Hola, hace 3 años me quitaron unos pólipos del endometrio y me diagnosticaron ovarios poliquísticos me han tratado tengo bastante sobrepeso perdí 17 kg y los volví a recuperar mi ginecólogo me recomendó tomar metformina y inofolic fert desde septiembre del año pasado estoy tomando el inofolic fert porque el dianben lo tuve que dejar ya que los efectos secundarios eran tener muchas diarreas y también padezco de colon irritable con lo cual me estaba haciendo bastante daño ahora mismo llevo 5 meses sin regla y me gustaría saber, sí el PCOS, me podría ayudar en mi caso
Though surgery is not commonly performed, the polycystic ovaries can be treated with a laparoscopic procedure called "ovarian drilling" (puncture of 4–10 small follicles with electrocautery, laser, or biopsy needles), which often results in either resumption of spontaneous ovulations[74] or ovulations after adjuvant treatment with clomiphene or FSH.[citation needed] (Ovarian wedge resection is no longer used as much due to complications such as adhesions and the presence of frequently effective medications.) There are, however, concerns about the long-term effects of ovarian drilling on ovarian function.[74]
Shahin et al. [65] Randomised controlled trial using with an active control arm for comparative effectiveness. One menstrual cycle. 147 women aged less than 35 years with un-explained infertility and recurrent clomiphene resistance for ovulation induction. Anovulatory participants were excluded (n = 28). Anovulation was diagnosed by serum oestradiol < 200 ng/ml and absence of a dominant ovarian follicle on day 9 of the menstrual cycle. Complete data sets available for 119 women. All women received Clomiphene citrate (clomiphene) 150 mg on menstrual cycle days 3–7. A randomised group also took Cimicifuga racemosa 20 mg per day between days 1–12. Cimicifuga racemosa described as ‘phytoestrogens’ was provided in the commercial preparation Klimadynon®, manufactured by Norica in Germany. A trigger injection (human chorionic gonadotropin, 10 000 IU) and timed intercourse was recommended when a dominant follicle > 17 mm was observed. Pregnancy rate measured as increasing serum human chorionic gonadotropin (HCG) over two days. Clinical pregnancy defined as detection of gestational sac with embryonic heart-beat. Endometrial thickness measured by ultrasound concurrent with follicle maturation monitoring. Number of days to ovulation (trigger injection) Serum concentration for FSH oestradiol and LH. Luteal progesterone measured on days 21–23 of the menstrual cycle. Miscarriage and multiple pregnancy rates. Pregnancy rate in clomiphene alone group was 20.3% and 43.3% in the clomiphene plus Cimicifuga racemosa group (P < 0.01). Clinical pregnancy rate in the combination group was 36.7% versus 13.6% in the clomiphene alone group (P < 0.01). Endometrial thickness in combination group was 8.9 (±1.4) versus 7.5 (±1.3) (p < 0.001). Days to ovulation in clomiphene alone group was 13.0 ± 1.1 and in the clomiphene plus Cimicifuga racemosa group 14.2 ± 1.3 (n.s.). Luteal progesterone peak (ng/ml) in combination group was 13.3 (±3.1) versus 9.3 (±2.0) in clomiphene alone group (p < 0.01). All other hormone measures were not significantly different No detailed current baseline criteria for other causes of infertility. Confounding factors include current male fertility status. This may have caused an imbalance between the two groups. There is no description of the distribution of excluded (anovulatory) participants between groups.
We used the following definitions. PCOS according to the Rotterdam diagnostic criteria, specified by the presence of two out of three features; oligo/amenorrhoea, hyperandrogenism and polycystic ovaries on ultrasound [29, 30]. Associated endocrine features for PCOS included elevated LH [31], which is strongly associated with infertility (p = 0.0003) [32] and miscarriage [33] and elevated fasting glucose which is prevalent in approximately 31% of women with PCOS including normal weight women [34].
As many as 70% of PCOS women are insulin resistant and 10% have DM[20-22]. In PCOS women with normal glucose metabolism initially, the rate of conversion to abnormal glucose metabolism can be 25% over just three years[23]. More alarming, insulin abnormalities are highly prevalent in adolescents with PCOS[24]. Almost 20% of young Thai women with PCOS actually have DM[25]. Overall, normal glucose levels on an OGTT do not predict IR and IR, despite normal glucose levels, is correlated with CRP, dyslipidemia and other CAD risk factors[26]. Therefore, glucose levels alone lack the sensitivity to predict metabolic risk in PCOS patients. Precursor states of insulin abnormalities likely predict long term CAD risk well before glucose abnormalities. IR can be just as severe in diabetics and non-diabetics[27], stressing the seriousness of this metabolic impairment as a precursor and not a separate disease. Animal models have shown that IR alone damages myocardial cells, providing direct evidence of end organ disease[28]. Human data link HOMA-IR to left ventricular dysfunction[29]. Abnormal glucose metabolism short of IGT and DM still deserves attention, identification and treatment[30].
We undertook two searches of the scientific literature. The first search sought pre-clinical studies which explained the reproductive endocrine effects of whole herbal extracts in oligo/amenorrhoea, hyperandrogenism and PCOS. Herbal medicines from the first search informed key words for the second search. The second search sought clinical studies, which corroborated laboratory findings. Subjects included women with PCOS, menstrual irregularities and hyperandrogenism.
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One laboratory study and two clinical investigations provided evidence for the two herb combination, Glycyrrhiza uralensis and Paeonia lactiflora[53, 58, 59] (Table 1). An animal study found significant reductions in free and total testosterone following exposure to the combination [53] (Table 1). These findings were supported in two open label clinical trials including women with PCOS (n = 34) [59] and women with hyperandrogenism (n = 8) [58]. Both trials examined the effects on androgens for the aqueous extract TJ-68 (equal parts Glycyrrhiza uralensis and Paeonia lactiflora), 75 grams per day for 24 weeks and 5–10 grams per day for 2–8 weeks respectively. In the trial including women with PCOS, mean serum testosterone was significantly reduced from 137.1 ng/dL (±27.6) to 85.3 ng/dL (±38), p < 0.001 at four weeks of treatment [59]. Similar effects were observed in the women with oligomenorrhoea and hyperandrogenism which showed serum testosterone reduced from 50-160 ng/dL prior to treatment to less than 50 ng/dL [58]. However statistical significance was not reached due to the small sample size despite positive outcomes in seven out of eight participants (Table 1).
