MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.
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Polycystic ovary syndrome (PCOS) is a prevalent, complex endocrine disorder characterised by polycystic ovaries, chronic anovulation and hyperandrogenism leading to symptoms of irregular menstrual cycles, hirsutism, acne and infertility. Evidence based medical management emphasises a multidisciplinary approach for PCOS, as conventional pharmaceutical treatment addresses single symptoms, may be contra-indicated, is often associated with side effects and not effective in some cases. In addition women with PCOS have expressed a strong desire for alternative treatments. This review examines the reproductive endocrine effects in PCOS for an alternative treatment, herbal medicine. The aim of this review was to identify consistent evidence from both pre-clinical and clinical research, to add to the evidence base for herbal medicine in PCOS (and associated oligo/amenorrhoea and hyperandrogenism) and to inform herbal selection in the provision clinical care for these common conditions.
PCOS women with different phenotypes have been found similarly insulin resistant in response to a 3 h 75 g OGTT[31]. Obese (compared to lean) PCOS women tend to have a higher degree of IR. Correlation between hyperandrogenism and IR is significant in many studies but not as significant as the link between insulin abnormalities and obesity[32]. PCOS women demonstrate greater variation in insulin parameters compared to controls, independent of weight[33]. Animal studies of prenatal testosterone exposure show downstream IR in early postnatal life[34]. Some human data shows a high degree of correlation between hyperandrogenism and IR[35,36] and the relationship between hyperandrogenism and IR seem to differ between PCOS and non-PCOS women[35].
New evidence suggests that using medications that lower insulin levels in the blood may be effective in restoring menstruation and reducing some of the health risks associated with PCOS. Lowering insulin levels also helps to reduce the production of testosterone, thus diminishing many of the symptoms associated with excess testosterone: hair growth on the body, alopecia (scalp hair loss), acne and possibly cardiovascular risk.
The prevalence of infertility in women with PCOS varies between 70 and 80%. According to the American Society for Reproductive Medicine, the evaluation of infertility in women with PCOS or other causes of subfertility should start after six months of attempting pregnancy without success if the couple has regular sexual intercourse (2 to 3 times/week) without using contraceptive methods 7. To optimize the efficacy of the treatment of infertile women with PCOS, evaluations of tubal patency (hysterosalpingography or laparoscopy with chromotubation) and semen analysis (spermogram) are mandatory before deciding on treatment. However, tubal patency evaluation may not be necessary prior to initiating clomiphene citrate (CC) treatment. Notably, if a patient is resistant to this drug and/or requires the use of gonadotropins and/or presents with other causes of infertility, a tubal patency evaluation becomes mandatory prior to initiating the therapeutic treatment of infertility 8.
Jump up ^ Legro RS, Barnhart HX, Schlaff WD, Carr BR, Diamond MP, Carson SA, Steinkampf MP, Coutifaris C, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Giudice LC, Leppert PC, Myers ER (2007). "Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome". N. Engl. J. Med. 356 (6): 551–66. doi:10.1056/NEJMoa063971. PMID 17287476.[non-primary source needed]
Polycystic ovary syndrome (PCOS) is a complex condition that is most often diagnosed by the presence of two of the three following criteria: hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. Because these findings may have multiple causes other than PCOS, a careful, targeted history and physical examination are required to ensure appropriate diagnosis and treatment. This article provides an algorithmic approach to the care of patients with suspected or known PCOS.
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]
88. Moghetti P, Castello R, Negri C, Tosi F, Perrone F, Caputo M, Zanolin E, Muggeo M. Metformin effects on clinical features, endocrine and metabolic profiles, and insulin sensitivity in polycystic ovary syndrome: a randomized, double-blind, placebo-controlled 6-month trial, followed by open, long-term clinical evaluation. J Clin Endocrinol Metab. 2000;85:139–146. [PubMed]
A stroll around the block with your dog (spouse/significant other, neighbor, or exercise buddy), your favorite exercise class at the gym, following a video at home, or peddling on an exercise bike while you watch TV…whatever you choose to get you moving will be good.14 Aim to fit in at least 30 minutes, five times a week – the basic recommendations from the US Centers for Disease Control and Prevention.15
Excess insulin. Insulin is the hormone produced in the pancreas that allows cells to use sugar, your body's primary energy supply. If your cells become resistant to the action of insulin, then your blood sugar levels can rise and your body might produce more insulin. Excess insulin might increase androgen production, causing difficulty with ovulation.
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