. A menudo, las mujeres con PCOS tienen problemas de fertilidad. Es decir, la capacidad para quedar embarazadas.
“I always look at diet and lifestyle — how I can help patients modify their focus and remove obstacles that may be in their way on the path towards wellness,” says April Blake, ND. “As a naturopathic doctor, I prefer to utilize therapies that are gentle and less invasive, and focus on mind-body medicine and lifestyle. If you’re looking for alternatives to traditional treatments, there are several evidence-based therapeutics that have been shown to be effective.”
Lifestyle change is considered the first-line treatment for infertility in obese women with PCOS. Preconception counseling, administering folic acid to reduce the risk of fetal neural tube defects, encouragement of physical activity and identification of risk factors, such as obesity, tobacco use and alcohol consumption, should be performed. A 5 to 10% loss in body weight over a period of six months regardless of body mass index may be associated with improvement in central obesity, hyperandrogenism and ovulation rate 9. However, no studies with the proper methodology have assessed the live birth rate, which is the primary reproductive outcome 10.
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.
Diet, exercise, and maintaining a healthy body weight may help many women manage the symptoms of PCOS. These lifestyle changes are recommended to help decrease insulin resistance. Weight reduction can also decrease testosterone, insulin, and LH levels. Regular exercise and healthy foods will help lower blood pressure and cholesterol as well as improve sleep apnea problems. Refraining from smoking cigarettes or other tobacco products also may lower androgen levels.
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.
Human data regarding metformin improvement in IR in PCOS women shows mixed results and is complicated by varying methods of assessing IR. Short term (3 mo) treatment with metformin (1500 mg per day) failed to affect IR as measured by AUC-Insulin after 75-g OGTT. Metformin (1600 mg per day) in obese PCOS women treated for 6 mo failed to reduce IR as measured by QUICKI. This is in contrast to similar length studies on obese PCOS women who demonstrated decreased IR as measured by HOMA-IR, QUICKI and ISI, and correlated with alterations in phosphoproteins related to IR. Longer term metformin therapy (2 years, 1600 mg per day) in young, obese PCOS women reduced fasting insulin, hyperandrogenism and produced borderline reductions in HOMA-IR (P = 0.05). Metformin was compared prospectively to naltrexone and prenisolone in combination with oral contraceptive pills (OCPS). IR was unchanged despite lowered androgen levels. Metformin has been compared to orlistat and pioglitazone over a 4 mo treatment course and although each treatment reduced IR as measured by HOMA-IR, metformin (1500 mg per day) had the least reduction (< 20%).
Consulte a su proveedor de atención médica si tiene periodos mensuales irregulares, dificultades para quedar embarazada o exceso de acné o de crecimiento de vello. Si le dicen que tiene SOP, los cambios de estilo de vida como la pérdida de peso (si tiene sobrepeso) y el aumento de actividad física pueden reducir la resistencia a la insulina, lo cual puede ayudar a controlar el SOP.
Gynecologic ultrasonography, specifically looking for small ovarian follicles. These are believed to be the result of disturbed ovarian function with failed ovulation, reflected by the infrequent or absent menstruation that is typical of the condition. In a normal menstrual cycle, one egg is released from a dominant follicle – in essence, a cyst that bursts to release the egg. After ovulation, the follicle remnant is transformed into a progesterone-producing corpus luteum, which shrinks and disappears after approximately 12–14 days. In PCOS, there is a so-called "follicular arrest"; i.e., several follicles develop to a size of 5–7 mm, but not further. No single follicle reaches the preovulatory size (16 mm or more). According to the Rotterdam criteria, which are widely used for diagnosis, 12 or more small follicles should be seen in an ovary on ultrasound examination. More recent research suggests that there should be at least 25 follicles in an ovary to designate it as having polycystic ovarian morphology (PCOM) in women aged 18–35 years. The follicles may be oriented in the periphery, giving the appearance of a 'string of pearls'. If a high resolution transvaginal ultrasonography machine is not available, an ovarian volume of at least 10 ml is regarded as an acceptable definition of having polycystic ovarian morphology instead of follicle count.
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) .G 2. No oestrogenic effects in female reproductive tissues .