Natuklasan ng mga pag-aaral ng paghahambing ng mga pagkain para sa PCOS na ang mga low-carbohydrate diet ay epektibo para sa parehong pagbaba ng timbang at pagpapababa ng mga antas ng insulin. Ang isang mababang glycemic index (low-GI) diyeta na nakakakuha ng karamihan sa mga carbohydrates mula sa prutas, gulay, at buong butil ay nakakatulong na makontrol ang panregla na mas mahusay kaysa sa regular na diyeta sa pagbaba ng timbang (21).
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]
Polycystic (say: pah-lee-SIS-tik) ovary syndrome (PCOS) is a common hormone imbalance that affects about 1 in 10 women. Girls as young as 11 can get PCOS. Do you have PCOS or common signs of PCOS? Read answers to commonly asked questions about PCOS below, or go straight to our Living Well With PCOS [ PDF 459K] guide and PCOS Fitness Worksheet [ PDF 504K].
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.
A randomized study suggested that combined metformin/letrozole and bilateral ovarian drilling are similarly effective as second-line treatment in infertile women with clomiphene citrate–resistant PCOS. [52] In this study, 146 patients were given metformin and letrozole, and 73 underwent bilateral ovarian drilling. There was significant reduction in testosterone, fasting insulin, and ratio of fasting glucose to fasting insulin in the metformin/letrozole group. There was significant reduction in follicle-stimulating hormone (FSH), luteinizing hormone (LH), and ratio of LH to FSH in the bilateral drilling group. There was no significant difference between the patients in the 2 groups regarding cycle regularity, ovulation, pregnancy rate, and abortion rate. [52]
Tu médico o un nutricionista titulado puede ver lo que comes y tu nivel de ejercicio y de actividad física a fin de diseñar un programa para perder peso hecho a tu medida. El ejercicio es una gran forma de combatir el aumento de peso que suele acompañar al síndrome de ovario poliquístico, así como una forma de reducir la hinchazón, otro de los síntomas que a veces experimentan las chicas que padecen esta afección.
The differential diagnosis of PCOS is broad and includes both endocrinologic and malignant etiologies. Figure 119 provides an algorithm for the workup of select presentations. For any woman with suspected PCOS, the Endocrine Society recommends excluding pregnancy, thyroid dysfunction, hyperprolactinemia, and nonclassical congenital adrenal hyperplasia.19 Depending on presentation, conditions such as hypothalamic amenorrhea and primary ovarian insufficiency should also be excluded. In women with rapid symptom onset or significant virilization, such as deepening voice or clitoromegaly, an androgen-secreting tumor should be ruled out. Finally, Cushing syndrome or acromegaly should be excluded in patients with physical findings that suggest either condition.19 There is no need to order laboratory testing for these conditions if the patient does not have suggestive physical findings.
Ascertain that kidney and liver function are normal and that the patient does not have advanced congestive heart failure before starting metformin therapy. The usual starting dose is 500 mg given orally twice a day. Because common adverse effects are nausea, vomiting, and diarrhea, metformin should be taken with meals. Patients who develop these adverse effects can be instructed to decrease the dosage to once a day for a week and then gradually increase the dosage. Also, inform patients that there is a high likelihood that they will have ovulatory cycles while taking metformin. The US Food and Drug Administration (FDA) has not approved metformin for this indication.
Polycystic ovary syndrome (PCOS) can be a daunting diagnosis to receive. The National Polycystic Ovary Syndrome Association defines the condition as a “genetic, hormonal, metabolic, and reproductive disorder that affects women.” (1) One in 10 women have it (about half don’t know it), and the complications can include infertility, obesity, and mood disorders.
The homeostatic model assessment (HOMA), a more complex fasting calculation, has been compared to clamp techniques with good results. HOMA is the product of fasting glucose (mg/dL) and insulin (μU/mL) divided by a constant[45]. One major limitation of HOMA rests on the previous reflection that many young PCOS women display stimulated but not fasting metabolic abnormalities. In fact, HOMA in young PCOS patients missed 50% of IR as compared to OGTT with insulin-AUC calculations[52]. G/I ratio correlated strongly with clamp-demonstrated IR in a small study of PCOS women - interestingly, both lean and obese PCOS women had evidence of IR. Sex hormone binding globulin (SHBG) did not correlate with IR in this study[47], as has been previously postulated[53].
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.
More powerful and expensive imaging methods such as computed tomography (CT scan) and magnetic resonance imaging (MRI) can also detect cysts, but they are generally reserved for situations in which other conditions that may cause related symptoms, such as ovarian or adrenal gland tumors are suspected. CT scans require X-rays and sometimes injected dyes, which can be associated with some degree of complications in certain patients.
Many assisted-reproduction techniques are available for women who have difficulty conceiving because of PCOS. Working with UChicago Medicine experts in reproductive endocrinology, the Center for Polycystic Ovary Syndrome offers a full spectrum of standard and innovative fertility therapies — from oral and injectible medications that stimulate ovulation to advanced in vitro fertilization techniques, including use of donor eggs.
PCOS-related hormonal dysfunction can result in irregular or absent ovulation (anovulation). A variety of drugs can be used to treat this, enhancing the quality of both the egg (oocyte) and ovulation. Typical, first-line treatments include the fertility drugs Clomid (clomiphene citrate) and Femara (letrozole). While Clomid is commonly used to enhance ovulation, Femara may work better in women with PCOS as it neither raises estrogen levels nor increases the risk of multiple births to the same degree as Clomid.

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.


“It’s a frustrating, difficult, and sometimes heartbreaking thing to deal with,” Eaton said. Eaton’s PCOS has given her male-pattern baldness, acne, obesity, and skin tags. In spite of her challenging symptoms, she dances and works out several times a week. “There aren't many women who look like me who can get on the floor and move like I do, who are comfortable enough in their skin to step into the spotlight and demand that people look at them,” she said.
Paeonia lactiflora combined with Cinnamomum cassia in a preparation called Unkei-to was investigated in an in-vitro study for ovarian production of 17-beta-oestradiol and progesterone, [42] (Table 1). Granulosa cells obtained from women undergoing IVF were examined for steroid hormone concentration following incubation with different doses over 48 hours. Oestradiol was significantly increased (p < 0.01) following exposure to doses of 0.3 ug/ml of Unkei-to. Supporting clinical evidence was found in one clinical trial of 157 infertile women aged 17–29 years, including a subgroup of 42 women with hyper-functioning (PCOS) oligo/amenorrhoea. Treatment with Unkei-to, 7.5 grams per day for eight weeks, demonstrated significant reductions of mean LH in the PCOS sub-group of 49.7% (±15.3). Ovulation was confirmed in 30 out of 42 oligo/amenorrheic women [57] (Table 1). Limitations however include findings based on sub-group comparisons without description of subgroup baseline characteristics (other than oligomenorrhoea). Although the same aqueous extract intervention was investigated in pre-clinical and clinical studies, it contained additional herbal extracts and it was irrational to attribute hormonal effects to Paeonia lactiflora and Cinnamomum cassia.
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.
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.
Three menstrual cycles each separated by two months of no treatment. Two groups matched for demographics, age, BMI, primary and secondary infertility and duration of infertility (months). Treatment arm n = 96, control n = 98. 1. Number of days to ovulation (trigger injection). Follicular maturation monitored by ultrasound. Number of days to trigger injection was 15 (±1.7) for the clomiphene alone group and 12.0 (±1.9) in the clomiphene plus Cimicifuga racemosa group (p = 0.01) Measures for miscarriages are based on per cycle are not valid. Miscarriages per pregnancy are of greater relevance.
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.
Regular menstruation is important for the prevention of endometrial cancer. Women with PCOS are three times more likely to have endometrial cancer than women without. When a woman isn’t menstruating on a frequent basis, the lining of the uterus (endometrium) can begin to grow excessively and undergo atypical cell changes resulting in a precancerous condition called endometrial hyperplasia. If left untreated, this can develop into full endometrial cancer. Hormonal birth-control pills are often prescribed to help women with PCOS shed their endometrium more regularly, an important measure for preventing the overgrowth of cells in the uterus.
Ang oral contraceptive pills (magkasamang estrogen at progestin) ay binibigay para maging regular ang regla ng babaeng may PCOS. Kapag nagreregla buwan buwan ang babaeng may PCOS ay hindi kumakapal ang lining ng matres at nakakatulong maiwasan ang kanser sa lining ng matres (endometrial cancer). Ang pag-inom ng contraceptive pills ay makakatulong din sa taghiyawat at sobrang buhok (bigote o sa dibdib at ibang parte ng katawan). Hindi rin mabubuntis habang umiinom ng pills.

Hormonal aberrations in women with PCOS (e.g., elevated androgen levels) can cause menstrual irregularities (e.g., oligomenorrhea, amenorrhea, anovulatory cycles) that can lead to dysfunctional uterine bleeding and infertility.2 First-line agents for ovulation induction and treatment of infertility in patients with PCOS include metformin8,11,15,32,35,36 and clomiphene (Clomid),6,7 alone or in combination, as well as rosiglitazone.19,20,32
The name ‘Polycystic Ovarian Syndrome’ points to the ovaries because it was long considered to be a reproductive issue. But it is now widely accepted that polycystic ovaries develop as a result of endocrine disorders characterized by a series of hormone imbalances: hyperandrogenism (specifically excess testosterone) and Insulin Resistance due to excess insulin that can trigger a cascade of other hormonal problems.4 From a systemic point of view, the continuing and/or increase of PCOS symptoms is likely due to a continuing hormonal imbalance.
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)
She vain, but she's vain about her aesthetic, not her body. She mentions her imperfections all the time rather than hiding them; she knows she has cellulite, we know that she has cellulite, it isn't something she's trying to hide from the world. Her imperfections are part of her 'poor and free' aesthetic (see gutterpunks for an example of a subculture that glorifies this). The people who point out the problems with her body are adding nothing to the discussion. The comments about her body flaws do nothing but clutter the threads with self-serving, childish garbage, usually in horrible tumblr-speak. Like yeah, we get that Luna's breasts are saggy. We've seen them and heard it a billion times already. Just stop.

One note: “It takes about six months before the effect of these medications are seen on hair growth,” says David A. Ehrmann, MD, director of the University of Chicago Center for PCOS in Illinois. (This is because one hair growth cycle takes two to three months.) “When patients don’t know that, they get frustrated when they don’t see results quickly,” he says. Talk to your doctor about what you can realistically expect and when.


*DISCLAIMER: These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. The views and nutritional advice expressed by Luna Smooth are not intended to be a substitute for conventional medical service. If you have a severe medical condition, see your physician of choice. Individual results may vary.
Polycystic ovary syndrome (PCOS) is a condition associated with hormone imbalances that affects women. Though the underlying cause of PCOS is not known or well understood, it is believed that an imbalance of sex hormones and resistance to the effects of the hormone insulin are the main problems. These problems result in a characteristic group of signs, symptoms and complications such as excess facial and body hair, irregular menstrual periods, infertility, and insulin resistance.
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.
Grassi, Angela MS, RD, LDN and Stephanie B. Mattei, Psy.D, Troiano, Leah. The PCOS Workbook: Your Guide to Complete Physical and Emotional Health. Luca Publishing, 2009. The PCOS Workbook is a guide that includes step–by–step guidelines, questionnaires, and exercises that will help you learn skills and empower you to make positive changes in your life that might not get rid of PCOS, but will help you live with it.

Ito ay para lamang sa inyong dagdag kaalaman at hindi maituturing na kapalit ng pagkonsulta sa inyong doktor. Huwag uminom ng gamot nang hindi nagpapatingin sa doktor. Mainam na magpatingin sa isang obstetrician-gynecologist (Ob-Gyn). May mga Ob-Gyn na specialists din sa reproductive endocrinology o fertility na maaring makatulong sa mga babaeng may polycystic ovary syndrome (PCOS). Ang doktor ninyo ang magsasabi kung alin ang nararapat na gamot.


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]
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